Development of spirometric reference equations for children living at high altitude

Aristizabal‐Duque, Ricardo; Sossa-Briceño, Mónica P; Rodríguez‐Martínez, Carlos E.

doi:10.1111/crj.13234

Cited by 3 publications

(3 citation statements)

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“…This group found that the predicted values at the pulmonary function level in the Latin American population are like the ones reported for American population that have come originally from Mexico [ 42 ]. A study has recently been published in which predictive equations have been performed for each spirometric variable among children living at moderate and high altitude in Colombia, which could be useful for further analysis among children [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

et al. 2022

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Background The reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization. Objective The objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude. Methodology A cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3180 m) in Andean highlands. The sample size estimates permitted to recruited 118 patients (40 men and 78 women) from Limoncocha and 95 (39 men and 56 women) from Oyacachi. Chi-square method was used to analyze association or independence of categorical variables, while Student’s t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn’t meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups. Results The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001), with a proportion difference of 15.2% for men and 8.5% for women. The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants. Conclusion Residents of Oyacachi had greater FVC and FEV1 than their peers from Limoncocha, a finding physiologically plausible according to published literature. Lung size and greater ventilatory capacities could be an adaptive mechanism developed by the highlander in response to hypoxia. Our results support the fact that this difference in FVC and FEV1 is a compensatory mechanism towards lower barometric and alveolar partial pressure of oxygen pressure.

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Section: Discussionmentioning

confidence: 99%

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

et al. 2022

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“…This group found that the predicted values at the pulmonary function level in the Latin American population are like the American population of Mexican origin within the NHANES III study [38]. A study has recently been published in which predictive equations have been performed for each spirometric variable among children living at moderate and high altitude in Colombia, which could be useful for further analysis among children [39].…”

Section: Discussionmentioning

confidence: 99%

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Ortíz-Prado¹,

Encalada²,

Mosquera³

et al. 2021

Preprint

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BackgroundThe reference values for lung function are associated to anatomical and lung morphology parameters, but anthropometry it is not the only influencing factor: altitude and genetics are two important agents affecting respiratory physiology. Altitude and its influence on respiratory function has been studied independently of genetics, considering early and long-term acclimatization.ObjectiveThe objective of this study is to evaluate lung function through a spirometry study in autochthonous Kichwas permanently living at low and high-altitude.MethodologyA cross-sectional study of spirometry differences between genetically matched lowland Kichwas from Limoncocha (230 m) at Amazonian basin and high-altitude Kichwas from Oyacachi (3,180 m) in Andean highlands. Chi-square method was used to analyze association or independence of categorical variables, while Student’s t test was applied to comparison of means within quantitative variables. ANOVA, or in the case that the variables didn’t meet the criteria of normality, Kruskal Wallis test were used to compare more than two groups.ResultsPeople from Oyacachi (high altitude) showed a higher predicted values than those from Limonocha (low altitude). The FVC and the FEV1 were significantly greater among highlanders than lowlanders (p value < 0.001). The FEV1/FVC was significantly higher among lowlanders than highlanders for men and women. A restrictive pattern was found in 12.9% of the participants.ConclusionResidents of Oyacachi had greater lung capacity than their peers from Limoncocha, a finding physiologically plausible according to published literature. When analyzing the spirometric patterns obtained in these populations, it was evident that no person had an obstructive pattern, while on the other hand, the restrictive pattern appeared in Limoncocha and Oyacachi populations in 12.9% although it is clear that there is a predominance of this in the individuals belonging to Limoncocha.

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“…Recientemente, nuevos valores espirométricos se han establecido en Bogotá (2.640 metros sobre el nivel del mar (msmn)) en niños 6-17 años, donde la talla fue la mejor variable predictiva (aunque se incluyó también la edad y el peso), y cuyos resultados demostraron que los valores de VEF1 y CFV son significativamente mayores que en las ecuaciones generadas por la Global Lung Function Initiative (GLI). Esto es se debe principalmente al crecimiento acelerado del volumen torácico en relación con la estatura, que es el resultado de la adaptación a un ambiente hipóxico y disminución de la densidad del aire que ocurre en las alturas (9). También se han establecido valores de oscilometría de impulso (IOS) en niños 3-5 años que viven en Bogotá, donde nuevamente la talla fue la mejor variable predictiva y cuyos resultados muestran como límite superior normal una caída de 28% en la resistencia total de la vía aérea (R5Hz) o un incremento de 36% en la reactancia (X5Hz) post broncodilatador (10).…”

Section: Sección Serie / Seriesunclassified

Neumología De Altura: Saturación De Oxígeno, Edema Pulmonar Y Pruebas De Función Pulmonar

Castro-Rodriguez

Ucrós

2023

Neumol Pediatr

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En las alturas, sobre todo a 2500 metros sobre el nivel del mar, la cantidad absoluta de oxígeno va decreciendo y por lo tanto la cantidad disponible para el intercambio gaseoso disminuye, produciéndose una vasoconstricción hipóxica pulmonar (VHP). La VHP asociada a la hipoxia hipobárica de la altura produce un aumento de la presión pulmonar que es mayor en los lactantes y a mayores alturas. No hay valores únicos de saturación de oxígeno (SatO2) en la altura, porque ésta va disminuyendo según el mayor nivel de altura, aumenta con la edad, y la brecha entre la vigilia y sueño es grande (sobre todo en los primeros meses de vida). El 25% de los niños sanos que viven en altura tienen valores de SatO2 significativamente menores que el 75% restante. Los valores normales de los índices de apnea/hipopnea son distintos a los de nivel del mar. El edema pulmonar de las alturas es una patología frecuente, que se produce por un incremento desproporcionado en la VHP reflejando una hiperactividad del lecho vascular pulmonar ante la exposición aguda a la hipoxia hipobárica. Tiene cuatro fenotipos, es infrecuente en menores de 5 años y rara vez es mortal, la sospecha clínica y el manejo oportuno con oxigeno es la clave. Finalmente, en la altura los valores normales de la función pulmonar de la espirometría, oscilometría de impulso y capacidad de difusión son distintos que a nivel del mar.

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Development of spirometric reference equations for children living at high altitude

Cited by 3 publications

References 16 publications

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

A comparative analysis of lung function and spirometry parameters in genotype-controlled natives living at low and high altitude

Neumología De Altura: Saturación De Oxígeno, Edema Pulmonar Y Pruebas De Función Pulmonar

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