Do Changes in Lung Function Predict High-Altitude Pulmonary Edema at an Early Stage?

Senn, Oliver; Clarenbach, Christian F.; Fischler, Manuel; Thalmann, Rahel; Rocca, Hans‐Peter Brunner‐La; Egger, Patrick; Maggiorini, Marco; Bloch, Konrad E.

doi:10.1249/01.mss.0000229102.37359.af

Cited by 41 publications

(38 citation statements)

References 25 publications

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“…Furthermore, seven studies [4][5][6][7][8][9]12] reporting decreased FVC had 4-26 subjects, i.e. had less statistical power than the present study.…”

Section: Lung Volumescontrasting

confidence: 60%

“…Two studies that report predicted values [12], or data that permit calculation of predicted values [7], and also show a reduction in FVC of 8 and 7% report vital capacities of 87-96% pred. In the light of these discrepancies, careful attention was paid to providing the greatest encouragement of maximal efforts.…”

Section: Lung Volumesmentioning

confidence: 99%

“…P revious investigations reported reduced forced vital capacity (FVC) [1][2][3][4][5][6][7][8][9][10][11][12] and reduced forced expiratory volume in 1 s (FEV1) [3,7,9,10,12], as well as increased closing volume (CV) [4,12,13], during the first days after ascent to altitudes of 2,800-5,300 m. These findings were interpreted as being consistent with pulmonary interstitial fluid accumulation or subclinical high-altitude pulmonary oedema (HAPE). However, there are several other factors that could also account for or contribute to the observed changes.…”

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confidence: 99%

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No evidence for interstitial lung oedema by extensive pulmonary function testing at 4,559 m

Dehnert¹,

Luks²,

Schendler

et al. 2009

Eur Respir J

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The aim of the present study was to better understand previously reported changes in lung function at high altitude.Comprehensive pulmonary function testing utilising body plethysmography and assessment of changes in closing volume were carried out at sea level and repeatedly over 2 days at high altitude (4,559 m) in 34 mountaineers.In subjects without high-altitude pulmonary oedema (HAPE), there was no significant difference in total lung capacity, forced vital capacity, closing volume and lung compliance between low and high altitude, whereas lung diffusing capacity for carbon monoxide increased at high altitude. Bronchoconstriction at high altitude could be excluded as the cause of changes in closing volume because there was no difference in airway resistance and bronchodilator responsiveness to salbutamol. There were no significant differences in these parameters between mountaineers with and without acute mountain sickness. Mild alveolar oedema on radiographs in HAPE was associated only with minor decreases in forced vital capacity, diffusing capacity and lung compliance and minor increases in closing volume.Comprehensive lung function testing provided no evidence of interstitial pulmonary oedema in mountaineers without HAPE during the first 2 days at 4,559 m. Data obtained in mountaineers with early mild HAPE suggest that these methods may not be sensitive enough for the detection of interstitial pulmonary fluid accumulation.

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“…Furthermore, seven studies [4][5][6][7][8][9]12] reporting decreased FVC had 4-26 subjects, i.e. had less statistical power than the present study.…”

Section: Lung Volumescontrasting

confidence: 60%

Section: Lung Volumesmentioning

confidence: 99%

mentioning

confidence: 99%

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No evidence for interstitial lung oedema by extensive pulmonary function testing at 4,559 m

Dehnert¹,

Luks²,

Schendler

et al. 2009

Eur Respir J

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show abstract

“…However, there is a large overlap of individual values [7] and statistically significant differences can only be obtained in studies of large groups. These blood gas changes might be due to a mild interstitial oedema not visible on chest radiographs [8], but suggested by a slight decrease of vital capacity and increase of closing volume [9,10]; however, these are inconsistent findings [11]. Furthermore, a lower ventilatory drive in hypoxia might contribute to more severe hypoxaemia in AMS, at least in some individuals [12,13].…”

Section: Ams and Hacementioning

confidence: 99%

“…A lower ventilatory drive in hypoxia [7,13], impaired gas exchange due to interstitial pulmonary oedema [10] and fluid retention [7] or increased metabolism [1] may contribute to slightly more pronounced hypoxaemia in AMS.…”

Section: Hypoxaemiamentioning

confidence: 99%

Acute high-altitude sickness

2017

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At any point 1-5 days following ascent to altitudes ⩾2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.

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Effect of Acetazolamide and AutoCPAP Therapy on Breathing Disturbances Among Patients With Obstructive Sleep Apnea Syndrome Who Travel to Altitude

Latshang¹,

Nussbaumer-Ochsner²,

Henn³

et al. 2012

JAMA

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Do Changes in Lung Function Predict High-Altitude Pulmonary Edema at an Early Stage?

Cited by 41 publications

References 25 publications

No evidence for interstitial lung oedema by extensive pulmonary function testing at 4,559 m

No evidence for interstitial lung oedema by extensive pulmonary function testing at 4,559 m

Acute high-altitude sickness

Effect of Acetazolamide and AutoCPAP Therapy on Breathing Disturbances Among Patients With Obstructive Sleep Apnea Syndrome Who Travel to Altitude

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