Fluid distribution and tissue thickness changes in 29 men during 1 week at moderate altitude (2,315 m)

Hc, Gunga; Kirsch, K.; Baartz, F. J.; Hj, Steiner; Wittels, P.; Röcker, L.

doi:10.1007/bf00601801

Cited by 16 publications

(16 citation statements)

References 15 publications

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“…Nearly all of these studies took place at altitudes above 3000 m usually in combination with trekking or climbing expeditions, so quite different from the present group. However, in the literature we found that only a few studies reported about stable (Armiellini et al 1997) or even increased total body water during altitude exposure (Gunga et al 1995;Westerterp et al 1996). Our own earlier study was performed at a comparable moderate altitude (2300 m) to the present study, but the subjects at that time were healthy, some of them well-trained soldiers, with a lower mean age and the study lasted in total only about 6 days, including the pre-and post-data collection (Gunga et al 1995).…”

Section: Total Body Water and Moderate Altitude Exposurementioning

confidence: 85%

“…The weight of the probe and the Teflon ring together was 6.5 g. The coupling of the equipment with the tissues induced a deformation from an undisturbed level of less than 2%, assuming a subcutaneous tissue thickness between 2 and 8 mm. This was experimentally tested (Kirsch et al 1980;Gunga et al 1994bGunga et al , 1995. Based on the alterations in tissue thickness, the volume increase or decrease at the respective body areas could be determined.…”

Section: Fluid Distributionmentioning

confidence: 99%

“…The occurrence of superficial fluid accumulation in tissue (peripheral edema) can be observed in healthy subjects quite frequently during the stages of high-altitude exposure (>3500 m), especially in the acclimatory phases (Ba¨rtsch 1993;Westerterp et al 1994;Gunga et al 1995). Since subjects with metabolic syndrome are often faced with increased sodium reabsorption, which usually leads to increased retention of body water, we hypothesized that our Austrian Moderate Altitude Study (AMAS) subjects with metabolic syndrome might be even more susceptible than healthy humans to peripheral edemas in the superficial tissues of the body.…”

mentioning

confidence: 99%

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Austrian Moderate Altitude Study (AMAS 2000) – fluid shifts, erythropoiesis, and angiogenesis in patients with metabolic syndrome at moderate altitude (≅1700 m)

Gunga

Fries²,

Humpeler

et al. 2003

Eur J Appl Physiol

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It was hypothesized that subjects with metabolic syndrome (hypertension, obesity, hyperlipidemia, diabetes mellitus): (1) develop measurable peripheral edema at moderate altitude and (2) might show differences on erythropoiesis, iron status and vascular endothelial growth factor (VEGF) in comparison to healthy subjects during and after a long-term stay (3-week exposure) at moderate altitude (congruent with 1700 m). Twenty-two male subjects with metabolic syndrome were selected. Baseline investigations (t1) were performed in Innsbruck (500 m). All participants were transferred by bus to 1700 m (Alps) and remained there for 3 weeks with examinations on day 1 (after the first night at altitude, t2), day 4 (t3), day 9 (t4) and day 19 (t5). After returning to Innsbruck, post-altitude examinations were conducted after 7-10 days (t6) and 6-7 weeks (t7), respectively. Body mass was decreased from t1 to t7 (P<0.01). Total body water was decreased at t2 (P<0.01), returned to control level (t3, t4), and was found elevated at t7 (P<0.01). Lean body mass did not change, but body fat decreased during the study (P<0.01). Tissue thickness at the forehead decreased during and after altitude exposure (P<0.01), whereas tissue thickness at the tibia did not alter. Erythropoietin (EPO) was elevated as early as t2 and remained increased until t5. Reticulocyte count was increased at t3 and remained above pre-altitude values. VEGF levels were unchanged. After a 3-week exposure to moderate altitude, patients with metabolic syndrome had reduced their body mass, mainly because of a reduction in body fat. The moderate altitude was found to stimulate erythropoiesis in these patients but this was not sufficient to increase serum VEGF concentration.

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Section: Total Body Water and Moderate Altitude Exposurementioning

confidence: 85%

Section: Fluid Distributionmentioning

confidence: 99%

mentioning

confidence: 99%

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Austrian Moderate Altitude Study (AMAS 2000) – fluid shifts, erythropoiesis, and angiogenesis in patients with metabolic syndrome at moderate altitude (≅1700 m)

Gunga

Fries²,

Humpeler

et al. 2003

Eur J Appl Physiol

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“…Some degree of tissue edema is not uncommon upon ascent to altitude (Gunga et al, 1995;Maggiorini et al, 1990). If present within the skeletal muscle or overlying subcutaneous tissue, this might have attenuated the NIR light signal and falsely lowered recorded Sto 2 values.…”

Section: Nirs-vot At High Altitudementioning

confidence: 99%

The Use of Skeletal Muscle Near Infrared Spectroscopy and a Vascular Occlusion Test at High Altitude

Martin

Levett

Bezemer

et al. 2013

High Altitude Medicine & Biology

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Martin, Daniel, Denny Levett, Rick Bezemer, Hugh Montgomery, and Mike Grocott. The use of skeletal muscle near infrared spectroscopy and a vascular occlusion test at high altitude. High Alt Med Biol 14:256-262, 2013.-Microcirculatory function, central to tissue regulation of oxygen flux, may be altered by the chronic hypoxemia experienced at high altitude. We hypothesized that at high altitude, adaptations within skeletal muscle would result in reduced oxygen consumption and reduced microcirculatory responsiveness, detectable by near infrared spectroscopy (NIRS) during a vascular occlusion test (VOT). The VOT comprised 3 min of noninvasive arterial occlusion; thenar eminence tissue oxygenation (Sto 2 ) was measured by NIRS during the VOT at sea level, 4900 m and 5600 m (after 7 and 17 days at altitude, respectively) in 12 healthy volunteers. Data were derived from Sto 2 time-curves using specifically designed computer software. Mean ( -SD) resting Sto 2 was reduced at 4900 m and 5600 m (69.3 ( -8.2)% ( p = 0.001) and 64.2 ( -6.1)% ( p < 0.001) respectively) when compared to sea level (84.4 ( -6.0)%. The rate of Sto 2 recovery after vascular occlusion (Sto 2 upslope) was significantly reduced at 4900 m (2.4 ( -0.4)%/sec) and 5600 m (2.4 ( -0.8)%/sec) compared to sea level (3.7 ( -1.3)%/sec) ( p = 0.021 and p = 0.032, respectively). There was no change from sea level in the rate of desaturation during occlusion (Sto 2 downslope) at either altitude. The findings suggest that in resting skeletal muscle of acclimatizing healthy volunteers at high altitude, microvascular reactivity is reduced (Sto 2 upslope after a short period of ischemia) but that oxygen consumption remains unchanged (Sto 2 downslope).

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“…Several studies suggest that a prolonged stay at high altitude may be associated with interstitial fluid accumulation in systemic tissues. This was shown for subcutaneous tissue [8] at 2,300 m and for mild pericardial effusion at 5,200 m, which increased over the first 7 days [9]. Furthermore, a small decrease in lung compliance compatible with mild interstitial pulmonary oedema was measured by PELLEGRINO et al [10] after 2 days of rest at 3,611 m and 1 day of rest at the same location, where we found no change in lung compliance during the first 48 h at altitude after more rapid ascent.…”

Section: From the Authorsmentioning

confidence: 99%

From the authors:

Dehnert¹,

Luks²,

Swenson³

et al. 2010

Eur Respir J

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To the Editors:In an article published in a recent issue of the European Respiratory Journal, DEHNERT et al.[1] report various measurements made after climbing at high altitude. Among them were carbon monoxide (CO) transfer measurements. I was surprised by the finding of an increase in the transfer factor of the lung for CO (TL,CO) at altitude, as an article presently in press [2], already published in abstract form [3], in which TL,CO and the transfer factor of the lung for nitric oxide (TL,NO) decreased slightly but significantly at altitude. At 5,000 m, two thirds of the subjects decreased their TL,NO by .5% after a short maximal exercise. This discrepancy could be due to the fact that DEHNERT et al.[1] divided the measured value at altitude by a factor ,1 which, in fact, should only be used to estimate the predicted values at altitude. Altitude hypoxia, due to reduced capillary oxygen pressure, increases the conductance of blood for CO and, therefore, the CO transfer. Thus, if one wants to compare the results obtained at altitude to those at sea level, we should either multiply the measured results by this factor or express the results as % predicted, taking into account the equation cited in DEHNERT et al.[1] for the predicted value at altitude. When looking for a detection of interstitial oedema, NO transfer would be more sensitive than CO, as the former is mainly dependent on the membrane conductance and the latter is dependent on both membrane and blood conductances [4]. [1] observed a small but significant decrease in TL,CO in acclimatised subjects after maximal exercise at 5,000 m, which H. Guénard considers to be in disagreement with the small increase we found in nonacclimatised subjects at rest at 4,559 m. He suggests that the discrepancy is due to an erroneous calculation of diffusing capacity of the lung for carbon monoxide (DL,CO) on our part. Furthermore, he points out that transfer factor of the lung for nitric oxide (TL,NO), which was also slightly decreased in the study of DE BISSCHOP et al. H. Guénard[1], is a better measure of diffusion than TL,CO, since nitric oxide uptake is dependent only on membrane conductance and is not influenced by blood conductance.First, we need to emphasise that corrections of the DL,CO measurements for altitude were done properly. The equipment used in the study performed an automated correction of DL,CO for the lower oxygen tension at altitude according to the formula given by MACINTYRE et al. where DL,CO and DL,CO,Alt are the measured single-breath DL,CO at low altitude and that predicted for altitude, respectively, PI,O 2 ,Alt is the inspiratory oxygen tension (PI,O 2 ) at altitude, and 150 mmHg is the assumed at sea level.As pointed out by H. Guénard, this formula predicts DL,CO at high altitude based on measurements performed at low altitude. Since our values measured at high altitude were compared with the baseline values at low altitude, the automated correction multiplied the measured values by (1+0.00316(PI,O 2 -150)), i.e. by a term that is less than o...

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Fluid distribution and tissue thickness changes in 29 men during 1 week at moderate altitude (2,315 m)

Cited by 16 publications

References 15 publications

Austrian Moderate Altitude Study (AMAS 2000) – fluid shifts, erythropoiesis, and angiogenesis in patients with metabolic syndrome at moderate altitude (≅1700 m)

Austrian Moderate Altitude Study (AMAS 2000) – fluid shifts, erythropoiesis, and angiogenesis in patients with metabolic syndrome at moderate altitude (≅1700 m)

The Use of Skeletal Muscle Near Infrared Spectroscopy and a Vascular Occlusion Test at High Altitude

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