Lung function and breathing pattern in subjects developing high altitude pulmonary edema
The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. In 18 mountaineers, spirometry...
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| creator | Clarenbach, Christian F Senn, Oliver Christ, Andreas L Fischler, Manuel Maggiorini, Marco Bloch, Konrad E |
| description | The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage.
In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls).
In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P |
| doi_str_mv | 10.1371/journal.pone.0041188 |
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In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls).
In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances). In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05) but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively) in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances).
The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0041188</identifier><identifier>PMID: 22829927</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Altitude ; Altitude Sickness - physiopathology ; Ascent ; Biology ; Breathing ; Chemical reactions ; Comparative analysis ; Control stability ; Edema ; Female ; Foreign exchange rates ; Gas exchange ; Gases ; Heart failure ; Heart rate ; High altitude ; High-altitude environments ; Humans ; Hypertension, Pulmonary - physiopathology ; Hypoxemia ; Hypoxia ; Intensive care ; Low altitude ; Lung - physiology ; Lung - physiopathology ; Lungs ; Male ; Marathons ; Mechanical ventilation ; Medicine ; Middle Aged ; Oximetry ; Oxygen ; Oxygen content ; Physiology ; Pulmonary edema ; Pulmonary functions ; Pulmonary hypertension ; Respiration ; Respiratory function ; Spirometry ; Tomography ; Ventilation ; Vital Capacity</subject><ispartof>PloS one, 2012-07, Vol.7 (7), p.e41188-e41188</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>2012 Clarenbach et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Clarenbach et al. 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-9128e1d9863ceb4f514cf71bfced212ee5d34c6411e5a00df9023ffa3f4850343</citedby><cites>FETCH-LOGICAL-c758t-9128e1d9863ceb4f514cf71bfced212ee5d34c6411e5a00df9023ffa3f4850343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400591/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400591/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22829927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clarenbach, Christian F</creatorcontrib><creatorcontrib>Senn, Oliver</creatorcontrib><creatorcontrib>Christ, Andreas L</creatorcontrib><creatorcontrib>Fischler, Manuel</creatorcontrib><creatorcontrib>Maggiorini, Marco</creatorcontrib><creatorcontrib>Bloch, Konrad E</creatorcontrib><title>Lung function and breathing pattern in subjects developing high altitude pulmonary edema</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage.
In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls).
In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances). In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05) but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively) in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances).
The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE.</description><subject>Adult</subject><subject>Altitude</subject><subject>Altitude Sickness - physiopathology</subject><subject>Ascent</subject><subject>Biology</subject><subject>Breathing</subject><subject>Chemical reactions</subject><subject>Comparative analysis</subject><subject>Control stability</subject><subject>Edema</subject><subject>Female</subject><subject>Foreign exchange rates</subject><subject>Gas exchange</subject><subject>Gases</subject><subject>Heart failure</subject><subject>Heart rate</subject><subject>High altitude</subject><subject>High-altitude environments</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Hypoxemia</subject><subject>Hypoxia</subject><subject>Intensive care</subject><subject>Low altitude</subject><subject>Lung - physiology</subject><subject>Lung - physiopathology</subject><subject>Lungs</subject><subject>Male</subject><subject>Marathons</subject><subject>Mechanical ventilation</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Oximetry</subject><subject>Oxygen</subject><subject>Oxygen content</subject><subject>Physiology</subject><subject>Pulmonary edema</subject><subject>Pulmonary functions</subject><subject>Pulmonary hypertension</subject><subject>Respiration</subject><subject>Respiratory function</subject><subject>Spirometry</subject><subject>Tomography</subject><subject>Ventilation</subject><subject>Vital 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Oliver</au><au>Christ, Andreas L</au><au>Fischler, Manuel</au><au>Maggiorini, Marco</au><au>Bloch, Konrad E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lung function and breathing pattern in subjects developing high altitude pulmonary edema</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-07-19</date><risdate>2012</risdate><volume>7</volume><issue>7</issue><spage>e41188</spage><epage>e41188</epage><pages>e41188-e41188</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage.
In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls).
In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances). In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05) but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively) in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances).
The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>22829927</pmid><doi>10.1371/journal.pone.0041188</doi><tpages>e41188</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Altitude Altitude Sickness - physiopathology Ascent Biology Breathing Chemical reactions Comparative analysis Control stability Edema Female Foreign exchange rates Gas exchange Gases Heart failure Heart rate High altitude High-altitude environments Humans Hypertension, Pulmonary - physiopathology Hypoxemia Hypoxia Intensive care Low altitude Lung - physiology Lung - physiopathology Lungs Male Marathons Mechanical ventilation Medicine Middle Aged Oximetry Oxygen Oxygen content Physiology Pulmonary edema Pulmonary functions Pulmonary hypertension Respiration Respiratory function Spirometry Tomography Ventilation Vital Capacity |
| title | Lung function and breathing pattern in subjects developing high altitude pulmonary edema |
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