Ventilatory function and oxygen delivery at high altitude in the Himalayas
This study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a M...
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| Veröffentlicht in: | Respiratory physiology & neurobiology 2023-08, Vol.314, p.104086-104086, Article 104086 |
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| creator | Prosperi, Pierpaolo Verratti, Vittore Taverna, Alberto Rua, Riccardo Bonan, Sofia Rapacchiale, Giorgia Bondi, Danilo Di Giulio, Camillo Lorkowski, Jacek Spacone, Antonella |
| description | This study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a Mount Everest expedition in Nepal. Spirometry and arterial blood gas content were evaluated at baseline in Kathmandu (≈1400 m), at the Pyramid Laboratory - Observatory (peak altitude of ≈5000 m), and on return to Kathmandu 2–3 days after arrival at each site. All participants took 250 mg of acetazolamide per os once daily during the ascent. We found that arterial hemoglobin saturation, O2 and CO2 partial pressures, and the bicarbonate level all decreased (in all cases, p |
| doi_str_mv | 10.1016/j.resp.2023.104086 |
| format | Article |
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•Sojourners to high altitude show < PaO2 and PaCO2 and > bicarbonate content accelerated by using acetazolamide.•Lung function disturbances expressed by decreases in the FEV1/FVC ratio suggest latent airway obstruction.•PaO2 < 47 mmHg and SaO2 < 75% at 5000 m have 100% negative and 55% positive predictive value for the development of AMS.•Finger SpO2 overestimates SaO2 and thus pulse oximetry may not correctly monitor high-altitude health threats.</description><identifier>ISSN: 1569-9048</identifier><identifier>EISSN: 1878-1519</identifier><identifier>DOI: 10.1016/j.resp.2023.104086</identifier><identifier>PMID: 37257573</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Altitude ; Altitude hypoxia ; Altitude Sickness ; Arterial blood gas content ; Female ; Forced Expiratory Volume ; Himalayas ; Humans ; Hypoxia ; Male ; Middle Aged ; Oxygen ; Pulse oximetry ; Spirometry</subject><ispartof>Respiratory physiology & neurobiology, 2023-08, Vol.314, p.104086-104086, Article 104086</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-d962ca5d6a0b2f951e74e3df937d643978f896468eef7e2cf8208526203e738e3</citedby><cites>FETCH-LOGICAL-c400t-d962ca5d6a0b2f951e74e3df937d643978f896468eef7e2cf8208526203e738e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.resp.2023.104086$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37257573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prosperi, Pierpaolo</creatorcontrib><creatorcontrib>Verratti, Vittore</creatorcontrib><creatorcontrib>Taverna, Alberto</creatorcontrib><creatorcontrib>Rua, Riccardo</creatorcontrib><creatorcontrib>Bonan, Sofia</creatorcontrib><creatorcontrib>Rapacchiale, Giorgia</creatorcontrib><creatorcontrib>Bondi, Danilo</creatorcontrib><creatorcontrib>Di Giulio, Camillo</creatorcontrib><creatorcontrib>Lorkowski, Jacek</creatorcontrib><creatorcontrib>Spacone, Antonella</creatorcontrib><title>Ventilatory function and oxygen delivery at high altitude in the Himalayas</title><title>Respiratory physiology & neurobiology</title><addtitle>Respir Physiol Neurobiol</addtitle><description>This study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a Mount Everest expedition in Nepal. Spirometry and arterial blood gas content were evaluated at baseline in Kathmandu (≈1400 m), at the Pyramid Laboratory - Observatory (peak altitude of ≈5000 m), and on return to Kathmandu 2–3 days after arrival at each site. All participants took 250 mg of acetazolamide per os once daily during the ascent. We found that arterial hemoglobin saturation, O2 and CO2 partial pressures, and the bicarbonate level all decreased (in all cases, p < 0.001 with R2 =0.70–0.90), while pHa was maintained stable at the peak altitude. Forced vital capacity (FVC) remained stable, while forced expiratory volume in 1 s (FEV1) decreased (p = 0.010, n2p =0.228), resulting in a lower FEV1/FVC ratio (p < 0.001, n2p =0.380). The best predictor for acute mountain sickness was the O2 partial pressure at the peak altitude (p = 0.004, R2 =0.39). Finger pulse oximetry overestimated peripheral saturation relative to arterial saturation. We conclude that high-altitude hypoxia alters the respiratory function and the oxygen saturation of the arterial blood hemoglobin. Additionally, air rarefaction and temperature reduction, favoring hypoxic bronchoconstriction, could affect respiration. Pulse oximetry seems not enough to assist medical decisions at high altitudes.
•Sojourners to high altitude show < PaO2 and PaCO2 and > bicarbonate content accelerated by using acetazolamide.•Lung function disturbances expressed by decreases in the FEV1/FVC ratio suggest latent airway obstruction.•PaO2 < 47 mmHg and SaO2 < 75% at 5000 m have 100% negative and 55% positive predictive value for the development of AMS.•Finger SpO2 overestimates SaO2 and thus pulse oximetry may not correctly monitor high-altitude health threats.</description><subject>Adult</subject><subject>Altitude</subject><subject>Altitude hypoxia</subject><subject>Altitude Sickness</subject><subject>Arterial blood gas content</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Himalayas</subject><subject>Humans</subject><subject>Hypoxia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Oxygen</subject><subject>Pulse oximetry</subject><subject>Spirometry</subject><issn>1569-9048</issn><issn>1878-1519</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PwzAMhiMEgjH4AxxQjlw68tEmqcQFTXxqEhfgGmWJu2Xq2pGkiP17Mg04crJlv35tPwhdUDKhhIrr1SRA3EwYYTwXSqLEARpRJVVBK1of5rwSdVGTUp2g0xhXhFBJJT9GJ1yySlaSj9DzO3TJtyb1YYubobPJ9x02ncP913YBHXbQ-k_ITZPw0i-W2LTJp8EB9h1OS8CPfm1aszXxDB01po1w_hPH6O3-7nX6WMxeHp6mt7PCloSkwtWCWVM5YcicNXVFQZbAXVNz6UTJa6kaVYtSKIBGArONYkRVTDDCQXIFfIyu9r6b0H8MEJNe-2ihbU0H_RA1U4yKvErwLGV7qQ19jAEavQn53LDVlOgdQ73SO4Z6x1DvGeahyx__Yb4G9zfyCy0LbvYCyF9-egg6Wg-dBecD2KRd7__z_wY1uoI7</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Prosperi, Pierpaolo</creator><creator>Verratti, Vittore</creator><creator>Taverna, Alberto</creator><creator>Rua, Riccardo</creator><creator>Bonan, Sofia</creator><creator>Rapacchiale, Giorgia</creator><creator>Bondi, Danilo</creator><creator>Di Giulio, Camillo</creator><creator>Lorkowski, Jacek</creator><creator>Spacone, Antonella</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202308</creationdate><title>Ventilatory function and oxygen delivery at high altitude in the Himalayas</title><author>Prosperi, Pierpaolo ; Verratti, Vittore ; Taverna, Alberto ; Rua, Riccardo ; Bonan, Sofia ; Rapacchiale, Giorgia ; Bondi, Danilo ; Di Giulio, Camillo ; Lorkowski, Jacek ; Spacone, Antonella</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-d962ca5d6a0b2f951e74e3df937d643978f896468eef7e2cf8208526203e738e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Altitude</topic><topic>Altitude hypoxia</topic><topic>Altitude Sickness</topic><topic>Arterial blood gas content</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Himalayas</topic><topic>Humans</topic><topic>Hypoxia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Oxygen</topic><topic>Pulse oximetry</topic><topic>Spirometry</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prosperi, Pierpaolo</creatorcontrib><creatorcontrib>Verratti, Vittore</creatorcontrib><creatorcontrib>Taverna, Alberto</creatorcontrib><creatorcontrib>Rua, Riccardo</creatorcontrib><creatorcontrib>Bonan, Sofia</creatorcontrib><creatorcontrib>Rapacchiale, Giorgia</creatorcontrib><creatorcontrib>Bondi, Danilo</creatorcontrib><creatorcontrib>Di Giulio, Camillo</creatorcontrib><creatorcontrib>Lorkowski, Jacek</creatorcontrib><creatorcontrib>Spacone, Antonella</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory physiology & neurobiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prosperi, Pierpaolo</au><au>Verratti, Vittore</au><au>Taverna, Alberto</au><au>Rua, Riccardo</au><au>Bonan, Sofia</au><au>Rapacchiale, Giorgia</au><au>Bondi, Danilo</au><au>Di Giulio, Camillo</au><au>Lorkowski, Jacek</au><au>Spacone, Antonella</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventilatory function and oxygen delivery at high altitude in the Himalayas</atitle><jtitle>Respiratory physiology & neurobiology</jtitle><addtitle>Respir Physiol Neurobiol</addtitle><date>2023-08</date><risdate>2023</risdate><volume>314</volume><spage>104086</spage><epage>104086</epage><pages>104086-104086</pages><artnum>104086</artnum><issn>1569-9048</issn><eissn>1878-1519</eissn><abstract>This study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a Mount Everest expedition in Nepal. Spirometry and arterial blood gas content were evaluated at baseline in Kathmandu (≈1400 m), at the Pyramid Laboratory - Observatory (peak altitude of ≈5000 m), and on return to Kathmandu 2–3 days after arrival at each site. All participants took 250 mg of acetazolamide per os once daily during the ascent. We found that arterial hemoglobin saturation, O2 and CO2 partial pressures, and the bicarbonate level all decreased (in all cases, p < 0.001 with R2 =0.70–0.90), while pHa was maintained stable at the peak altitude. Forced vital capacity (FVC) remained stable, while forced expiratory volume in 1 s (FEV1) decreased (p = 0.010, n2p =0.228), resulting in a lower FEV1/FVC ratio (p < 0.001, n2p =0.380). The best predictor for acute mountain sickness was the O2 partial pressure at the peak altitude (p = 0.004, R2 =0.39). Finger pulse oximetry overestimated peripheral saturation relative to arterial saturation. We conclude that high-altitude hypoxia alters the respiratory function and the oxygen saturation of the arterial blood hemoglobin. Additionally, air rarefaction and temperature reduction, favoring hypoxic bronchoconstriction, could affect respiration. Pulse oximetry seems not enough to assist medical decisions at high altitudes.
•Sojourners to high altitude show < PaO2 and PaCO2 and > bicarbonate content accelerated by using acetazolamide.•Lung function disturbances expressed by decreases in the FEV1/FVC ratio suggest latent airway obstruction.•PaO2 < 47 mmHg and SaO2 < 75% at 5000 m have 100% negative and 55% positive predictive value for the development of AMS.•Finger SpO2 overestimates SaO2 and thus pulse oximetry may not correctly monitor high-altitude health threats.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37257573</pmid><doi>10.1016/j.resp.2023.104086</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Altitude Altitude hypoxia Altitude Sickness Arterial blood gas content Female Forced Expiratory Volume Himalayas Humans Hypoxia Male Middle Aged Oxygen Pulse oximetry Spirometry |
| title | Ventilatory function and oxygen delivery at high altitude in the Himalayas |
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