AimsIt is unknown whether subclinical high-altitude pulmonary oedema reduces spontaneously after prolonged altitude exposure. Continuous positive airway pressure (CPAP) removes extravascular lung fluids and improves haemoglobin oxygen saturation in acute cardiogenic oedema. We evaluated the presence of pulmonary extravascular fluid increase by assessing CPAP effects on haemoglobin oxygen saturation under acute and prolonged altitude exposure.Methods and resultsWe applied 7 cm H2O CPAP for 30 min to healthy individuals after acute (Capanna Margherita, CM, 4559 m, 2 days permanence, and <36 h hike) and prolonged altitude exposure (Mount Everest South Base Camp, MEBC, 5350 m, 10 days permanence, and 9 days hike). At CM, CPAP reduced heart rate and systolic pulmonary artery pressure while haemoglobin oxygen saturation increased from 80 (median), 78-81 (first to third quartiles), to 91, 84-97 (P < 0.001). After 10 days at MEBC, haemoglobin oxygen saturation spontaneously increased from 77 (74-82) to 86 (82-89) (P < 0.001) while heart rate (from 79, 64-92, to 70, 54-81; P < 0.001) and respiratory rate (from 15, 13-17, to 13, 13-15; P < 0.001) decreased. Under such conditions, these parameters were not influenced by CPAP.ConclusionAfter ascent excessive lung fluids accumulate affecting haemoglobin oxygen saturation and, in these circumstances, CPAP is effective. Acclimatization implies spontaneous haemoglobin oxygen saturation increase and, after prolonged altitude exposure, CPAP is not associated with HbO2-sat increase suggesting a reduction in alveolar fluids.

Agostoni, P., Caldara, G., Bussotti, M., Revera, M., Valentini, M., Gregorini, F., et al. (2010). Continuous positive airway pressure increases haemoglobin O2 saturation after acute but not prolonged altitude exposure. EUROPEAN HEART JOURNAL, 31(4), 457-463 [10.1093/eurheartj/ehp472].

Continuous positive airway pressure increases haemoglobin O2 saturation after acute but not prolonged altitude exposure

REVERA, MIRIAM;FAINI, ANDREA;LOMBARDI, CAROLINA;BILO, GRZEGORZ;GIULIANO, ANDREA;Mancia, G;PARATI, GIANFRANCO;
2010

Abstract

AimsIt is unknown whether subclinical high-altitude pulmonary oedema reduces spontaneously after prolonged altitude exposure. Continuous positive airway pressure (CPAP) removes extravascular lung fluids and improves haemoglobin oxygen saturation in acute cardiogenic oedema. We evaluated the presence of pulmonary extravascular fluid increase by assessing CPAP effects on haemoglobin oxygen saturation under acute and prolonged altitude exposure.Methods and resultsWe applied 7 cm H2O CPAP for 30 min to healthy individuals after acute (Capanna Margherita, CM, 4559 m, 2 days permanence, and <36 h hike) and prolonged altitude exposure (Mount Everest South Base Camp, MEBC, 5350 m, 10 days permanence, and 9 days hike). At CM, CPAP reduced heart rate and systolic pulmonary artery pressure while haemoglobin oxygen saturation increased from 80 (median), 78-81 (first to third quartiles), to 91, 84-97 (P < 0.001). After 10 days at MEBC, haemoglobin oxygen saturation spontaneously increased from 77 (74-82) to 86 (82-89) (P < 0.001) while heart rate (from 79, 64-92, to 70, 54-81; P < 0.001) and respiratory rate (from 15, 13-17, to 13, 13-15; P < 0.001) decreased. Under such conditions, these parameters were not influenced by CPAP.ConclusionAfter ascent excessive lung fluids accumulate affecting haemoglobin oxygen saturation and, in these circumstances, CPAP is effective. Acclimatization implies spontaneous haemoglobin oxygen saturation increase and, after prolonged altitude exposure, CPAP is not associated with HbO2-sat increase suggesting a reduction in alveolar fluids.
Articolo in rivista - Articolo scientifico
haemoglobin, altitude
English
2010
31
4
457
463
none
Agostoni, P., Caldara, G., Bussotti, M., Revera, M., Valentini, M., Gregorini, F., et al. (2010). Continuous positive airway pressure increases haemoglobin O2 saturation after acute but not prolonged altitude exposure. EUROPEAN HEART JOURNAL, 31(4), 457-463 [10.1093/eurheartj/ehp472].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/16823
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