Department of Anaesthesiology and Critical Care Medicine, Medical School Innsbruck, Austria.
Ecole polytechnique fédérale de Lausanne, Switzerland.
Respir Physiol Neurobiol. 2020 Oct;281:103513. doi: 10.1016/j.resp.2020.103513. Epub 2020 Jul 31.
Testing the hypoxic ventilatory response (HVR) at low-altitude helps to detect those who do not hyperventilate appropriately in hypoxia but might not necessarily predict the HVR and the risk to develop acute mountain sickness (AMS) at high altitude. However, a low HVR seems to be particularly prevalent in individuals susceptible to high-altitude pulmonary edema (HAPE+). In this short communication, we assessed differences in physiological parameters in two comparable women before and 3 hours after exposure to 3,480 meters. One woman had a (clinically diagnosed) history of high-altitude pulmonary edema (HAPE+) while the other did well at previous exposures to high altitude (HAPE-).
Heart rate, blood pressure, ventilation, arterial blood gas variables, arterial haemoglobin saturation, haemoglobin concentration, arterial oxygen content and delta plasma volume were measured or calculated before and after arrival at high altitude.
At high altitude, plasma volume decreased in the HAPE- woman which in turn increased haemoglobin concentration. Ventilation was elevated in the HAPE- but not in the HAPE + woman. Arterial oxygen content fell in the HAPE + while it was preserved in the HAPE- woman. This resulted from lower peripheral oxygen saturation (-35%), lower haemoglobin concentration (-12%) and lower arterial partial pressure of oxygen (-59%) in the HAPE+.
Considerable haemoglobin desaturation and lack of haemoconcentration were characteristics of the HAPE + woman when exposed to high altitude, while the higher arterial oxygen content in the HAPE- woman was related to both haemoconcentration and hyperventilation (and associated haemoglobin saturation).
在低海拔地区测试低氧通气反应(HVR)有助于发现那些在低氧环境下不能适当过度通气的人,但不一定能预测 HVR 和在高海拔地区发生急性高山病(AMS)的风险。然而,低 HVR 似乎在易患高海拔肺水肿(HAPE+)的个体中特别常见。在这个简短的交流中,我们评估了两名可比较的女性在暴露于 3480 米 3 小时前后的生理参数差异。一名女性有(临床诊断)高海拔肺水肿(HAPE+)病史,而另一名女性在之前的高海拔暴露中表现良好(HAPE-)。
在到达高海拔前后测量或计算心率、血压、通气、动脉血气变量、动脉血红蛋白饱和度、血红蛋白浓度、动脉氧含量和 delta 血浆容量。
在高海拔地区,HAPE-女性的血浆容量减少,进而增加血红蛋白浓度。通气在 HAPE-女性中升高,但在 HAPE+女性中没有升高。动脉氧含量在 HAPE+女性中下降,而在 HAPE-女性中保持不变。这是由于 HAPE+女性外周氧饱和度(-35%)、血红蛋白浓度(-12%)和动脉血氧分压(-59%)较低所致。
在暴露于高海拔时,HAPE+女性存在相当大的血红蛋白饱和度下降和无血红蛋白浓缩,而 HAPE-女性较高的动脉氧含量与血红蛋白浓缩和过度通气(以及相关的血红蛋白饱和度)有关。