High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA), Av. Copacabana Prolongacion #55, La Paz 2826, Bolivia.
Int J Environ Res Public Health. 2021 Jul 17;18(14):7619. doi: 10.3390/ijerph18147619.
Acute high-altitude illnesses are of great concern for physicians and people traveling to high altitude. Our recent article "Acute Mountain Sickness, High-Altitude Pulmonary Edema and High-Altitude Cerebral Edema, a View from the High Andes" was questioned by some sea-level high-altitude experts. As a result of this, we answer some observations and further explain our opinion on these diseases. High-Altitude Pulmonary Edema (HAPE) can be better understood through the Oxygen Transport Triad, which involves the pneumo-dynamic pump (ventilation), the hemo-dynamic pump (heart and circulation), and hemoglobin. The two pumps are the first physiologic response upon initial exposure to hypobaric hypoxia. Hemoglobin is the balancing energy-saving time-evolving equilibrating factor. The acid-base balance must be adequately interpreted using the high-altitude Van Slyke correction factors. Pulse-oximetry measurements during breath-holding at high altitude allow for the evaluation of high altitude diseases. The Tolerance to Hypoxia Formula shows that, paradoxically, the higher the altitude, the more tolerance to hypoxia. In order to survive, all organisms adapt physiologically and optimally to the high-altitude environment, and there cannot be any "loss of adaptation". A favorable evolution in HAPE and pulmonary hypertension can result from the oxygen treatment along with other measures.
急性高原病是医生和前往高原地区的人们非常关注的问题。我们最近的一篇文章“急性高原病、高原肺水肿和高原脑水肿，来自高海拔安第斯山脉的观点”受到了一些海平面高海拔专家的质疑。因此，我们对一些观察结果进行了回答，并进一步解释了我们对这些疾病的看法。高原肺水肿 (HAPE) 可以通过氧运输三联体更好地理解，该三联体涉及气动泵（通气）、血液动力学泵（心脏和循环）和血红蛋白。这两个泵是初次暴露于低压缺氧时的第一个生理反应。血红蛋白是平衡节能时间演变的平衡因素。必须使用高海拔范斯莱克校正因子充分解释酸碱平衡。在高海拔屏息期间进行脉搏血氧仪测量可评估高原疾病。缺氧耐受公式表明，矛盾的是，海拔越高，对缺氧的耐受能力越强。为了生存，所有生物都在生理上和最佳地适应高海拔环境，不会有任何“适应丧失”。通过氧疗和其他措施，可以使 HAPE 和肺动脉高压得到有利的进化。
