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P217 Extravascular lung water in healthy lowlanders during repeated high altitude exposure
Poster Walks Poster Walk 6: Basic Science/Pulmonary hypertension
P217 Extravascular lung water in healthy lowlanders during repeated high altitude exposure P.R. Bader1, M. Lichtblau1, M. Furian1, L. Muralt1, S.E. Hartmann2, J.M. Rawling3, M.J. Poulin2, K.E. Bloch1, S. Ulrich1 1 Pulmonology, University Hospital Zurich, Zürich, Switzerland, 2University of Calgary, 3Family Medicine, University of Calgary, Calgary, Canada Introduction: High altitude pulmonary edema (HAPE) is a life-threatening condition associated with increasing extravascular lung water (EVLW). In healthy individuals, we investigated 1) whether EVLW is observed upon acute exposure to very high altitude; 2) changes in EVLW over a one-week stay at altitude; and 3) the effect of re-exposure on EVLW to the same altitude. Methods: EVLW was assessed in twenty-one healthy lowlanders (living< 800m, meanSD age 254 years, FEV1 9612% predicted) by lung ultrasonography and quantified as lung comets during two consecutive sojourns to the ALMA Observatory (Atacama, Chile). Participants slept at 2900m and drove 45-minutes by car to 5050m on six consecutive days and stayed there for 6-8 hours. Measurement took place at low altitude (LA1; Santiago, 520m), and after the first and the sixth night at 5050m (HA1 and HA6, respectively). This cycle was repeated following an identical protocol, after 7-days rest at LA (i.e., cycle 2). ClinicalTrials.gov [NCT02760186]. Results: The median numbers (Q1;Q4) of lung comets in cycle 1 were 0 (0;0), and 1 (0;3.5) and 7 (3;10) in LA, HA1 and HA6 (LAvs.HA1 and HA6; HA1vs.HA6; p< 0.01). In cycle 2, lung comets were 1 (0;2), 2 (0.5;3) and 12 (7.5;13) (LA1vs.HA6; HA1vs.HA6; both p< 0.01). Comparing the two cycles, a difference was found between LA and HA6 (p< 0.01). Conclusions: In healthy lowlanders acutely exposed to hypobaric hypoxia, EVLW is increased after the first night, further increases until after the sixth night and is still present after return to low altitude. Repeated exposure after a break at lowland reveals even more pronounced EVLW accumulation. This may have repercussions for individuals who engage in repetitive ascent to altitude for occupational purposes. DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.122
POSTER WALKS
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
116A
[
151#5S CHEST MAY 2017
]
P217 Extravascular lung water in healthy lowlanders during repeated high altitude exposure P.R. Bader1, M. Lichtblau1, M. Furian1, L. Muralt1, S.E. Hartmann2, J.M. Rawling3, M.J. Poulin2, K.E. Bloch1, S. Ulrich1 1 Pulmonology, University Hospital Zurich, Zürich, Switzerland, 2University of Calgary, 3Family Medicine, University of Calgary, Calgary, Canada Introduction: High altitude pulmonary edema (HAPE) is a life-threatening condition associated with increasing extravascular lung water (EVLW). In healthy individuals, we investigated 1) whether EVLW is observed upon acute exposure to very high altitude; 2) changes in EVLW over a one-week stay at altitude; and 3) the effect of re-exposure on EVLW to the same altitude. Methods: EVLW was assessed in twenty-one healthy lowlanders (living< 800m, meanSD age 254 years, FEV1 9612% predicted) by lung ultrasonography and quantified as lung comets during two consecutive sojourns to the ALMA Observatory (Atacama, Chile). Participants slept at 2900m and drove 45-minutes by car to 5050m on six consecutive days and stayed there for 6-8 hours. Measurement took place at low altitude (LA1; Santiago, 520m), and after the first and the sixth night at 5050m (HA1 and HA6, respectively). This cycle was repeated following an identical protocol, after 7-days rest at LA (i.e., cycle 2). ClinicalTrials.gov [NCT02760186]. Results: The median numbers (Q1;Q4) of lung comets in cycle 1 were 0 (0;0), and 1 (0;3.5) and 7 (3;10) in LA, HA1 and HA6 (LAvs.HA1 and HA6; HA1vs.HA6; p< 0.01). In cycle 2, lung comets were 1 (0;2), 2 (0.5;3) and 12 (7.5;13) (LA1vs.HA6; HA1vs.HA6; both p< 0.01). Comparing the two cycles, a difference was found between LA and HA6 (p< 0.01). Conclusions: In healthy lowlanders acutely exposed to hypobaric hypoxia, EVLW is increased after the first night, further increases until after the sixth night and is still present after return to low altitude. Repeated exposure after a break at lowland reveals even more pronounced EVLW accumulation. This may have repercussions for individuals who engage in repetitive ascent to altitude for occupational purposes. DOI:
http://dx.doi.org/10.1016/j.chest.2017.04.122
POSTER WALKS
Copyright ª 2017 American College of Chest Physicians and Swiss Respiratory Society SGP. Published by Elsevier Inc and Karger. All rights reserved.
116A
[
151#5S CHEST MAY 2017
]