Effects of Altitude on Chronic Obstructive Pulmonary Disease Patients: Risks and Care

Georges, Thomas; Blanc, Carolin Le; Ferréol, S.; Menu, Pierre; Dauty, Marc

doi:10.3390/life11080798

Cited by 4 publications

(3 citation statements)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to medical practice, it is recommended to obtain a detailed medical history and symptoms including recent exacerbation, current treatments and adaptation of those if required, baseline exercise capacity, previous altitude exposure experiences as well as the logistics of the intended journey should be reviewed and this is surely useful. 30 In addition, screening by the simple and widely accessible pulse oximetry is recommended.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients

Bauer

Müller²,

Schneider³

et al. 2022

ERJ Open Res

View full text Add to dashboard Cite

Background/aimsAmongst numerous travelers to high altitude are many with the highly prevalent chronic obstructive pulmonary disease (COPD), who are at particular risk for altitude-related adverse health effects (ARAHE). We investigated hypoxia altitude simulation testing (HAST) to predict ARAHE in COPD patients traveling to altitude.Methods/resultsThis prospective diagnostic accuracy study included 75 COPD patients (40 women, age 58±9 years, FEV1 40–80% pred.), SpO2≥92% and PaCO2<6kPa. Patients underwent baseline evaluation and HAST, breathing normobaric hypoxic air (FiO2of 15%) for 15 min, at low altitude (LA, 760m). Cutoff values for a positive HAST were set according to BTS-guidelines (PaO2<6.6kPa and/or SpO2<85%). The following day, patients traveled to high altitude (HA, 3100m) for 2 overnight stays where ARAHE development including acute mountain sickness (AMS), Lake Louise Score (LLS)≥4 and/or AMSc ≥0.7, severe hypoxemia (SpO2<80% for>30min or 75% for >15min) or intercurrent illness was observed. ARAHE occurred in 50 (66%) patients and 23/75 (30%) were positive in HAST by SpO2, 11/64 (17%) by PaO2. For SpO2/PaO2we report a sensitivity of 46/25%, specificity of 84/95%, positive predictive value of 85/92% and negative predictive value of 44/37%.ConclusionIn COPD patients ascending to HA, ARAHE are common. Despite an acceptable positive predictive value of HAST to predict ARAHE, its clinical use is limited by its insufficient sensitivity and overall accuracy. Counseling COPD patients before altitude travel remains challenging and best focuses on early recognition and therapy of ARAHE with oxygen and descent.

show abstract

Section: Discussionmentioning

confidence: 99%

Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients

Bauer

Müller²,

Schneider³

et al. 2022

ERJ Open Res

View full text Add to dashboard Cite

show abstract

“…Hypoxia acts as a central link in the pathogenesis of many diseases. In the dynamics of hypoxic exposure, in accordance with the partial pressure of oxygen in the environment, the oxygen tension in the blood also changes, which also occurs during endogenous hypoxia in various diseases [1][2][3][4]. It is known that under extreme conditions, adaptive mechanisms are activated, indicators of various body systems change to maintain the functional activity of tissues and organs, both under conditions of endogenous oxygen deficiency and oxygen deficiency in the environment [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The Reaction of Various Functional Systems of the Body in the Dynamics of Oxygen Deficiency

Karapetyan¹,

Adamyan²,

Sahakyan³

2022

AJBIO

View full text Add to dashboard Cite

The paper presents a comparative analysis of data on the effect of moderate and acute hypoxia on the functional state of systems at various levels of organization -molecular (amide groups of brain proteins), cellular (background electrical activity of neurons), systemic (electroencephalogram -EEG, electrocardiogram (ECG) and organismic (integrative signal of the body). Changes in electrographic parameters have an adaptive meaning for the body and are of a phase nature: in moderate hypoxia (4500-5000 m) the indicators are activated, and at acute hypoxia (7500 -8000 m) -are depressed. 15-30 minutes after exposure to hypoxia at normal atmospheric pressure, the values of almost all indicators are back to normal. It is shown, that a prolonged aftereffect of acute hypoxia is observed at the organism molecular level. Under oxygen deficiency, the number of amide groups of brain proteins increases. After the hypoxic factor, this violation persists for a day. The data of the influence of hypoxia on animals, lead to the conclusion, that the functional systems of different levels of organization react ambiguously to the impact of increasing oxygen deficiency. However, in the dynamics of hypoxia in the values of the integrative signal recorded by a non-invasive method from the body surface, phase changes are not observed, on the contrary, the shifts are unidirectional. Certain deviations of the indicators of the integrative signal in the phase of moderate hypoxia increase during acute hypoxia and continue for several hours. We conclude that the remote "Bioscope" signal being integral in nature, is not the sum of individual electrographic indicators of various functional systems and has a high sensitivity and specificity to the change of physiological state of animal.

show abstract

“…At moderate and high altitude levels, the partial pressure of oxygen is reduced, ultimately leading to alveolar hypoxia. Acute hypoxia causes increases in SBP and DBP, heart rate (HR), cardiac output (CO), catecholamine, impaired HR variability (increased low frequency/high frequency ratio), and SVR [ 3 , 4 , 6 , 16 , 17 , 18 , 19 ]. The increase in CO at high altitude is mainly due to an increased HR.…”

Section: Introductionmentioning

confidence: 99%

Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity

Tsao

Hwang

Tsai

et al. 2021

IJERPH

View full text Add to dashboard Cite

Cardiovascular physiological responses involving hypoxemia in low temperature environments at high altitude have yet to be adequately investigated. This study aims to demonstrate the health effects of hypoxemia and temperature changes in cardiovascular functions (CVFs) by comparing intra-individual differences as participants ascend from low (298 m, 21.9 °C) to high altitude (2729 m, 9.5 °C). CVFs were assessed by measuring the arterial pressure waveform according to cuff sphygmomanometer of an oscillometric blood pressure (BP) device. The mean ages of participants in winter and summer were 43.6 and 41.2 years, respectively. The intra-individual brachial systolic, diastolic BP, heart rate, and cardiac output of participants significantly increased, as participants climbed uphill from low to high altitude forest. Following the altitude increase from 298 m to 2729 m, with the atmosphere gradually reducing by 0.24 atm, the measured average SpO2 of participants showed a significant reduction from 98.1% to 81.2%. Using mixed effects model, it is evident that in winter, the differences in altitude affects CVFs by significantly increases the systolic BP, heart rate, left ventricular dP/dt max and cardiac output. This study provides evidence that cardiovascular workload increased significantly among acute high-altitude travelers as they ascend from low to high altitude, particularly in winter.

show abstract

Effects of Altitude on Chronic Obstructive Pulmonary Disease Patients: Risks and Care

Cited by 4 publications

References 83 publications

Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients

Hypoxia-altitude simulation test to predict altitude-related adverse health effects in COPD patients

The Reaction of Various Functional Systems of the Body in the Dynamics of Oxygen Deficiency

Seasonal Effects of High-Altitude Forest Travel on Cardiovascular Function: An Overlooked Cardiovascular Risk of Forest Activity

Contact Info

Product

Resources

About