Individual Susceptibility to High Altitude and Immersion Pulmonary Edema and Pulmonary Lymphatics

Ea, Carter; Mayo,; MacInnis, Martin J.; Dc, McKenzie; Koehle, Michael S.

doi:10.3357/asem.3736.2014

Cited by 17 publications

(12 citation statements)

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“…Bronchoalveolar lavage analysis ruled out an inflammatory process as the background for the development of oedema [38]. The prevailing theory claims that several factors, such as increased intrathoracic blood volume and cardiac output, increased pulmonary vasoconstriction and an individually smaller pulmonary lymphatic network contribute to increased hydrostatic pressure that leads to pulmonary capillary stress failure [38,39]. High pulmonary vascular pressure occurs during immersion as a result of a central blood volume shift, augmented by active vasoconstriction in cold water and the diving reflex [40].…”

Section: Noncardiogenic Oedema and Haemoptysismentioning

confidence: 99%

Sports-related lung injury during breath-hold diving

Mijačika

Dujić

2016

Eur Respir Rev

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The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage. @ERSpublications Breath-hold diving may result in acute respiratory symptoms, but does not lead to chronic lung dysfunction http://ow.ly/D03r302uMOD

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Section: Noncardiogenic Oedema and Haemoptysismentioning

confidence: 99%

Sports-related lung injury during breath-hold diving

Mijačika

Dujić

2016

Eur Respir Rev

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“…The risk factors associated with development of HAPE are the rate of ascent ( >350 m per day above 2000 m), the genetic and physiological constitution of the individual, race and family of the individual, the altitude traversed (especially sleeping altitude), any previous history of HAPE, exertion/exercise (particularly high-intensity exercise), cold, administration/intake of any sedatives, any recent infections or disease affecting the lower airways and an idiopathic tendency of pulmonary hypertension [9,[13][14][15][16][17][18][19].…”

Section: Symptoms and Risk Factorsmentioning

confidence: 99%

“…These, susceptible individuals had marked differences in characters like lung volume, lung density, lung mass, number of interlobular septa in lungs, PAP levels and nasal transepithelial potential differences at rest. These evidence indicated towards a genetic and cellular component in the etiology of HAPE [13,21,[24][25][26][27][28]. A number of genomic studies had been performed using global genomics approaches such as microarray or using targeted approaches such as qPCR to determine the association of genes with HAPE susceptibility.…”

Section: Evidences From Genomicsmentioning

confidence: 99%

“…It was found to be associated with the decreased amiloride-sensitive fraction, both being significantly lower in HAPE-prone individuals even at low altitude [26]. Chloride channels K (CLCNK), along with sodium channels are responsible for membrane potential stabilization and salt reabsorption in lungs [13]. Most of these channels along with transient receptor potential Ca 2+ and K + cation channels, are localized in caveolae.…”

Section: Evidences From Proteomicsmentioning

confidence: 99%

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High Altitude Pulmonary Edema: An Update on Omics Data and Redefining Susceptibility

Gangwar¹

2015

J Proteomics Bioinform

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“…This fluid shift can aggravate existing chronic conditions that compromise cardiac and pulmonary function. Carter et al 27 used quantitative measures of lung computed-tomographic density to identify anatomic correlates in individuals who were prone to IPE or high-altitude pulmonary edema (HAPE). They measured lung tissue density, total lung mass, and the thickness Figure 2.…”

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confidence: 99%

Pulmonary Aspects of Exercise and Sports

Bové

2016

Methodist DeBakey Cardiovascular Journal

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Although the lungs are a critical component of exercise performance, their response to exercise and other environmental stresses is often overlooked when evaluating pulmonary performance during high workloads. Exercise can produce capillary leakage, particularly when left atrial pressure increases related to left ventricular (LV) systolic or diastolic failure. Diastolic LV dysfunction that results in elevated left atrial pressure during exercise is particularly likely to result in pulmonary edema and capillary hemorrhage. Data from race horses, endurance athletes, and triathletes support the concept that the lungs can react to exercise and immersion stress with pulmonary edema and pulmonary hemorrhage. Immersion in water by swimmers and divers can also increase stress on pulmonary capillaries and result in pulmonary edema. Swimming-induced pulmonary edema and immersion pulmonary edema in scuba divers are well-documented events caused by the fluid shifts that occur with immersion, elevated pulmonary venous pressure during extreme exercise, and negative alveolar pressure due to inhalation resistance. Prevention strategies include avoiding extreme exercise, avoiding over hydration, and assuring that inspiratory resistance is minimized. Figure 1. Pulmonary capillary wedge pressure (PCWP) measured during increasing exercise intensity, determined by oxygen consumption (VO 2 ), in well-trained (circles) and average-trained (squares) men with a mean age of 29.6. Note that the well-trained subjects preserved normal levels of PCWP until they reached high levels of exercise, while the average-trained men demonstrated increases in PCWP at lower levels of exercise intensity. Adapted from Stickland et al. 4MDCVJ | XII (2) 2016 94 houstonmethodist.org/debakey-journal of interstitial hemorrhage and fluid accumulation following a high workload in one horse that developed EIPH. West et al. 9 suggested that two factors contributed to this problem in horses: (1) They were likely to have a congenital weakness of pulmonary capillaries that resulted in capillary rupture at high pulmonary venous and capillary pressure, and (2) they developed high pulmonary venous pressure due to failure of the left ventricle with subsequent elevation of LV end diastolic pressure during high workloads.Human studies of lung responses to high workloads 10 corroborate the studies of West et al. to some extent. Zavorsksy et al. 11 studied individuals under several different workloads and performed lung imaging to document the presence or absence of lung edema. Radiographic image readers were blinded to the exposures and reported visual evidence of lung fluid. In individuals undergoing a diagnostic graded exercise test, no evidence of lung edema was noted. However, 15% of individuals who ran on a treadmill at 70% of maximum capacity for 2 hours demonstrated evidence of pulmonary edema, as did 65% of those who ran at maximum capacity for 7 minutes. Similar findings were noted in female athletes.12 Pingitore et al. examined 48 athletes before and aft...

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Individual Susceptibility to High Altitude and Immersion Pulmonary Edema and Pulmonary Lymphatics

Cited by 17 publications

References 0 publications

Sports-related lung injury during breath-hold diving

Sports-related lung injury during breath-hold diving

High Altitude Pulmonary Edema: An Update on Omics Data and Redefining Susceptibility

Pulmonary Aspects of Exercise and Sports

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