1,177 results match your criteria Pulmonary Edema High-Altitude


Mitochondrial DNA mutations contribute to high altitude pulmonary edema via increased oxidative stress and metabolic reprogramming during hypobaric hypoxia.

Biochim Biophys Acta Bioenerg 2021 Apr 14;1862(8):148431. Epub 2021 Apr 14.

Defence Institute of Physiology and Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Lucknow Road, Timarpur, Delhi 110054, India.

High altitude pulmonary edema (HAPE) is experienced by non-acclimatized sea level individuals on exposure to high altitude hypoxic conditions. Available evidence suggests that genetic factors and perturbed mitochondrial redox status may play an important role in HAPE pathophysiology. However, the precise mechanism has not been fully understood. Read More

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High-Altitude Pulmonary Edema in Ohio at an Elevation of 339 Meters.

Open Access Emerg Med 2021 31;13:151-153. Epub 2021 Mar 31.

Department of Emergency Medicine, Mercy Health St. Elizabeth Boardman Hospital, Youngstown, OH, USA.

Background: HAPE (High-Altitude Pulmonary Edema) is a life-threatening form of high-altitude illness caused by noncardiogenic pulmonary edema. It has been most commonly reported in individuals who live at lower elevations and travel to elevations above 2500 m, typically in those who do so without any acclimatization. It can also occur in residents of high altitudes who descend to lower altitudes and then return to their native altitude without acclimatization. Read More

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Pulmonary hypertension is attenuated and ventilation-perfusion matching is maintained during chronic hypoxia in deer mice native to high altitude.

Am J Physiol Regul Integr Comp Physiol 2021 Apr 7. Epub 2021 Apr 7.

Department of Biology, McMaster University, Canada.

Hypoxia at high altitude can constrain metabolism and performance, and can elicit physiological adjustments that are deleterious to health and fitness. Hypoxic pulmonary hypertension is a particularly serious and maladaptive response to chronic hypoxia, which results from vasoconstriction and pathological remodeling of pulmonary arteries, and can lead to pulmonary edema and right ventricle hypertrophy. We investigated whether deer mice (Peromyscus maniculatus) native to high altitude have attenuated this maladaptive response to chronic hypoxia, and whether evolved changes or hypoxia-induced plasticity in pulmonary vasculature might impact ventilation-perfusion (V-Q) matching in chronic hypoxia. Read More

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Extravascular lung water and cardiac function assessed by echocardiography in healthy lowlanders during repeated very high-altitude exposure.

Int J Cardiol 2021 Jun 26;332:166-174. Epub 2021 Mar 26.

Department of Respiratory Medicine, University Hospital Zurich, Zurich, Switzerland. Electronic address:

Background: High-altitude pulmonary edema is associated with elevated systolic pulmonary artery pressure (sPAP) and increased extravascular lung water (EVLW). We investigated sPAP and EVLW during repeated exposures to high altitude (HA).

Methods: Healthy lowlanders underwent two identical 7-day HA-cycles, where subjects slept at 2900 m and spent 4-8 h daily at 5050 m, separated by a weeklong break at low altitude (LA). Read More

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Point-of-Care Ultrasound Diagnosis of Acute High Altitude Illness: A Case Report.

Wilderness Environ Med 2021 Mar 17. Epub 2021 Mar 17.

Department of Emergency Medicine, Liège University Hospital, Liège, Belgium.

With the advent of high-quality portable ultrasound machines, point-of-care ultrasound (POCUS) has gained interest as a promising diagnostic tool for patients with high altitude illness. Although POCUS is used successfully in hospital environments to detect interstitial pulmonary edema and increased intracranial pressure, the relationship between specific sonographic criteria and high altitude illness is still unclear. We report the case of a healthy 32-y-old male who developed acute respiratory distress and neurologic impairment at 4321 m while participating in a high altitude medical research expedition. Read More

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High-altitude pulmonary edema.

Evol Med Public Health 2021 6;9(1):118-119. Epub 2021 Jan 6.

Department of Emergency Medicine, University of New Mexico, Albuquerque, USA.

High Altitude Pulmonary Edema (HAPE) is a potentially fatal disease of altitude, in which the lungs can become filled with fluid. In this article we explore the mechanisms causing this condition and how it can be viewed as a condition of a mismatch between current environment and evolutionary experience. Read More

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January 2021

The Fundamentals of Respiratory Physiology to Manage the COVID-19 Pandemic: An Overview.

Front Physiol 2020 18;11:615690. Epub 2021 Feb 18.

EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.

The growing coronavirus disease (COVID-19) crisis has stressed worldwide healthcare systems probably as never before, requiring a tremendous increase of the capacity of intensive care units to handle the sharp rise of patients in critical situation. Since the dominant respiratory feature of COVID-19 is worsening arterial hypoxemia, eventually leading to acute respiratory distress syndrome (ARDS) promptly needing mechanical ventilation, a systematic recourse to intubation of every hypoxemic patient may be difficult to sustain in such peculiar context and may not be deemed appropriate for all patients. Then, it is essential that caregivers have a solid knowledge of physiological principles to properly interpret arterial oxygenation, to intubate at the satisfactory moment, to adequately manage mechanical ventilation, and, finally, to initiate ventilator weaning, as safely and as expeditiously as possible, in order to make it available for the next patient. Read More

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February 2021

Hypoxia-induced inflammation: Profiling the first 24-hour posthypoxic plasma and central nervous system changes.

PLoS One 2021 4;16(3):e0246681. Epub 2021 Mar 4.

Department of Ophthalmology, Stanford University, School of Medicine, Stanford, California, United States of America.

Central nervous system and visual dysfunction is an unfortunate consequence of systemic hypoxia in the setting of cardiopulmonary disease, including infection with SARS-CoV-2, high-altitude cerebral edema and retinopathy and other conditions. Hypoxia-induced inflammatory signaling may lead to retinal inflammation, gliosis and visual disturbances. We investigated the consequences of systemic hypoxia using serial retinal optical coherence tomography and by assessing the earliest changes within 24h after hypoxia by measuring a proteomics panel of 39 cytokines, chemokines and growth factors in the plasma and retina, as well as using retinal histology. Read More

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Quercetin: a savior of alveolar barrier integrity under hypoxic microenvironment.

Tissue Barriers 2021 Apr 26;9(2):1883963. Epub 2021 Feb 26.

Hematology Division, Defence Institute of Physiology and Allied Sciences, Lucknow Road, Timarpur Delhi-India.

High altitude pulmonary edema (HAPE) is generally characterized by the loss of alveolar epithelial barrier integrity. The current study was undertaken to assess the noninvasive approaches of HAPE diagnosis and to evaluate the prophylactic potential of quercetin in preventing alveolar junction impairments. Male SD rats fed with quercetin 1 h prior to hypoxia (7,620 m, for 6 h) were selected. Read More

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Severe Hypoxic Exercise Does Not Impair Lung Diffusion in Elite Swimmers.

High Alt Med Biol 2021 Mar 19;22(1):90-95. Epub 2021 Feb 19.

Secció de Fisiologia, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Barcelona, Spain.

García, Iker, Franchek Drobnic, Casimiro Javierre, Victoria Pons, and Ginés Viscor. Severe hypoxic exercise does not impair lung diffusion in elite swimmers. . Read More

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Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders.

Int J Environ Res Public Health 2021 02 10;18(4). Epub 2021 Feb 10.

Department of Internal Medicine, Excellence Cluster Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Justus Liebig University of Giessen, Aulweg 130, 35392 Giessen, Germany.

Alveolar hypoxia is the most prominent feature of high altitude environment with well-known consequences for the cardio-pulmonary system, including development of pulmonary hypertension. Pulmonary hypertension due to an exaggerated hypoxic pulmonary vasoconstriction contributes to high altitude pulmonary edema (HAPE), a life-threatening disorder, occurring at high altitudes in non-acclimatized healthy individuals. Despite a strong physiologic rationale for using vasodilators for prevention and treatment of HAPE, no systematic studies of their efficacy have been conducted to date. Read More

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February 2021

Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: A view from the High Andes.

Respir Physiol Neurobiol 2021 05 2;287:103628. Epub 2021 Feb 2.

High Altitude Pulmonary and Pathology Institute (HAPPI-IPPA), Av. Copacabana - Prolongación # 55, La Paz, Bolivia.

Background: Travelling to high altitude for entertainment or work is sometimes associated with acute high altitude pathologies. In the past, scientific literature from the lowlanders' point of view was mostly based on mountain climbing. Nowadays, descent is not mandatory in populated highland cities. Read More

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Novel formulation development from (Berk.) for management of high-altitude maladies.

3 Biotech 2021 Jan 2;11(1). Epub 2021 Jan 2.

Phyto Analytical Chemistry and Toxicology Division, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization (DRDO), Delhi, 110054 India.

(Berk.) is a fungus closely related to medicinal mushroom, which belongs to the family . It is a well-known and rich herbal source of bioactive active constituents. Read More

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January 2021

Validation of a Score for the Detection of Subjects with High Risk for Severe High-Altitude Illness.

Med Sci Sports Exerc 2021 06;53(6):1294-1302

Ospedale U. Parini-Azienda USL della Valle d'Aosta, Centro di Medicina e Neurologia di Montagna, Aosta, ITALY.

Purpose: A decision tree based on a clinicophysiological score (severe high-altitude illness (SHAI) score) has been developed to detect subjects susceptible to SHAI. We aimed to validate this decision tree, to rationalize the prescription of acetazolamide (ACZ), and to specify the rule for a progressive acclimatization.

Methods: Data were obtained from 641 subjects in 15 European medical centers before and during a sojourn at high altitude. Read More

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Altitude-Related Disorders on Mount Kilimanjaro, Tanzania: Two-Year Survey in a Local Referral Center.

Wilderness Environ Med 2021 Mar 9;32(1):36-40. Epub 2021 Jan 9.

Department of Medicine, Kilimanjaro Christian Medical Center, Moshi Kilimanjaro, United Republic of Tanzania.

Introduction: A significant number of climbers on Mount Kilimanjaro are affected by altitude-related disorders. The aim of this study was to determine the main causes of morbidity and mortality in a representative cohort of climbers based on local hospital records.

Methods: We conducted a 2-y retrospective chart review of all patients presenting to the main referral hospital in the region after a climb on Mount Kilimanjaro, including all relevant records and referrals for postmortem studies. Read More

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D4F prophylaxis enables redox and energy homeostasis while preventing inflammation during hypoxia exposure.

Biomed Pharmacother 2021 Jan 8;133:111083. Epub 2020 Dec 8.

Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India. Electronic address:

Apo-A1 is correlated with conditions like hyperlipidemia, cardiovascular diseases, high altitude pulmonary edema and etc. where hypoxia constitutes an important facet.Hypoxia causes oxidative stress, vaso-destructive and inflammatory outcomes. Read More

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January 2021

[Differential diagnosis of high altitude pulmonary edema and COVID-19 with computed tomography feature].

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2020 Dec;37(6):1031-1036

Department of Diagnostic Radiology, Xinjiang General Hospital of PLA, Urumqi 830000, P.R.China.

To investigate the computed tomography (CT) characteristics and differential diagnosis of high altitude pulmonary edema (HAPE) and COVID-19, CT findings of 52 cases of HAPE confirmed in Medical Station of Sanshili Barracks, PLA 950 Hospital from May 1, 2020 to May 30, 2020 were collected retrospectively. The size, number, location, distribution, density and morphology of the pulmonary lesions of these CT data were analyzed and compared with some already existed COVID-19 CT images which come from two files, "Radiological diagnosis of COVID-19: expert recommendation from the Chinese Society of Radiology (First edition)" and "A rapid advice guideline for the diagnosis and treatment of 2019 novel corona-virus (2019-nCoV) infected pneumonia (standard version)". The simple or multiple ground-glass opacity (GGO) lesions are located both in the HAPE and COVID-19 at the early stage, but only the thickening of interlobular septa, called "crazy paving pattern" belongs to COVID-19. Read More

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December 2020

Pericytes Within A Pulmonary Neurovascular Unit in Coronavirus Disease 2019 Elicited Pathological Changes.

Authors:
Zhen He

Curr Neurovasc Res 2020 ;17(5):784-792

Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR72079, United States.

A pericyte-centered theory suggesting that embolisms occurring within the microvasculature of a neurovascular unit that can result in either parenchymal hemorrhage or intravascular congestion is presented here. Dysfunctional microvascular pericytes are characterized by their location in the neurovascular unit, either on the arteriole or venule side. Pathophysiological and pathological changes caused by coronavirus disease 2019 (COVID-19) include pulmonary hypertension, edema, focal hemorrhage, microvascular congestion, and thrombosis. Read More

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A comprehensive review of histopathological findings of infections induced by COVID-19.

Cell Mol Biol (Noisy-le-grand) 2020 Oct 31;66(7):143-151. Epub 2020 Oct 31.

Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

The severe acute respiratory syndrome (SARS)-Coronavirus (CoV2) virus, first identified in Wuhan, China, caused the coronavirus disease 2019 (COVID-19) which soon became a global pandemic, as labelled by the World Health Organization (WHO). The transmission method of the infection is primarily through droplets of various sizes. The SARS-CoV2 virus leads to a severe respiratory illness which in the first place causes the simulation of the acute respiratory syndrome. Read More

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October 2020

Vascular homeostasis at high-altitude: role of genetic variants and transcription factors.

Pulm Circ 2020 Oct-Dec;10(4):2045894020913475. Epub 2020 Nov 19.

Genomics and Molecular Medicine, CSIR-Institute of Genomics and Integrative Biology, Delhi, India.

High-altitude pulmonary edema occurs most frequently in non-acclimatized low landers on exposure to altitude ≥2500 m. High-altitude pulmonary edema is a complex condition that involves perturbation of signaling pathways in vasoconstrictors, vasodilators, anti-diuretics, and vascular growth factors. Genetic variations are instrumental in regulating these pathways and evidence is accumulating for a role of epigenetic modification in hypoxic responses. Read More

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November 2020

Evaluation of Serial Chest Radiographs of High-Altitude Pulmonary Edema Requiring Medical Evacuation from South Pole Station, Antarctica: From Diagnosis to Recovery.

Mil Med 2020 Dec 3. Epub 2020 Dec 3.

Department of Emergency Medicine, University of California at Davis, Sacramento, CA 95817, USA.

Introduction: Chest radiography is a diagnostic tool commonly used by medical providers to assess high-altitude pulmonary edema (HAPE). Although HAPE often causes a pattern of pulmonary edema with right lower lung predominance, previous research has shown that there is no single radiographic finding associated with the condition. The majority of research involves a retrospective analysis of chest radiographs taken at the time of HAPE diagnosis. Read More

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December 2020

Might a high hemoglobin mass be involved in non-cardiogenic pulmonary edema? The case of the chronic maladaptation to high-altitude in the Andes.

Med Hypotheses 2021 Jan 24;146:110418. Epub 2020 Nov 24.

School of Biological Sciences & Engineering. Yachay Tech University, San Miguel de Urcuquí, Ecuador. Electronic address:

Exposure to hypoxic environments when ascending at high altitudes may cause life-threatening pulmonary edema (HAPE) due to a rapid accumulation of extracellular fluid flooding in the pulmonary alveoli. In Andeans, high-altitude adaptation occurs at the expense of being more prone to chronic mountain sickness: relative hypoventilation, excess pulmonary hypertension, and secondary polycythemia. Because HAPE prevalence is high in the Andes, we posit the hypothesis that a high hemoglobine mass may increase HAPE risk. Read More

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January 2021

High-altitude Illnesses and Air Travel: Pediatric Considerations.

Pediatr Clin North Am 2021 02;68(1):305-319

Pediatric Cardiology, Kardiozentrum, Obrajes, Calle 14 # 669, La Paz, Bolivia.

Healthy children may present acute mountain sickness (AMS) within a few hours after arrival at high altitudes. In few cases, serious complications may occur, including high-altitude pulmonary edema and rarely high-altitude cerebral edema. Those with preexisting conditions especially involving hypoxia and pulmonary hypertension shall not risk travelling to high altitudes. Read More

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February 2021

Point-of-Care Ultrasound Diagnosis of Community-Acquired Pneumonia in a High-Altitude, Resource-Poor Setting.

Prehosp Emerg Care 2020 Dec 18:1-5. Epub 2020 Dec 18.

Department of Emergency Medicine, Liège University Hospital, Liège, Belgium.

Point-of-care ultrasound (POCUS) for the evaluation of patients with suspected high-altitude pulmonary edema can be a useful tool in remote, high-altitude areas. The same technique can also yield high differential diagnostic accuracy for other relevant causes of acute respiratory distress at high altitude. With the recent development of high-quality, hand-held ultrasound devices, POCUS can be used with increasing reliability in such environments. Read More

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December 2020

Expression of Aquaporin-1 and Aquaporin-5 in a Rat Model of High-Altitude Pulmonary Edema and the Effect of Hyperbaric Oxygen Exposure.

Dose Response 2020 Oct-Dec;18(4):1559325820970821. Epub 2020 Oct 30.

Department of Rehabilitation Medicine, XinHua College, Sun Yat-Sen University, Guangzhou, China.

Objective: To investigate the therapeutic roles of hyperbaric oxygen exposure on high-altitude pulmonary edema and to determine whether aquaporin-1 and aquaporin-5 were involved in the pathogenesis of HAPE in rats.

Methods: Rats were divided into 5 groups: The control group, the HAPE group (HAPE model), the HBO group (hyperbaric oxygen exposure), the NBO group (normobaric oxygen exposure), and the NA group (normal air exposure). Western blot and real-time PCR were used to analyze the pulmonary expressions of AQP1 and AQP5. Read More

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October 2020

Pneumolysis and "Silent Hypoxemia" in COVID-19.

Indian J Clin Biochem 2020 Nov 9:1-5. Epub 2020 Nov 9.

High Altitude Pulmonary and Pathology Institute (IPPA), Av. Copacabana - Prolongación # 55, Teleféricos Celeste Y Blanco, Estación Av. Del Poeta, La Paz, Bolivia.

COVID-19 can evolve to a severe lung compromise with life-threatening hypoxemia. The mechanisms involved are not fully understood. Their understanding is crucial to improve the outcomes. Read More

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November 2020

Morbidity Among Athletes Presenting for Medical Care During 3 Iterations of an Ultratrail Race in the Himalayas.

Wilderness Environ Med 2020 Dec 7;31(4):437-440. Epub 2020 Nov 7.

MedStar Union Memorial Hospital/Mountain Medicine Society of Nepal, Kathmandu, Nepal.

Introduction: Although ultratrail races are increasing in popularity, there is a dearth of data regarding illnesses and medical care at these events. Data about injuries and illnesses for races taking place in the Himalayas, where the nearest medical facility can be hundreds of miles away, are even harder to find. This study aimed to describe the injuries and illnesses befalling the participants of a 7-stage 212 km (132 mi) trail race at high altitude. Read More

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December 2020

[Travelling to High Altitude Destinations after Recovery from COVID-19-infection: New Aspects of Medical Advice in Altitude Medicine].

Pneumologie 2021 Mar 5;75(3):214-220. Epub 2020 Nov 5.

Klinikum Bielefeld, Abteilung Anästhesiologie, operative Intensivmedizin, Notfallmedizin und Schmerztherapie, Bielefeld.

After loosening of travel restrictions due to the COVID-19 pandemic, tourism to high-altitude destinations over 2500 metres is expected to increase again.In line with this trend, it can be expected that patients after recovery from COVID-19 infection will seek advice from specialists on altitude or travel medicine before travelling to high altitudes.Here, the physician on altitude medicine is faced with major challenges, as such a question has not been raised so far. Read More

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The role of hypoxia-induced modulation of alveolar epithelial Na- transport in hypoxemia at high altitude.

Pulm Circ 2020 Jul-Sep;10(1 Suppl):50-58. Epub 2020 Oct 13.

Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany.

Reabsorption of excess alveolar fluid is driven by vectorial Na-transport across alveolar epithelium, which protects from alveolar flooding and facilitates gas exchange. Hypoxia inhibits Na-reabsorption in cultured cells and in-vivo by decreasing activity of epithelial Na-channels (ENaC), which impairs alveolar fluid clearance. Inhibition also occurs during in-vivo hypoxia in humans and laboratory animals. Read More

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October 2020

Differences in Tolerance to Hypoxia: Physiological, Biochemical, and Molecular-Biological Characteristics.

Biomedicines 2020 Oct 18;8(10). Epub 2020 Oct 18.

Department of Immunomorphology of Inflammation, Federal State Budgetary Institution 'Research Institute of Human Morphology', Moscow 117418, Russia.

Hypoxia plays an important role in the development of many infectious, inflammatory, and tumor diseases. The predisposition to such disorders is mostly provided by differences in basic tolerance to oxygen deficiency, which we discuss in this review. Except the direct exposure of different-severity hypoxia in decompression chambers or in highland conditions, there are no alternative methods for determining organism tolerance. Read More

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October 2020