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ARDS at high altitudes

Pratap Karki, Anna A Birukova
The maintenance of endothelial barrier integrity is absolutely essential to prevent the vascular leak associated with pneumonia, pulmonary edema resulting from inhalation of toxins, acute elevation to high altitude, traumatic and septic lung injury, acute lung injury (ALI), and its life-threatening complication, acute respiratory distress syndrome (ARDS). In addition to the long-known edemagenic and inflammatory agonists, emerging evidences suggest that factors of endothelial cell (EC) mechanical microenvironment such as blood flow, mechanical strain of the vessel, or extracellular matrix stiffness also play an essential role in the control of endothelial permeability and inflammation...
April 2018: Pulmonary Circulation
Wen-xin Wang, Bo Xu, Hu-sai Ma, Jian-bin Meng
OBJECTIVE: To assess the effect of prone position on the oxygenation of patients with acute respiratory distress syndrome (ARDS) after recruitment maneuvers (RM) failure at high altitudes. METHODS: Forty-one ARDS patients who were invalid for RM therapy at the altitude of 2260 metres area hospital were enrolled[mean oxygenation index (PaO(2)/FiO(2)) increased than RM<20% considered as RM invalid]. All were divided into acute respiratory distress syndrome (ARDSp) and extra-acute respiratory distress syndrome (ARDSexp) based on different etiology, and each group was randomly divided into the supine and the prone position group, i...
October 2012: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
R Khiaosa-Ard, C R Soliva, M Kreuzer, F Leiber
Alpine forages are assumed to have specific effects on ruminal digestion when fed to cattle. These effects were investigated in an experiment from two perspectives, either by using such forages as a substrate for incubation or as feed for a rumen fluid donor cow. In total, six 24-h in vitro batch culture runs were performed. Rumen fluid was collected from a non-lactating donor cow after having grazed pastures at ∼2000 m above sea level for 2, 6 and 10 weeks. These 'alpine runs' were compared with three lowland samplings from before and 2 and 6 weeks after the alpine grazing where a silage-concentrate mix was fed...
November 2012: Animal: An International Journal of Animal Bioscience
Laura A Dada, Jacob I Sznajder
Alveolar hypoxia occurs during ascent to high altitude and is also observed in patients with ARDS and acute hypoxemic respiratory failure, in which alveolar flooding is associated with a decrease in edema fluid clearance and increased mortality. The mechanisms that lead to the impairment of alveolar fluid clearance are not completely understood. Alveolar fluid reabsorption is accomplished mostly by active Na+ transport across the alveolar epithelium which creates an osmotic gradient responsible for the clearance of lung edema from the alveolar spaces...
2007: Advances in Experimental Medicine and Biology
Shi-fan Zhang, De-hai Zhang, Hui-ping Liu, Wei Gao, Xiao-hong Luo, Jian-ying Wu, Shu-xin Lin, Chuan-lan Liu, Xian-ying Zhang, Tian-duo Chen
OBJECTIVE: To compare the diagnostic parameters of acute respiratory distress syndrome/multiple organ dysfunction syndrome (ARDS/MODS) at high altitude (H-ARDS/MODS) with that on plain, and to establish a more practical diagnostic criterion of H-ARDS/MODS. METHODS: Five hundred and five cases fulfilled the criteria for the diagnosis of ARDS/MODS were divided into three groups according to the altitude of their habitation: control group including inhabitants (<430 m) on plain (CG, n=113), moderate high altitude group 1 inhabitants at the altitude of 1,517 m (H1G, n=314), moderate high altitude group 2 inhabitants at the altitude of 2,261 m to 2,400 m (H2G, n=78)...
April 2005: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
J R Pérez-Padilla
The ratio of PaO2 to the fraction of inspired oxygen (PaO2/FIO2) is commonly used to determine the severity of acute lung injury and acute respiratory distress syndrome (ARDS). The research presented here used computational models of the lung to analyze the effect of altitude on the PaO2/FIO2 ratio and pulmonary shunt. At a given shunt, the PaO2/FIO2 ratio is lower at higher altitudes. Therefore, when evaluating for ARDS based on a PaO2/FIO2 ratio of <200 mm Hg, patients residing at high altitudes will have less shunt and, presumably, less severe lung injury than patients at sea level...
October 2004: Archivos de Bronconeumología
Shi-fan Zhang, De-hai Zhang, Hui-ping Liu, Ga Da, Wei Gao, Shu-xin Lin, Tian-duo Chen, Fen-xue Liu, Chuan-lan Liu
OBJECTIVE: To compare the difference of the diagnostic parameters of acute respiratory distress syndrome/multiple organ dysfunction syndrome (ARDS/MODS) at high altitude (H-ARDS/MODS) with that on plains and reevaluate the practicality and feasibility of the diagnostic criteria of H-ARDS (Lanzhou conference, 1999). METHODS: Three hundred and sixty cases with relatively complete data were divided into three groups according to their originating altitude: control group on plains (CG, n=93), high altitude group 1 at the altitude of 1,517 m (H1G, n=223), high altitude group 2 at the altitude of 2,261-2,400 m (H2G, n=44)...
March 2003: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
E N G Vinhaes, M Dolhnikoff, P H N Saldiva
Carotid bodies are chemoreceptors sensitive to a fall of partial oxygen pressure in blood (hypoxia). The morphological alterations of these organs in patients with chronic obstructive pulmonary disease (COPD) and in people living at high altitude are well known. However, it is not known whether the histological profile of human carotid bodies is changed in acute clinical conditions such as acute respiratory distress syndrome (ARDS). The objective of the present study was to perform a quantitative analysis of the histology of carotid bodies collected from patients who died of ARDS...
October 2002: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
S F Zhang, S X Lin, W Gao, H P Liu, Y Liu, D H Zhang, T D Chen, Y M Guo, Y X Huang
China is a mountainous country. The Qing-Zang plateau, Yun-Gui plateau, and Yellow Land plateau, which are known as the world's ridge, are located in the west of China. The highland area over 3,000 m in height occupies one-sixth of the land area of China and half the highland area of the world. About 60-80 million people live in the regions where the elevation ranges from 1,500 m to 4,000 m. In the latter half of the last century, the influence of complex environmental factors on the human body, such as low oxygen pressure, cold climate, strong radiation, high wind speed, and super-evaporation, were studied in an extensive and profound way and formed an important field of altitude medicine...
September 2001: Intensive Care Medicine
K Kubo, M Hanaoka, S Yamaguchi, T Hayano, M Hayasaka, T Koizumi, K Fujimoto, T Kobayashi, T Honda
BACKGROUND: The precise mechanism of high altitude pulmonary oedema (HAPE) remains unclear. The purpose of this study was to evaluate the role of cytokines and P-selectin in the development of HAPE which occurred at moderate altitude in Japan. METHODS: The following cellular and biochemical markers and chemotactic cytokines were measured in the bronchoalveolar (BAL) fluid from four patients with HAPE at 2857-3180 m in the Japanese Alps: total proteins, albumin, lactate dehydrogenase (LDH), and interleukin (IL)-1 alpha, IL-1 beta, IL-1 receptor antagonist (ra), IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-alpha, and the soluble form of P-selectin...
July 1996: Thorax
L Nie, Z Gao, Y Li
The changes in arterial blood gas were observed and analysed in twenty-seven burned patients at high altitude. It was showed that a serious hypoxemia existed in burn patients, both in survivors and dead cases, and that hypoxemia occurred earlier in the cases with inhalation injury or dead cases than without inhalation injury. These results suggest that patients with inhalation injury should undergo tracheostomy as early as possible to ensure oxygen supply, and patients without inhalation injury should be give oxygen therapy routinely...
January 1996: Chinese Journal of Plastic Surgery and Burns
F León-Velarde, A Arregui, M Vargas, L Huicho, R Acosta
To determine whether chronic lower respiratory tract disorders contributed to the development of chronic mountain sickness (CMS), we compared hemoglobin (Hb), oxygen saturation (SaO2), peak expiratory flow rate (PEFR), and CMS scores (CMSsco) in 97 normal men at high altitude with those of men at high altitude with acute (ARD; n = 12), chronic upper (CURD; n = 33), and chronic lower (CLRD; n = 34) respiratory diseases. The clinical diagnosis of the different types of respiratory disorders was based on the results of a questionnaire and physical examination performed during an epidemiologic study...
July 1994: Chest
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