Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Variables Influencing the Pressure and Volume of the Pulmonary Circulation as Risk Factors for Developing High Altitude Pulmonary Edema (HAPE)

Thomas Küpper
* ORCID logo ,
Christian Apel
,
Daniela Bertsch
,
Michael Van der Giet
,
Simone Van der Giet
,
Maren Graß
,
Carina Gschwandtl
,
Nikole Heussen
ORCID logo ,
Christian Kühn
,
Miriam Hundt
,
Julia Risse
,
Sonja Schmitz
,
Lisa Timmermann
,
Knut Wernitz
,
Ulf Gieseler
,
Audry Morrison
,
Nina Hundt
Version 1 : Received: 25 August 2022 / Approved: 30 August 2022 / Online: 30 August 2022 (03:18:35 CEST)

A peer-reviewed article of this Preprint also exists.

Hundt, N.; Apel, C.; Bertsch, D.; Cerfontaine, C.; van der Giet, M.; van der Giet, S.; Graß, M.; Haunolder, M.; Heussen, N.M.; Jäger, J.; Kühn, C.; Morrison, A.; Museo, S.; Timmermann, L.; Wernitz, K.; Gieseler, U.; Küpper, T. Variables Influencing the Pressure and Volume of the Pulmonary Circulation as Risk Factors for Developing High Altitude Pulmonary Edema (HAPE). Int. J. Environ. Res. Public Health 2022, 19, 13887. Hundt, N.; Apel, C.; Bertsch, D.; Cerfontaine, C.; van der Giet, M.; van der Giet, S.; Graß, M.; Haunolder, M.; Heussen, N.M.; Jäger, J.; Kühn, C.; Morrison, A.; Museo, S.; Timmermann, L.; Wernitz, K.; Gieseler, U.; Küpper, T. Variables Influencing the Pressure and Volume of the Pulmonary Circulation as Risk Factors for Developing High Altitude Pulmonary Edema (HAPE). Int. J. Environ. Res. Public Health 2022, 19, 13887.

Abstract

Background: At altitudes beyond 2500 m the risk of developing high altitude pulmonary edema (HAPE) grows with the increases in pulmonary arterial pressure. HAPE is characterized by severe pulmonary hypertension, though the incidence and relevance of individual risk factors are not yet predictable. However, the systolic pulmonary pressure (SPAP) and peak in tricuspid regurgitation velocity (TVR) are crucial factors when diagnosing pulmonary hypertension by echocardiography. Methods: The SPAP and TVR of 27 trekkers aged 20-65 years en route in the Solu Khumbu region of Nepal was assessed. Echocardiograph measurements were performed at Lukla (2,860 m), Gorak Shep (5170 m), and the summit of Kala Patthar (5,675 m). The altitude profile and the participant’s characteristics were also compiled for correlation with the measured data. Results: The results showed a highly significant increase of SPAP and TVR after ascending Kala Patthar. The study revealed a lower increase of SPAP and TVR in the group of older participants, although the initial respective measurements in Gorak Shep were significantly higher for this group. A similar finding occurred in those using Diamox® as prophylaxis. There was an inverse relationship between TVR and SPAP, the peripheral capillary oxygen saturation and heart rate. Conclusions: The echocardiograph results indicate that older people are a risk group for developing a HAPE. The prophylactic use of acetazolamid led to higher initial SPAP values in Gorak Shep, and a lower increase of SPAP as well as TRV after ascending Kala Patthar. Arterial oxygen saturation measurements can provide an indicator for the self-assessment for the risk of developing HAPE and provide a rule of thumb for the altitude profile but does not replace a HAPE diagnosis. The collected data variables concerning backpack weight, sex, workload (actual ascent speed), and pre-existing diseases were not statistically significant factors related to SPAP and TVR (p=<0.05).

Keywords

HAPE; risk factors; echocardiography; pulmonary pressure; workload

Subject

Medicine and Pharmacology, Pulmonary and Respiratory Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.