Counseling Patients with Chronic Obstructive Pulmonary Disease Traveling to High Altitude.

IF 1.6 4区 医学 Q4 BIOPHYSICS
High altitude medicine & biology Pub Date : 2023-09-01 Epub Date: 2023-08-30 DOI:10.1089/ham.2023.0053
Konrad E Bloch, Talant M Sooronbaev, Silvia Ulrich, Mona Lichtblau, Michael Furian
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Abstract

Bloch, Konrad E., Talant M. Sooronbaev, Silvia Ulrich, Mona Lichtblau, and Michael Furian. Clinician's corner: counseling patients with chronic obstructive pulmonary disease traveling to high altitude. High Alt Med Biol. 24:158-166, 2023.-Mountain travel is increasingly popular also among patients with chronic obstructive pulmonary disease (COPD), a highly prevalent condition often associated with cardiovascular and systemic manifestations. Recent studies have shown that nonhypercapnic and only mildly hypoxemic lowlanders with moderate to severe airflow obstruction owing to COPD experience dyspnea, exercise limitation, and sleep disturbances when traveling up to 3,100 m. Altitude-related adverse health effects (ARAHE) in patients with COPD include severe hypoxemia, which may be asymptomatic but expose patients to the risk of excessive systemic and pulmonary hypertension, cardiac arrhythmia, and even myocardial or cerebral ischemia. In addition, hypobaric hypoxia may impair postural control, psycho-motor, and cognitive performance in patients with COPD during altitude sojourns. Randomized, placebo-controlled trials have shown that preventive treatment with oxygen at night or with acetazolamide reduces the risk of ARAHE in patients with COPD while preventive dexamethasone treatment improves oxygenation and altitude-induced excessive sleep apnea, and lowers systemic and pulmonary artery pressure. This clinical review provides suggestions for pretravel assessment and preparations and measures during travel that may reduce the risk of ARAHE and contribute to pleasant mountain journeys of patients with COPD.

Abstract Image

Abstract Image

为前往高海拔地区的慢性阻塞性肺病患者提供咨询。
Bloch、Konrad E.、Talant M.Soolonbaev、Silvia Ulrich、Mona Lichtblau和Michael Furian。临床医生的角落:为前往高海拔地区的慢性阻塞性肺病患者提供咨询。High Alt-Med Biol.24:158-1662023。-山地旅行在慢性阻塞性肺病(COPD)患者中也越来越受欢迎,这是一种高度流行的疾病,通常与心血管和全身表现有关。最近的研究表明,非高碳酸血症和轻度低氧血症的低地人因COPD而出现中度至重度气流阻塞,在旅行至3100英里时会出现呼吸困难、运动受限和睡眠障碍 m.COPD患者的高原相关健康不良反应(ARAHE)包括严重低氧血症,这可能是无症状的,但会使患者面临过度全身和肺动脉高压、心律失常甚至心肌或脑缺血的风险。此外,低压缺氧可能会损害COPD患者在高原逗留期间的姿势控制、心理运动和认知能力。随机安慰剂对照试验表明,夜间用氧气或乙酰唑胺进行预防性治疗可以降低COPD患者患ARAHE的风险,而预防性地塞米松治疗可以改善氧合和海拔高度引起的过度睡眠呼吸暂停,并降低体动脉和肺动脉压。这篇临床综述为旅行前评估以及旅行期间的准备和措施提供了建议,这些建议可能会降低ARAHE的风险,并有助于COPD患者愉快的山地旅行。
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来源期刊
High altitude medicine & biology
High altitude medicine & biology 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
9.50%
发文量
44
审稿时长
>12 weeks
期刊介绍: High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.
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