Abstract:
BACKGROUND/OBJECTIVE:We examined the changes in ventilation during sleep at high altitude using the LifeShirt monitoring system on 2 climbers who were attempting to summit Mount Aconcagua (6956 m). METHODS:Prior to the summit attempt, we measured cardiovascular and pulmonary function at 401 m (Rochester, MN) and gathered respiratory and cardiovascular data during sleep using the LifeShirt monitoring system with exposure to normobaric normoxia and normobaric hypoxia (simulated 4300 m). We then monitored the ventilatory response during sleep at 3 altitudes (4100 m, 4900 m, and 5900 m). RESULTS:During normoxic sleep, subjects had normal oxygen saturation (O(2sat)), heart rate (HR), respiratory rate (RR), tidal volume (V(T)) and minute ventilation (V(E)), and exhibited no periodic breathing (O(2sat) = 100 +/- 2%, HR = 67 +/- 1 beats/min, RR = 16 +/- 3 breaths/min, V(T) = 516 +/- 49 mL, and V(E) = 9 +/- 1 L/min, mean +/- SD). Sleep during simulated 4300 m caused a reduction in O(2sat), an increase in HR, RR, V(T), and V(E), and induced periodic breathing in both climbers (O(2sat) = 79 +/- 4%, HR = 72 +/- 14 beats/min, RR = 20 +/- 3 breaths/min, V(T) = 701 +/- 180 mL, and V(E) = 14 +/- 3 L/min). All 3 levels of altitude had profound effects on O(2sat), HR, and the ventilatory strategy during sleep (O(2sat) = 79 +/- 2, 70 +/- 8, 60 +/- 2%; HR = 70 +/- 12, 76 +/- 6, 80 +/- 3 beats/min; RR = 17 +/- 6, 18 +/- 4, 20 +/- 6 breaths/min; V(T) = 763 +/- 300, 771 +/- 152, 1145 +/- 123 mL; and V(E) = 13 +/- 1, 14 +/- 0, 22 +/- 4 L/min; for 4100 m, 4900 m, and 5900 m, respectively). There were strong negative correlations between O(2sat) and V(E) and ventilatory drive (V(T)/T(i), where T(i) is the inspiratory time) throughout the study. CONCLUSIONS:Interestingly, the changes in ventilatory response during simulated altitude and at comparable altitude on Aconcagua during the summit attempt were similar, suggesting reductions in FiO(2), rather than in pressure, alter this response.
journal_name
Wilderness Environ Medjournal_title
Wilderness & environmental medicineauthors
Snyder EM,Stepanek J,Bishop SL,Johnson BDdoi
10.1580/06-WEME-BR-041R.1subject
Has Abstractpub_date
2007-07-01 00:00:00pages
138-45issue
2eissn
1080-6032issn
1545-1534pii
1080-6032-18-2-138journal_volume
18pub_type
杂志文章abstract:OBJECTIVE:This study was designed to evaluate the effectiveness of a new protocol implemented to standardize snakebite management in Iran. METHODS:In this study, 27 patients treated according to the new protocol in 2012 (P+) were compared with 22 patients treated according to the previous modality in the year before i...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2014.09.011
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:The study aimed to examine the physiological responses to acute normobaric hypoxia during an intermittent walking protocol. METHODS:Twelve active healthy male participants completed a 125-minute test that involved rest and walking (50% VO(2max)) during normoxic (20.93%O(2)) and 2 hypoxic conditions (14%O(2) ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,随机对照试验
doi:10.1580/07-WEME-OR-143.1
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:High altitude pulmonary edema (HAPE) is a potentially deadly disease associated with exposure to altitudes greater than 3000 m. Individuals who have previously experienced HAPE are at a significantly higher risk of recurrence, suggesting an underlying genetic component to HAPE pathogenesis. In a previous nuc...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wem.2012.03.007
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:Clinical and bacteriological features of cobra (Naja) bites are still relatively unknown in Vietnam. This study aimed to characterize the clinical and bacteriological characteristics of local wounds in patients with presumed Naja spp bite, as well as their antibiotic treatment. METHODS:A cross-sectional s...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.01.002
更新日期:2020-06-01 00:00:00
abstract::Injuries caused by wild boar attacks are rare. A 34-year-old male shepherd sustained injuries caused by a wild boar attack, and was brought to our emergency department. The patient had 2 skin and deep tissue lacerations on the posterior aspect of his thigh. Herein, we discuss the clinical management of a wild boar bit...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2011.06.005
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Planning and providing emergency and primary care for a large transient population of visitors and employees in a national park can be problematic. Furthermore, planning for emergency and primary health care needs of visitors and itinerant workers in a wilderness area national park has not been well documente...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2000)011[0257:pfaaem]2.3.co;2
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:Cricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. METHODS:This st...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2020.05.003
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:To identify the clinical and histopathological characteristics of patients who develop acute interstitial nephritis (AIN) following snake envenomation. METHODS:A retrospective analysis of patients diagnosed with snake envenomation-induced AIN from October 2013 to November 2014. RESULTS:After snake envenoma...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2015.12.009
更新日期:2016-06-01 00:00:00
abstract::This case report describes the use of a hydration bladder as an improvised air splint for a left forearm fracture in an austere environment. The literature regarding the use of air splints in the prehospital and wilderness environments is scarce, and it does not appear that this technique has been previously described...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.10.008
更新日期:2019-03-01 00:00:00
abstract::This article describes 3 incidents in which therapeutic or experimental warming of cold individuals caused first- to third-degree burns to the skin. Mechanisms for these injuries are considered. We conclude that active external rewarming of the trunk of a cold patient in the field can be administered safely and burn r...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.06.005
更新日期:2019-12-01 00:00:00
abstract::The purpose of this case study is to examine the physiological/behavioral factors leading up to heat exhaustion in a male wildland firefighter during wildland fire suppression. The participant (24 years old, 173 cm, 70 kg, and 3 years firefighting experience) experienced heat exhaustion following 7 hours of high ambie...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2011.01.008
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:Avalanches pose a life-threatening risk to participants of outdoor winter activities. Determining the causes of death in avalanche fatalities can aid rescue and resuscitation strategies and hopefully improve survival. METHODS:The study population included all avalanche fatalities in Utah from the 1989-90 to ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/07-WEME-OR-092R1.1
更新日期:2007-01-01 00:00:00
abstract::There are many tales describing ferocious schools of piranha attacking humans, but there are few scientific data supporting such behavior. The very few documented instances of humans attacked and eaten by piranha schools include 3 that occurred after death by other causes (eg, heart failure and drowning). These predac...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2003)14[249:paohis]2.0.co;2
更新日期:2003-01-01 00:00:00
abstract::Crocodilians represent one of the oldest constant animal lineages on the planet, in no small part due to their formidable array of predatory adaptations. As both human and crocodilian populations expand, they increasingly encroach on each others' territories, bringing morbidity and mortality to both populations. In th...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,评审
doi:10.1580/1080-6032(2005)16[143:CAIAAA]2.0.CO;2
更新日期:2005-10-01 00:00:00
abstract::Three groups of five men each were dehydrated overnight in the heat (115 degrees F) on two occasions (D1 and D2) to approximately 5.5% of their starting body weight. During the 3-week period between D1 and D2, one group (AC) was acclimatized to heat and physically conditioned, the second group (C) was physically condi...
journal_title:Wilderness & environmental medicine
pub_type: 传,古典文章,历史文章,杂志文章
doi:10.1580/1080-6032(2000)011[0204:wpadeo]2.3.co;2
更新日期:2000-10-01 00:00:00
abstract::We describe a case report of a subject suffering high-altitude cerebral and pulmonary edema successfully treated with low flow rates of supplemental oxygen administered with a breathing system designed to conserve oxygen supplies at high altitude. ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/pr08-04.1
更新日期:2005-07-01 00:00:00
abstract::We report the case of a previously healthy 32-year-old man presenting with severe headache on 2 separate expeditions to Cho Oyu (8201 m). No brain imaging was performed after the first expedition. On the second expedition, thrombosis of the superior sagittal sinus was detected. Investigations for hypercoagulable state...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/pr19-04.1
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to review the patient characteristics and management of 56 cases of high altitude pulmonary edema at the Pheriche Himalayan Rescue Association Medical Aid Post, and to measure the use of medications in addition to descent and oxygen. METHODS:In a retrospective case series, we re...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2012.07.004
更新日期:2013-03-01 00:00:00
abstract::During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,评审
doi:10.1016/j.wem.2016.11.007
更新日期:2017-06-01 00:00:00
abstract::Teaching emergency procedural skills in a wilderness setting can be logistically challenging. To teach these skills as part of a wilderness medicine elective for medical students, we designed an outdoor simulation session with low-fidelity models. The session involved 6 stations in which procedural skills were taught ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2013.11.001
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To determine the incidence of femur fractures in mountain rescue in England and Wales. To investigate the attitudes of rescuers toward the use of femoral traction splints. To review the literature for evidence on the use of traction splints in prehospital medicine and test the hypothesis that femoral tractio...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2015.01.006
更新日期:2015-09-01 00:00:00
abstract::A tool that can differentiate ischemic stroke from other neurological conditions (eg, hemorrhagic stroke, high-altitude cerebral edema) in the field could enable more rapid thrombolysis when appropriate. The resources (eg, an MRI or CT scanner) to investigate stroke at high altitude may be limited, and hence a portabl...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2010.10.007
更新日期:2011-03-01 00:00:00
abstract::The lowest recorded core temperature from which a person with accidental hypothermia has survived neurologically intact is 11.8°C in a 2-y-old boy. The lowest recorded temperature from which an adult has been resuscitated neurologically intact is 13.7°C in a 29-y-old woman. The lowest core temperature with survival fr...
journal_title:Wilderness & environmental medicine
pub_type: 历史文章,杂志文章
doi:10.1016/j.wem.2020.02.003
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:This study sought to create a model for testing topical treatment of jellyfish stings. It sought to determine which treatments 1) stimulate/inhibit nematocyst discharge; 2) decrease pain; and 3) decrease skin inflammation; it also sought to discover whether there is a clinical correlation between stimulated ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wem.2015.10.008
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Most recreational whitewater fatalities are caused by fixed underwater entrapment or by "flush drowning," an obscure term frequently associated with high-volume rivers, continuous rapids, cold water, and a lack of prolonged underwater entrapment. Although entrapment drowning is typically associated with su...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.09.006
更新日期:2020-03-01 00:00:00
abstract::High-altitude pulmonary edema (HAPE) is a recognized risk of rapid ascent to high altitude. Since the recognition of this entity more than 30 years ago, most pulmonary deaths at high altitude have been attributed to HAPE. However, as the bodies can almost never be recovered for postmortem examination, rare diagnoses t...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(1995)006[0220:pepaha]2.3.co;2
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:To compare altitude responses of 2 ultraendurance athletes and 2 nonathletes during a 2-week expedition on Denali (Mount McKinley). METHODS:The severity of acute mountain sickness (AMS) symptoms (Lake Louise AMS guidelines) and pulmonary function parameters (forced vital capacity, forced expiratory volume in...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/1080-6032(2005)16[198:prouaa]2.0.co;2
更新日期:2005-01-01 00:00:00
abstract::Treating skin disorders in wilderness settings is often challenging. In this report we describe common skin conditions affecting the feet of river runners on the Colorado River in Grand Canyon National Park. These conditions are frequently referred to by river runners with a catchall term, "tolio." Several skin disord...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2019.09.003
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:A clinical course ranging from mild local findings to life-threatening systemic findings may occur after scorpion stings. The purpose of this study was to identify priority markers indicating scorpion sting-related cardiac involvement. METHODS:Our study was performed between July 2014, and September 2015 ...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1016/j.wem.2018.06.013
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Antarctic expeditioners face extremes of environmental conditions along with isolation which affect normal human activity at a polar station. Diets of polar expeditioners consist of products that have been kept in storage for more than a year. Processing and preservation adversely affect the nutritive value o...
journal_title:Wilderness & environmental medicine
pub_type: 杂志文章
doi:10.1580/06-WEME-OR-004R3.1
更新日期:2007-01-01 00:00:00