Ventilatory responses to hypoxia and high altitude during sleep in Aconcagua climbers.

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 Med

authors

Snyder EM,Stepanek J,Bishop SL,Johnson BD

doi

10.1580/06-WEME-BR-041R.1

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

138-45

issue

2

eissn

1080-6032

issn

1545-1534

pii

1080-6032-18-2-138

journal_volume

18

pub_type

杂志文章
  • Effectiveness of a clinical protocol implemented to standardize snakebite management in Iran: initial evaluation.

    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

    authors: Monzavi SM,Salarian AA,Khoshdel AR,Dadpour B,Afshari R

    更新日期:2015-06-01 00:00:00

  • Physiological responses to graded acute normobaric hypoxia using an intermittent walking protocol.

    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

    authors: Richardson A,Twomey R,Watt P,Maxwell N

    更新日期:2008-01-01 00:00:00

  • Association of endothelial nitric oxide synthase (eNOS) G894T polymorphism with high altitude pulmonary edema susceptibility: a meta-analysis.

    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

    authors: Luo Y,Chen Y,Zhang Y,Zhou Q,Gao Y

    更新日期:2012-09-01 00:00:00

  • Clinical Features, Bacteriology, and Antibiotic Treatment Among Patients with Presumed Naja Bites in Vietnam.

    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

    authors: Ngo ND,Le QX,Pham AQ,Nguyen NT,Ha HT,Dinh MMQ,Le TQ

    更新日期:2020-06-01 00:00:00

  • Management of a wild boar wound: a case report.

    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

    authors: Kose O,Guler F,Baz AB,Akalin S,Turan A

    更新日期:2011-09-01 00:00:00

  • Planning for an annual episodic mass gathering: emergency department and clinic utilization in Yellowstone.

    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

    authors: Chang EC,Koval E,Freer L,Kraus S

    更新日期:2000-01-01 00:00:00

  • Developing Cricothyroidotomy Skills Using a Biomaterial-Covered Model.

    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

    authors: Ozkaya Senuren C,Yaylaci S,Kayayurt K,Aldinc H,Gun C,Şimşek P,Tatli O,Turkmen S

    更新日期:2020-09-01 00:00:00

  • Acute Interstitial Nephritis Following Snake Envenomation: A Single-Center Experience.

    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

    authors: Priyamvada PS,Shankar V,Srinivas BH,Rajesh NG,Parameswaran S

    更新日期:2016-06-01 00:00:00

  • Improvised Hydration Bladder Air Splint: A Wilderness Case Report.

    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

    authors: Hurt HF,Reilly AJ

    更新日期:2019-03-01 00:00:00

  • Risk of Burns During Active External Rewarming for Accidental Hypothermia.

    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

    authors: Giesbrecht GG,Walpoth BH

    更新日期:2019-12-01 00:00:00

  • High work output combined with high ambient temperatures caused heat exhaustion in a wildland firefighter despite high fluid intake.

    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

    authors: Cuddy JS,Ruby BC

    更新日期:2011-06-01 00:00:00

  • Cause of death in avalanche fatalities.

    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

    authors: McIntosh SE,Grissom CK,Olivares CR,Kim HS,Tremper B

    更新日期:2007-01-01 00:00:00

  • Piranha attacks on humans in southeast Brazil: epidemiology, natural history, and clinical treatment, with description of a bite outbreak.

    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

    authors: Haddad V Jr,Sazima I

    更新日期:2003-01-01 00:00:00

  • Crocodile attack in Australia: an analysis of its incidence and review of the pathology and management of crocodilian attacks in general.

    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

    authors: Caldicott DG,Croser D,Manolis C,Webb G,Britton A

    更新日期:2005-10-01 00:00:00

  • Work performance after dehydration: effects of physical conditioning and heat acclimatization. 1958.

    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

    authors: Buskirk ER,Iampietro PF,Bass DE

    更新日期:2000-10-01 00:00:00

  • Efficient breathing circuit for use at altitude.

    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

    authors: Pattinson KT,Somogyi RB,Fisher JA,Bradwell AR,Society the Birmingham Medical Research Expeditionary.

    更新日期:2005-07-01 00:00:00

  • Recurrent sagittal sinus thrombosis occurring at high altitude during expeditions to Cho Oyu.

    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

    authors: Skaiaa SC,Stave H

    更新日期:2006-07-01 00:00:00

  • Management of high altitude pulmonary edema in the Himalaya: a review of 56 cases presenting at Pheriche medical aid post (4240 m).

    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

    authors: Jones BE,Stokes S,McKenzie S,Nilles E,Stoddard GJ

    更新日期:2013-03-01 00:00:00

  • Junctional Hemorrhage Control for Tactical Combat Casualty Care.

    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

    authors: Kotwal RS,Butler FK Jr

    更新日期:2017-06-01 00:00:00

  • How to teach emergency procedural skills in an outdoor environment using low-fidelity simulation.

    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

    authors: Saxon KD,Kapadia AP,Juneja NS,Bassin BS

    更新日期:2014-03-01 00:00:00

  • Femoral Traction Splints in Mountain Rescue Prehospital Care: To Use or Not to Use? That Is the Question.

    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

    authors: Runcie H,Greene M

    更新日期:2015-09-01 00:00:00

  • Stroke at high altitude diagnosed in the field using portable ultrasound.

    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

    authors: Wilson MH,Levett DZ,Dhillon S,Mitchell K,Morgan J,Grocott MP,Imray C

    更新日期:2011-03-01 00:00:00

  • Induced Hypothermia to 4.2°C with Neurologically Intact Survival: A Forgotten Case Series.

    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

    authors: Zafren K,Paal P,Brugger H,Lechner R

    更新日期:2020-09-01 00:00:00

  • Efficacy of Topical Treatments for Chrysaora chinensis Species: A Human Model in Comparison with an In Vitro Model.

    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

    authors: DeClerck MP,Bailey Y,Craig D,Lin M,Auerbach LJ,Linney O,Morrison DE,Patry W,Auerbach PS

    更新日期:2016-03-01 00:00:00

  • Flush Drowning as a Cause of Whitewater Deaths.

    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

    authors: Farstad DJ,Luttrell JM

    更新日期:2020-03-01 00:00:00

  • Pulmonary embolism presenting as high-altitude pulmonary edema.

    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

    authors: Shlim DR,Papenfus K

    更新日期:1995-05-01 00:00:00

  • Physiological responses of ultraendurance athletes and nonathletes during an attempt to summit Denali.

    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

    authors: Seedhouse EL,Blaber AP

    更新日期:2005-01-01 00:00:00

  • Tolio: Foot Rot in Grand Canyon River Runners.

    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

    authors: Myers TM,Bigler CJ,Maurer MB,Gaither ME,Taylor WM

    更新日期:2020-03-01 00:00:00

  • Myocarditis and Early Markers of Cardiac Response Associated with Scorpion Stings in Children.

    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

    authors: Gökay SS,Kendir ÖT,Güllü UU,Nalbant T,Ekinci F,Matyar S,Ünal İ,Erdem S,Yildizdaş RD,Yilmaz HL

    更新日期:2018-12-01 00:00:00

  • Changes in vitamin status of Indian Antarctic expeditioners during a one-month stay in Austral Summer.

    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

    authors: Vats P,Singh SN,Singh VK,Shyam R,Upadhyay TN,Singh SB,Banerjee PK

    更新日期:2007-01-01 00:00:00