Monitoring of expiratory flow rates and lung volumes during a high altitude expedition.
BACKGROUND
Data on lung volumes and changes in flow-volume spirometry at high altitude are few and do not provide comprehensive assessment of the occurring changes. This study characterizes alterations of the forced expiratory flow-volume curve (FEFV-curve) and lung volumes at increasing altitude.


METHODS
FEFV-curve and lung volumes at increasing altitude were characterized by daily assessment of peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and maximal expiratory flow rates (MEF 25, 50, 75) at 25%, 50% and 75% of the FEFV-curve with a portable spirometer (turbinometric method) three times a day during an expedition to Mustagh Ata (7545m) in 15 healthy mountaineers.


RESULTS
With increasing altitude FVC and FEV1 were reduced by up to 25% (74.8% / 74.6% of baseline) and MEF25 was reduced to 81.5% of baseline values. PEF initially increased up to 4451m and returned to baseline values above 5000m. After descent below 2000m, all values normalized within one day. There were weak negative correlations between AMSS and FEV1, FVC and PEF (r = -0.23, p<0.001).


CONCLUSIONS
We found increasing pulmonary restriction at high altitude without a marked reduction of PEF. Assessment of the FEFV-curve at high altitudes with a portable spirometer is a practical method reflecting the true field situation and may provide clinically relevant information (impending pulmonary edema).
Fischer
R
R
Department of Medicine, Division of Pneumology, Medizinische Klinik Innenstadt, LMU Munich, Ziemssenstrasse 1, D-80336 Munich, Germany. rainald.fischer@med.uni-muenchen.de
Lang
S M
SM
Bergner
A
A
Huber
R M
RM
D000328:Adult; D000531:Altitude; D000532:Altitude Sickness / Q000503:physiopathology; D000704:Analysis of Variance; D015992:Body Mass Index; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008168:Lung / Q000502:physiology*; D008297:Male; D008448:Maximal Expiratory Flow Rate; D008875:Middle Aged; D009051:Mountaineering / Q000502:physiology*; D015999:Multivariate Analysis; D013147:Spirometry / Q000295:instrumentation*; D013997:Time Factors; D014797:Vital Capacity