Lung fluid movements in hypoxia.
Pulmonary edema is a problem of major clinical importance resulting from a persistent imbalance between forces that drive water into the airspace of the lung and the biological mechanisms for its removal. Here, we will first review the fundamental mechanisms implicated in the regulation of lung fluid homeostasis, namely, the Starling forces and the respiratory transepithelial sodium transport. Second, we will discuss the contribution of hypoxia to the perturbation of this fine balance and the role of such perturbations in the development of high-altitude pulmonary edema, a disease characterized by a very high morbidity and mortality. Finally, we will review possible interventions aimed to maintain/restore lung fluid homeostasis and their importance for the prevention/treatment of pulmonary edema.
Sartori
Claudio
C
Department of Internal Medicine and the Botnar Center for Extreme Medicine, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland. claudio.sartori@chuv.ch <claudio.sartori@chuv.ch>
Rimoldi
Stefano F
SF
Scherrer
Urs
U
D000531:Altitude; D000532:Altitude Sickness / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000378:metabolism*; D045604:Extracellular Fluid / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D000860:Hypoxia / Q000378:metabolism*; D011650:Pulmonary Alveoli / Q000378:metabolism; D011654:Pulmonary Edema / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control; D012128:Respiratory Distress Syndrome / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control; D012964:Sodium / Q000378:metabolism; D015222:Sodium Channels / Q000096:biosynthesis; D014661:Vasoconstriction; D014882:Water-Electrolyte Balance
D015222:Sodium Channels; D012964:Sodium