title: Lung membrane conductance and capillary volume derived from the NO and CO transfer in high-altitude newcomers.
abstract: Acute exposure to high altitude may induce changes in carbon monoxide (CO) membrane conductance (DmCO) and capillary lung volume (Vc). Measurements were performed in 25 lowlanders at Brussels (D0), at 4,300 m after a 2- or 3-day exposure (D2,3) without preceding climbing, and 5 days later (D7,8), before and after an exercise test, under a trial with two arterial pulmonary vasodilators or a placebo. The nitric oxide (NO)/CO transfer method was used, assuming both infinite and finite values to the NO blood conductance (θNO). Doppler echocardiography provided hemodynamic data. Compared with sea level, lung diffusing capacity for CO increased by 24% at D2,3 and is returned to control at D7,8. The acute increase in lung diffusing capacity for CO resulted from increases in DmCO and Vc with finite and infinite θNO assumptions. The alveolar volume increased by 16% at D2,3 and normalized at D7,8. The mean increase in systolic arterial pulmonary pressure at rest at D2,3 was minimal. In conclusion, the acute increase in Vc may be related to the increase in alveolar volume and to the increase in capillary pressure. Compared with the infinite θNO value, the use of a finite θNO value led to about a twofold increase in DmCO value and to a persistent increase in DmCO at D7,8 compared with D0. After exercise, DmCO decreased slightly less in subjects treated by the vasodilators, suggesting a beneficial effect on interstitial edema.
authors.affiliation: Department of Pneumology, St. Elisabeth Hospital, Namur, Belgium. martinot.j@scarlet.be
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: Martinot
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mulè
authors.forename: Claire
authors.initials: C
authors.lastname: de Bisschop
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Overbeek
authors.forename: Nhat-Nam
authors.initials: NN
authors.lastname: Le-Dong
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
authors.forename: Hervé
authors.initials: H
authors.lastname: Guénard
mesh_terms: D000328:Adult; D000531:Altitude; D062186:Arterial Pressure / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001810:Blood Volume / Q000502:physiology*; D002196:Capillaries / Q000378:metabolism / Q000502:physiology*; D002248:Carbon Monoxide / Q000378:metabolism*; D004311:Double-Blind Method; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000378:metabolism / Q000502:physiology*; D009569:Nitric Oxide / Q000378:metabolism*; D011650:Pulmonary Alveoli / Q000098:blood supply / Q000378:metabolism / Q000502:physiology; D011652:Pulmonary Circulation / Q000502:physiology; D011653:Pulmonary Diffusing Capacity / Q000502:physiology; D012146:Rest / Q000502:physiology
chemical_list: D009569:Nitric Oxide; D002248:Carbon Monoxide
keywords: altitude; capillary volume; hypoxia; lung diffusion; membrane conductance; pulmonary capillary pressure; pulmonary hypertension