Frequent subclinical high-altitude pulmonary edema detected by chest sonography as ultrasound lung comets in recreational climbers

Critical Care Medicine

Volumn 38, Issue 9, 2010, Pages 1818-1823

  Pratali, Lorenza ^a   Cavana, Marco ^b   Sicari, Rosa ^a   Picano, Eugenio ^a  

^a INSTITUTE OF CLINICAL PHYSIOLOGY   (Italy)

^b U B Rianimazione e Ambulatorio Medicina di Montagna   (Italy)

Author keywords

echocardiography; high altitude pulmonary edema; hypoxia; pressure; ultrasound lung comets

Indexed keywords

ADULT; ALTITUDE DISEASE; ARTICLE; CLINICAL ARTICLE; FEMALE; HEART RIGHT VENTRICLE FUNCTION; HEMODYNAMIC MONITORING; HUMAN; LUNG EDEMA; LUNG SCINTISCANNING; MALE; OXIMETRY; OXYGEN SATURATION; PRIORITY JOURNAL; PULMONARY ARTERY; SEA LEVEL; SYSTOLIC BLOOD PRESSURE; ALTITUDE; ECHOGRAPHY; MIDDLE AGED; MOUNTAINEERING; NEPAL; RECREATION; THORAX;

ADULT; ALTITUDE; FEMALE; HUMANS; MALE; MIDDLE AGED; MOUNTAINEERING; NEPAL; PULMONARY EDEMA; RECREATION; THORAX;

EID: 77956230744     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3181e8ae0e     Document Type: Article

References (40)

1. Moore LG, Niermeyer S, Zamudio S: Human adaptation to high altitude: Regional and life-cycle perspectives. Am J Phys Anthropol 1998; Suppl 27:25-64.
2. West JB, Readhead A: Working at high altitude: Medical problems, misconceptions, and solutions. Observatory 2004; 124:1-14.
3. Richalet JP, Donoso MV, Jiménez D, et al: Chilean miners commuting from sea level to 4500 m: A prospective study. High Alt Med Biol 2002; 3:159-166.
4. Hultgren HN, Honigman B, Theis K, et al: High-altitude pulmonary edema at a ski resort. West J Med 1996; 164:222-227.
5. Hackett PH, Roach RC: High-altitude illness. N Engl J Med 2001; 345:107-114.
6. Cremona G, Asnaghi R, Baderna P, et al: Pulmonary extravascular fluid accumulation in recreational climbers: A prospective study. Lancet 2002; 359:303-309.
7. Picano E, Frassi F, Agricola E, et al: Ultrasound lung comets: A clinically useful sign of extravascular lung water. J Am Soc Echocardiogr 2006; 19:356-363.
8. Jambrik Z, Monti S, Coppola V, et al: Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 2004; 93:1265-1270.
9. Agricola E, Bove T, Oppizzi M, et al: 'Ultrasound comet-tail images': A marker of pulmonary edema: A comparative study with wedge pressure and extravascular lung water. Chest 2005; 127:1690-1695.
10. Lichtenstein D, Mézière G, Biderman P, et al: The comet-tail artifact: an ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997; 158:1640-1646.
11. Frassi F, Pingitore A, Cialoni D, et al: Chest sonography detects lung water accumulation in healthy elite apnea divers. J Am Soc Echocardiogr 2008; 10:1150-1155.
12. Fagenholz PJ, Gutman JA, Murray AF, et al: Chest ultrasonography for the diagnosis and monitoring of high-altitude pulmonary edema. Chest 2007; 131:1013-1018.
13. Roach RC, Bartsch P, Hackett PH, et al: Lake Louise AMS Scoring Consensus Committee. The Lake Louise acute mountain sickness scoring system. In: Hypoxia and Molecular medicine. Sutton JR, Houston CS, Coates (G) (Eds.) Burlington, VT, Queen City Printers, 1993, pp 272-274.
14. Ballo P, Bocelli A, Motto A, et al: Concordance between M-mode, pulsed tissue Doppler, and colour tissue Doppler in the assessment of mitral annulus systolic excursion in normal subjects. Eur J Echocardiogr 2008; 9:748-753.
15. Tamborini G, Pepi M, Galli CA, et al: Feasibility and accuracy of a routine echocardiographic assessment of right ventricular function. Int J Cardiol 2007; 115:86-89.
16. Lang RM, Bierig M, Devereux RB, et al; Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography: Recommendations for chamber quantitation: A report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantitation Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18:1440-1463.
17. Gargani L, Doveri M, D'Errico L, et al: Ultrasound lung comets in systemic sclerosis: A chest sonography hallmark of pulmonary interstitial fibrosis. Rheumatology 2009; 48: 1382-1387.
18. Frassi F, Gargani L, Gligorova S, et al: Clinical and echocardiographic determinants of ultrasound lung comets. Eur J Echocardiogr 2007; 8:474-479.
19. Agricola E, Picano E, Oppizzi M, et al: Assessment of stress-induced pulmonary interstitial edema by chest ultrasound during exercise echocardiography and its correlation with left ventricular function. J Am Soc Echocardiogr 2006; 19:457-463.
20. Bedetti G, Gargani L, Corbisiero A, et al: Evaluation of ultrasound lung comets by hand-held echocardiography. Cardiovasc Ultrasound 2006; 4:34.
21. Frassi F, Gargani L, Tesorio P, et al: Prognostic value of extravascular lung water assessed with ultrasound lung comets by chest sonography in patients with dyspnea and/or chest pain. J Card Fail 2007; 13: 830-835.
22. Gargani L, Frassi F, Soldati G, et al: Ultrasound lung comets for the differential diagnosis of acute cardiogenic dyspnoea: A comparison with natriuretic peptides. Eur J Heart Fail 2008; 10:70-77.
23. Gargani L, Lionetti V, Di Cristofano C, et al: Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets. Crit Care Med 2007; 35: 2769-2774.
24. Rajan GR: Ultrasound lung comets: A clinically useful sign in acute respiratory distress syndrome/acute lung injury. Crit Care Med 2007; 35:2869-2870.
25. Fishman AP: Pulmonary edema. The waterexchanging function of the lung. Circulation 1972; 46:390-408.
26. Kronenberg RS, Safar P, Lee J, et al: Pulmonary artery pressure and alveolar gas exchange in man during acclimatization to 12,470 ft. J Clin Invest 1971; 50:827-837.
27. Jaeger JJ, Sylvester JT, Cymerman A, et al: Evidence for increased intrathoracic fluid volume in man at high altitude. J Appl Physiol 1979; 47:670-676.
28. Eldridge MW, Braun RK, Yoneda KY, et al: Effects of altitude and exercise on pulmonary capillary integrity: Evidence for subclinical high-altitude pulmonary edema. J Appl Physiol 2006; 100:972-980.
29. Hopkins SR, Garg J, Bolar DS, et al: Pulmonary blood flow heterogeneity during hypoxia and high-altitude pulmonary edema. Am J Respir Crit Care Med 2005; 171:83-87.
30. Zhao Y, Packer CS, Rhoades RA: Pulmonary vein contracts in response to hypoxia. Am J Physiol 1993; 265:L87-L92.
31. Maggiorini M, Mélot C, Pierre S, et al: Highaltitude pulmonary edema is initially caused by an increase in capillary pressure. Circulation 2001; 103:2078-2083.
32. Vivona ML, Matthay M, Blot Chabaud M, et al: Hypoxia reduces alveolar epithelial sodium and fluid transport in rats reversal by adrenergic agonist treatment. Am J Respir Cell Mol Biol 2001; 25:554-561.
33. Sartori C, Vollenweider L, Lö ffler BM, et al: Exaggerated endothelin release in highaltitude pulmonary edema. Circulation 1999; 99:2665-2668.
34. Miserocchi G, Negrini D, Passi A, et al: Development of lung edema: Interstitial fluid dynamics and molecular structure. News Physiol Sci 2001; 16:66-71.
35. Miserocchi G, Negrini D, Del Fabbro M, et al: Pulmonary interstitial pressure in intact in situ lung: The transition to interstitial edema. J Appl Physiol 1993; 74:1171-1177.
36. Miserocchi G, Passi A, Negrini D, et al: Pulmonary interstitial pressure and tissue matrix structure in acute hypoxia. Am J Physiol (Lung Cell Mol Physiol) 2001; 280:L881-L887.
37. Dehnert C, Luks AM, Schendler G, et al: No evidence for interstitial lung oedema by extensive pulmonary function testing at 4559 m. Eur Respir J 2009 Oct 19 [Epub ahead of print].
38. Grocott MP, Martin DS, Levett DZ, et al: Xtreme Everest Research Group. Arterial blood gases and oxygen content in climbers on Mount Everest. N Engl J Med 2009; 360: 140-149.
39. Vock P, Fretz C, Franciolli M, et al: Highaltitude pulmonary edema: Findings at high-altitude chest radiography and physical examination. Radiology 1989; 170: 661-666.
40. Gottdiener JS, Bednarz J, Devereux R, et al: American Society of Echocardiography recommendations for use of echocardiography in clinical trials. J Am Soc Echocardiogr 2004; 17:1086-1190