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[Gastrointestinal dysfunction in acute severe mountain sickness and its relation with multiple organ dysfunction
Ding-zhou Yang1, Qi-quan Zhou, Su-zhi Li
1Department of High Altitude Disease, High Altitude Medicine College, Third Military Medical University, Chongqing 400038, China.
Summary
Gastrointestinal dysfunction (GD) is a significant factor in multiple organ dysfunction syndrome (MODS) among patients with acute severe mountain sickness (ASMS). Glutamine treatment improved gut barrier function and reduced inflammatory markers in ASMS patients.
Area of Science:
- Altitude Medicine
- Gastroenterology
- Critical Care Medicine
Context:
- Acute severe mountain sickness (ASMS) can lead to multiple organ dysfunction syndrome (MODS), including high altitude pulmonary edema (HAPE) and high altitude cerebral edema (HACE).
- Gastrointestinal dysfunction (GD) is a common complication in ASMS, but its role in MODS development is not fully understood.
Purpose:
- To investigate the relationship between gastrointestinal dysfunction (GD) and multiple organ dysfunction syndrome (MODS) in patients with acute severe mountain sickness (ASMS).
- To evaluate the efficacy of glutamine (Gln) supplementation in improving gastrointestinal function and reducing inflammatory markers in ASMS patients.
Summary:
- A retrospective study of 3,184 ASMS patients revealed that 49.8% experienced GD, and 21.7% of those with MODS also had GD.
- Prospective analysis of 10 ASMS patients showed endoscopic evidence of gastrointestinal mucosal edema and hemorrhage.
- Treatment with glutamine (Gln) significantly reduced serum diamine oxidase (DAO), malonic dialdehyde (MDA), endotoxin levels, and the lactulose/mannitol (L/M) ratio, indicating improved gut barrier function.
Impact:
- GD plays a crucial role in the pathogenesis of MODS in ASMS.
- Glutamine supplementation shows promise in mitigating gastrointestinal damage and improving outcomes for ASMS patients with MODS.
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