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El edema pulmonar de gran altitud es causado inicialmente por un aumento en la presión capilar
M Maggiorini1, C Mélot, S Pierre
1Department of Internal Medicine, UniversitätsSpital, Zürich, Switzerland. klinmax@usz.unizh.ch
Circulation
|April 25, 2001
Resumen
El edema pulmonar de gran altitud (HAPE) es causado principalmente por el aumento de la presión capilar pulmonar, no por el aumento de la permeabilidad capilar. Este hallazgo ayuda a comprender el desarrollo de HAPE a gran altitud.
Área de la Ciencia:
- Fisiología Fisiología Fisiología.
- Medicina de la Altitud Medicina de la Altitud
- Investigaciones Cardiovasculares Investigación Cardiovascular Investigaciones Cardiovasculares
Sus antecedentes:
- El edema pulmonar de gran altitud (HAPE) implica hipertensión pulmonar severa y inflamación.
- El desencadenante inicial para HAPE aumento de la presión o la permeabilidad sigue sin estar claro.
Objetivo del estudio:
- Para investigar los roles de la presión capilar pulmonar y la permeabilidad en el desarrollo de HAPE.
- Para comparar las respuestas hemodinámicas en individuos susceptibles a la HAPE frente a controles a diferentes altitudes.
Principales métodos:
- La hemodinámica pulmonar medida, incluida la presión capilar (método de oclusión).
- Evaluación de la permeabilidad capilar utilizando el escape de transferrina marcado con 67Ga.
- Se compararon 16 sujetos susceptibles a la HAPE con 14 controles a baja (490m) y alta altitud (4559m).
Principales resultados:
- Los sujetos susceptibles a la HAPE mostraron una mayor vasoreactividad pulmonar a la hipoxia.
- A gran altitud, los sujetos susceptibles tenían arterias pulmonares más altas (37 frente a 26 mmHg) y presiones capilares (19 frente a 13 mmHg).
- El desarrollo de HAPE se correlacionó con la presión capilar pulmonar >19 mmHg; la permeabilidad no difería significativamente.
Conclusiones:
- El edema pulmonar de gran altitud se desencadena inicialmente por una presión capilar pulmonar elevada.
- La presión capilar pulmonar es un factor crítico en la patogénesis de la HAPE.
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