Acute hemodynamic changes by breathing hypoxic and hyperoxic gas mixtures in pulmonary arterial and chronic thromboembolic pulmonary hypertension.
Journal article

Acute hemodynamic changes by breathing hypoxic and hyperoxic gas mixtures in pulmonary arterial and chronic thromboembolic pulmonary hypertension.

  • Groth A Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Saxer S Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Bader PR Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Lichtblau M Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Furian M Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Schneider SR Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Schwarz EI Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Bloch KE Clinic of Pulmonology, University Hospital of Zurich, Switzerland.
  • Ulrich S Clinic of Pulmonology, University Hospital of Zurich, Switzerland. Electronic address: silvia.ulrich@usz.ch.
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  • 2018-06-13
Published in:
  • International journal of cardiology. - 2018
English BACKGROUND
There is insufficient evidence to counsel patients with pulmonary hypertension undergoing altitude or air travel. We thus aimed to study hemodynamic response of patients with pulmonary arterial or chronic thromboembolic pulmonary hypertension (PAH/CTEPH) during changes in inspiratory oxygen partial pressure.


METHODS AND RESULTS
Consecutive patients undergoing right heart catheterization had hemodynamic assessments whilst breathing ambient air (normoxia, FiO2 0.21, at altitude 490 m), nitrogen-enriched air (hypoxia, FiO2 0.16, simulated altitude 2600 m) and oxygen (hyperoxia, FiO2 1.0), each for 10 min. Data from patients with PAH/CTEPH with mean pulmonary artery pressure (mPAP) ≥25 mmHg, pulmonary artery wedge pressure ≤15 mmHg, were compared to data from controls, mPAP <20 mmHg. 28 PAH/CTEPH-patients, 15 women, median age (quartiles) 62y (49;73), mPAP 35 mmHg (31;44), PaO2 7.1 kPa (6.8;9.3) and 16 controls, 12 women, 60y (52;69), mPAP 18 mmHg (16;18), PaO2 9.5 kPa (8.5;10.6) were included. Hypoxia reduced the PaO2 in PAH/CTEPH-patients by median of 2.3 kPa, in controls by 3.3 kPa, difference (95%CI) in change 1.0 (0.02 to 1.9), p < 0.05. Corresponding changes in pulmonary vascular resistance, mPAP and cardiac output were nonsignificant in both groups. Hyperoxia decreased mPAP in PAH/CTEPH-patients by 4 mmHg (2 to 6), in controls by 2 mmHg (0 to 3), difference in change 3 mmHg (0 to 5), p < 0.05.


CONCLUSIONS
In patients with PAH/CTEPH, very short-term exposure to moderate hypoxia similar to 2600 m altitude or during commercial air travel did not deteriorate hemodynamics. These results encourage studying the response of PAH/CTEPH during daytrips to the mountain or air travel.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/94716
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