Altitude Travel in Patients With Pulmonary Hypertension: Randomized Pilot-Trial Evaluating Nocturnal Oxygen Therapy

Frontiers in Medicine

article

Mona Lichtblau¹  Michael Furian¹  Konrad E. Bloch¹  Silvia Ulrich¹  Stéphanie Saxer¹  Tsogyal D. Latshang¹  Sayaka S. Aeschbacher¹  Fabienne Huber¹  Philipp M. Scheiwiller¹  Joël J. Herzig¹  Simon R. Schneider¹  Elisabeth D. Hasler¹ 

[1] Department of Pulmonology, University Hospital Zurich

关键词: pulmonary hypertension;    altitude;    oxygen;    exercise performance;    sleep;    echocardiography;   

DOI  :  10.3389/fmed.2020.00502

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Stable patients with pulmonary arterial or chronic thromboembolic pulmonary hypertension (PH) wish to undergo altitude sojourns or air travel but fear disease worsening. This pilot study investigates health effects of altitude sojourns and potential benefits of nocturnal oxygen therapy (NOT) in PH patients. Methods: Nine stable PH patients, age 65 (47; 71) years, 5 women, in NYHA class II, on optimized medication, were investigated at 490 m and during two sojourns of 2 days/nights at 2,048 m, once using NOT, once placebo (ambient air), 3 L/min per nasal cannula, according to a randomized crossover design with 2 weeks washout at 30 min). Both recovered immediately with oxygen therapy. Two patients suffered from acute mountain sickness. In 6 patients with complete data, nocturnal mean SpO 2 and cyclic SpO 2 dips reflecting sleep apnea significantly differed from 490 to 2,048 m with placebo, and 2,048 m with NOT (medians, quartiles): SpO 2 93 (91; 95)%, 89 (85; 90)%, 97 (95; 97)%; SpO 2 dips 10.4/h (3.1; 26.9), 34.0/h (5.3; 81.3), 0.3/h (0.1; 2.3). 6 MWD at 490, 2,048 m without and with NOT was 620 m (563; 720), 583 m (467; 696), and 561 m (501; 688). Echocardiographic indices of heart function and PH were unchanged at 2,048 m with/without NOT vs. 490 m. Conclusions: 7/9 PH patients stayed safely at 2,048 m but revealed hypoxemia, sleep apnea, and reduced 6 MWD. Hemodynamic changes were trivial. NOT improved oxygenation and sleep apnea. The current pilot trial is important for designing further studies on altitude tolerance of PH patients.

【 授权许可】

CC BY