In the following morning, subjects hiked to Capanna Margherita, 4559 m, within 4–5 h and stayed there for 3 days. Study participants travelled from Alagna, Italy, 1130 m, to 3200 m by cable car and subsequently hiked 2 hours to the Gnifetti hut (3647 m), where they spent one night. Control subjects had all examinations with exception of polygraphic monitoring at 490 m. Low altitude baseline evaluation including clinical examination, pulmonary function and nocturnal polygraphic monitoring were carried out in Zurich (490 m) within 1 month before ascent to altitude. We evaluated whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. While previous studies had separately focused on various specific aspects, , the purpose of the current study was to perform a comprehensive evaluation including pulmonary function, blood gases and nocturnal polygraphic recordings in subjects developing HAPE in comparison to healthy controls at 4559 m in order to better understand the time course and pattern of physiologic alterations associated with HAPE. The purpose of the current study was therefore to further investigate physiologic characteristics differentiating subjects developing HAPE from those remaining free of HAPE. In contrast, Dehnert and colleagues found no changes in closing volume or other pulmonary function tests in subjects without a history of HAPE ascending to Capanna Regina Margherita. However, in a previous study we observed increases in closing volume even in some subjects not developing HAPE after rapid ascent to the Capanna Regina Margherita (4559 m). Cremona and colleagues reported on the potential role of closing volume as a sensitive marker of early subclinical HAPE. Since HAPE is preventable and treatable, it would be desirable, if early diagnosis was feasible by detecting physiologic changes that precede overt HAPE. A chest radiograph demonstrates pulmonary infiltrates but this is rarely available in the mountains. The diagnosis at high altitude is based on the presence of dyspnoea, tachypnea, cough, pulmonary crackles, and cyanosis. Mountaineers with a previous history of HAPE are at particular risk. High altitude pulmonary edema (HAPE) is a potentially life-threatening condition that occurs after rapid ascent to high altitude.
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