Effects of slow ascent to 4559 M on fluid homeostasis

Since acute mountain sickness (AMS) is associated with rapid ascent and with fluid retention, we assessed clinical status and fluid homeostasis in men slowly ascending on foot over 3 d to 4559 m and remaining at this altitude 5 d. We studied 15 male mountaineers, 6 of whom had previously had repeate...

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Published inAviation, space, and environmental medicine Vol. 62; no. 2; p. 105
Main Authors Bärtsch, P, Pfluger, N, Audétat, M, Shaw, S, Weidmann, P, Vock, P, Vetter, W, Rennie, D, Oelz, O
Format Journal Article
LanguageEnglish
Published United States 01.02.1991
Subjects
Adult
Altitude Sickness - physiopathology
Atrial Natriuretic Factor - blood
Body Fluids - physiology
Body Weight - physiology
Diuresis - physiology
Echocardiography
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Homeostasis - physiology
Humans
Male
Middle Aged
Pulmonary Edema - diagnostic imaging
Radiography
Urinary Retention - physiopathology
Water-Electrolyte Balance - physiology
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Summary:Since acute mountain sickness (AMS) is associated with rapid ascent and with fluid retention, we assessed clinical status and fluid homeostasis in men slowly ascending on foot over 3 d to 4559 m and remaining at this altitude 5 d. We studied 15 male mountaineers, 6 of whom had previously had repeated, severe AMS or high altitude pulmonary edema (HAPE), at 1170 m, 3611 m, and 4559 m. We found that four of the six subjects with previous AMS or HAPE compared with none of nine with no such history, developed these conditions. Those who remained well had a diuresis that could not be overcome by increasing fluid intake and no change in renin activity, plasma aldosterone, or atrial natriuretic peptide (ANP). Those who became ill showed considerable weight gain independent of fluid intake, and a great increase in ANP which correlated with measurements of right atrial cross section. We conclude that mountaineers who have previously experienced repeated AMS or HAPE get fluid retention despite slow ascent and that this is associated with widening of the atrium and an increase in ANP.
ISSN:0095-6562