Pulonary edema of high altitude. I. Production of pulmonary edema in animals under conditions of simulated high altitude

The piglet as an animal model for hypobaric hypoxia

The objective of this study was to evaluate the piglet as a suitable animal model for human diseases of high altitude. We studied 12 piglets, 4-10 weeks old, in a hypobaric chamber under conditions of high altitude at a pressure of 1/2 atmosphere (to approximately 320 Torr) for various periods of time (12, 24, 36, 48, and 72 hours) with continuous monitoring. The animals were decompressed every 24 hours for grooming and feeding. Two animals were studied as nonexposed controls, and one was studied as a control in the chamber without decompression. The animals were euthanized after the exposure, and a complete autopsy was performed. The tissues were then analyzed with light and electron microscopy. The animals all exhibited clinical features of ataxia, tachypnea with Cheyne-Stokes respiration, and lethargy. One animal vomited. The histologic and ultrastructural analysis showed normal organs, particularly lung and brain. The piglet may be a suitable animal model for the study of high altitude-related diseases in humans, but prolonged uninterrupted exposure and a delay in euthanasia after exposure to high altitude may be necessary for the development of reactive pathologic changes.

Viral respiratory infection increases susceptibility of young rats to hypoxia-induced pulmonary edema

Recent clinical observations of a high incidence of preexisting respiratory infections in pediatric cases of high-altitude pulmonary edema prompted us to ask whether such infections would increase the susceptibility to hypoxia-induced pulmonary edema in young rats. We infected weanling rats with Sendai virus, thus causing a mild respiratory infection. Within 7 days of infection, Sendai virus was essentially undetectable by using viral culture and immunohistochemical techniques. Animals at day 7 of Sendai virus infection were then exposed to normobaric hypoxia (fraction of inspired O2 = 0.1) for 24 h and examined for increases in gravimetric lung water and in vascular permeability, as well as for histological evidence of increased lung water. Bronchoalveolar lavage was performed on a separate series of animals. Compared with control groups, infected hypoxic animals showed significant increases in perivascular cuffing, gravimetric lung water, and lung protein leak. In addition, infected hypoxic animals had increases in lavage fluid cell counts and protein content compared with controls. We conclude that young rats, exposed to moderate hypoxia while recovering from a mild viral respiratory infection, may demonstrate evidence of early pulmonary edema formation, a finding of potential relevance to human high-altitude pulmonary edema.

HIGH ALTITUDE PULMONARY OEDEMA - AN EXPERIENCE IN EASTERN HIMALAYA

Three hundred and five cases of high altitude pulmonary oedema (HAPO) hospitalised in eastern Himalayan region have been analyzed. Incidence of HAPO was 5.5 per cent. Eighty per cent cases occurred during latter half of the year. Fifty six per cent of cases belonged to the third decade of life. HAPO cases occurred most commonly between the height of 2740 m to 5960 m. Eighty three per cent cases developed symptoms within 72 hours of induction to high altitude and 65.9 per cent suffered from the illness despite complete acclimatization. Breathlessness, headache and cough were the commonest symptoms. Tachycardia and tachypnoea was present in all cases. Twenty five per cent cases showed various ECG abnormalities. Mortality rate was 0.98 per cent.