Air blood barrier phenotype correlates with alveolo-capillary O 2 equilibration in hypobaric hypoxia

The O diffusion limitation across the air blood barrier (DO and subcomponents Dm and Vc) was evaluated in 17 healthy participants exposed to hypobaric hypoxia (HA, 3840m, P O ∼90mmHg). A 10% decrease in alveolar volume (VA) in all participants suggested the development of sub-clinical interstitial l...

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Published in:Respiratory physiology & neurobiology 2017-12, Vol.246, p.53-58
Main Authors: Beretta, Egidio, Lanfranconi, Francesca, Grasso, Gabriele Simone, Bartesaghi, Manuela, Alemayehu, Hailu Kinfu, Pratali, Lorenza, Catuzzo, Bruna, Giardini, Guido, Miserocchi, Giuseppe
Format: Article
Language:English
Subjects:
Adult
Blood-Air Barrier - physiopathology
Echocardiography
Female
Humans
Hypoxia - pathology
Hypoxia - therapy
Male
Middle Aged
Oxygen - blood
Partial Pressure
Pulmonary Diffusing Capacity - methods
Pulmonary Ventilation
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Summary:The O diffusion limitation across the air blood barrier (DO and subcomponents Dm and Vc) was evaluated in 17 healthy participants exposed to hypobaric hypoxia (HA, 3840m, P O ∼90mmHg). A 10% decrease in alveolar volume (VA) in all participants suggested the development of sub-clinical interstitial lung edema. In >80% of participants DO /VA increased, reflecting an individual strategy to cope with the hypoxia stimulus by remodulating Vc or Dm. Opposite changes in Dm/Vc ratio were observed and participants decreasing Vc showed reduced alveolar blood capillary transit time. The interplay between diffusion and perfusion (cardiac output) was estimated in order to investigate the individual adaptive response to hypoxia. It appears remarkable that despite individual differences in the adaptive response to HA, diffusion limitation did not exceed ∼11% of the alveolar-venous PO gradient, revealing an admirable functional design of the air-blood barrier to defend the O diffusion/perfusion function when facing hypobaric hypoxia corresponding to 50mmHg decreased P O .
ISSN:1569-9048
1878-1519
DOI:10.1016/j.resp.2017.08.006