High altitude medicine:
Saved in:
| Main Author: | |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Stanford, Calif.
Hultgren Publ.
1997
|
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVIII, 550 S. Ill., graph. Darst. |
| ISBN: | 0965518302 |
Staff View
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| 264 | 1 | |a Stanford, Calif. |b Hultgren Publ. |c 1997 | |
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| 650 | 4 | |a Anoxemia | |
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Record in the Search Index
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| adam_text | Table of Contents
Foreword xviii
Acknowledgments xix
Introduction xx
1. Physiologic Effects of High Altitude
Summary 1
Hypoxia and Hypoxemia 2
Aircraft 4
Altitude and Barometric Pressure 4
Intermediate Altitude 4
High Altitude 4
Very High Altitude 5
Extreme Altitude 5
Barometric Pressure 5
High Altitude Cities 7
Tourist Access to High Mountains 8
Ski Resorts 8 9
Trekkers and Climbers 9 10
High Altitude Populations 10 12
High Altitude Research Stations 12 13
2. Respiration and Pulmonary Function
Summary 15
Peripheral Chemoreceptors 15
Central Respiratory Centers 15 16
Carbon Dioxide (CO2) 16
Cerebrospinal Fluid and Respiration 17
Hypoxic Ventilatory Response (HVR) 17 19
Respiration at High Altitude 19 20
Exercise and Ventilation 20 22
Work of Breathing 22
Sleep 22 23
Pulmonary Function 23 28
Postural Hypoxemia 28 30
3. Systemic Circulation
Summary 33
Circulatory changes 33 34
Acute Hypoxia in Unacclimatized Subjects 34 35
Acute Hypoxia in Acclimatized Natives 35 36
Heart Rate 36 38
Cardiac Output 39 41
Left Ventricular Function 41 43
Systolic Time Intervals 43 47
Blood Volume and Systolic Time Intervals 47 48
Echocardiography in Operation Everest II 48 49
Left Ventricular Filling Pressure 49 50
Plasma Volume and Cardiac Output 50
The Electrocardiogram 50 51
Blood Pressure 52 53
Venous Tone 53
Reflex Vasoconstriction 53 55
Distribution of Blood Volume and Flow 55 57
Coronary Circulation 57 60
4. Pulmonary Circulation
Summary 64
Acute Exposure 64 67
Pulmonary Vasoconstriction 67 68
High Altitude Natives 68 69
Geographical Variations 69 71
Age 71
Pulmonary Vascular Resistance 72
Exercise 72 73
Acute Hypoxia 73
Clinical Implications 73 74
Zonal Distribution of Blood Flow 74 75
Right Ventricular Hypertrophy 75 76
Animal Studies 76 78
The Electrocardiogram 78 82
5. Blood and Plasma Volume
Part I: Red Cells Hemoglobin
Summary 86
Red Cell Volume 86
Ascent to High Altitude 86 87
High Altitude Natives 87 92
Polycythemia 92 93
Oxygen Transport 93 94
Age and Red Cell Mass 94
Blood Viscosity 95
Descent 95
Leucocytes 95
Hemoglobin 95 96
Variant hemoglobins 95
F Hemoglobin 96
Coagulation Factors 96 100
Part II: Plasma Volume
Summary 101
Diurnal Variation 102 103
Exercise 103 105
Total Blood Volume 105 106
6. Central Nervous System
Summary 109
Cerebral Blood Flow 109
Isocapnic Hypoxia 109 110
Hypocapnic Hypoxia 110 112
Effects of Hypoxia Upon the CNS 112
General Effects 112
Visual Impairment 112
Blindness 112
Code Tasks and Conceptual Reasoning 112 113
Memory 113
Cognitive Performance 113 117
Mental Performance at High Altitude 117 118
Psychological Problems 118
Acute Severe Hypoxia 118 120
Permanent Effects 121 122
7. Endocrine System
Summary 125
Sympathetic Nervous System 126
Norepinephrine 126
Epinephrine 126 127
Decrease in Catecholamine Effect 128
The Parasympathetic System 128
Renin Aldosterone Angiotensin 128 129
Acute Hypoxia 129
Exercise at Low and High Altitude 129
Long term Altitude Exposure 129 130
Atrial Natiuretic Factor (ANF) 130 132
Antidiuretic Hormone 132
Hormonal Interactions 132 134
Thyroid 134 135
8. Nutrition and Metabolism
Summary 139
Body Weight and Composition 139 142
Gastrointestinal Function 142 145
Miscellaneous Metabolic Functions 145 146
Hepatic Function 146
Dietary Composition 146 147
Caloric Requirements 147 151
Basal Metabolic Rate 151 153
Vitamins and Food Supplements 153 154
Iron 154
Prediction 231
Etiology 231
Hypocapnia 232
Hypercapnia 232
Fluid Retention 232 233
Vasogenic Theory 233 234
Cellular Edema 234 235
Prevention and Treatment 235
Ammonium Chloride 235
Carbon Dioxide 235 236
Rolaids and Antacids 236
Potassium Supplements 236 237
Furosemide 237 240
Morphine Sulfate 240
Steroids 240 241
Phenytoin 241
Acetazolamide 241 245
Almitrine 245
Hyperbaric Bag 245
Recommendations For Prevention 245 248
Treatment 248 249
Part 2: Subacute Mountain Sickness Symptons 249
Physical Findings 250
Incidence 250
Etiology 250
Treatment and Management 250 251
13. High Altitude Pulmonary Edema
Summary 256 257
Historical Aspects 257 260
Clinical Features 261
Symptoms 261 264
Physical Signs 264 265
Diagnostic Criteria 265 266
Severity Class 267 268
Clinical Assessment 268 269
Complications 269 271
Laboratory Studies 272 273
Electrocardiogram 273 274
Radiologic Features 274 275
Hemodynamics 275 276
Altitude of Occurrence 276 280
Acclimatization 280 281
Time of Onset 281 283
Incidence 283 285
Age and Gender 285
Severity 286
Reascent HAPE 286
Individual Susceptibility 287
Pathology 288 290
Medicolegal aspects 290
Mortality 290 292
Etiology 292 293
Overperfusion Concept 293 300
Sea Level Counterparts 300 302
Centrogenic Origin 302
Pulmonary Venous Constriction 302
Edema Fluid Protein 302 304
Susceptibility 304 306
Treatment 306 307
Descent 307 308
Oxygen 308
Pharmacologic Agents 308 311
Methods to Improve Oxygenation 311
Hyperbaric Therapy 311 312
Expiratory Positive Pressure 312
Other Methods 312 313
Emergency Room Management 313 314
Complications 314 315
Return to High Altitude 315
Prevention 315
14. High Altitude Cerebral Edema
Summary 321
Historical Aspects 321 322
Clinical Features 322
Symptoms and Signs 322 328
Diagnosis and Evaluation 328
Laboratory Studies 328
Special Studies 331
Duration of HACE and Late Sequelae 331 332
Epidemiology 332
Gender 332
Age 332
Altitude of Occurrence 332 333
Incidence 333 334
Duration of Altitude Stay and Mode of Travel 334
Previous Episodes 334
Associated Complications 334
Mortality 334
Autopsy Studies 334 335
Etiology 336
Ischemic Injury 336
Hypoxic Injury 336
Anoxia with a Circulatory Deficit 337
Increased Cerebral Blood Flow 338 339
Bony Box Theory 339 340
Vasogenic Theory 340 342
Multifactoral Concept 342 343
Treatment 343
Field Treatment 343.344
Hospital Management 344 345
Prevention 345
IS. Chronic Mountain Sickness
Summary 34g
Historical Aspects 348 349
Clinical Features 349
Symptoms 349
Physical Signs 349
Radiologic Studies 349 350
Electrocardiogram 350
Laboratory Data 352
Hemodynamics 351
Pulmonary Function 352
Diagnosis 352 354
Case Reports 354 355
Epidemiology 355 356
Pathology 357 358
Physiological Aspects of CMS 358
Polycythemia 358 359
Hypoventilation 359 360
Hypoxemia 360 362
Pulmonary Hypertension 362
Gender and Age 362 364
Treatment 364 365
16. Sleep
Summary 368
Frequent Arousals 368 369
Periodic Breathing 369 370
Nocturnal Dyspnea 371 372
Sleep Hypoxemia 372 374
Cardiac Rhythm 374 376
Mechanisms of Sleep Disorders 376 377
Prevention and Treatment 377 379
Sleepiness at Altitude 379
17. Systemic Edema
Summary 382
Incidence 383
Etiology 383 386
Prevention and Treatment 386 387
18. Thromboembolism
Summary 389
Venous Thrombosis 389
Pulmonary Embolism 389 392
Strokes 392 394
Transient Ischemic Attacks 394 395
Atrial Fibrillation 395
Thrombosis in Pulmonary Vessels 395 396
Prevention and Treatment 396
19. Headache
Summary 398
Clinical Features 398 400
Complications 400
Incidence 401
Diagnosis 401
Etiology 401 402
Treatment 402 403
Prevention 403
20. High Altitude Pulmonary Hypertension
Summary 406
Clinical Features 406 410
Clinical Complications 410 411
Diagnosis 411 412
21. Retinal Hemorrhages
Summary 413
Historical Notes 413
Clinical Features 413 414
Physical Findings 414
Incidence Epidemiology 414 415
Etiology 415 416
Prevention and Management 416 417
22. Syncope
Summary 419
Recent Arrivals 419 420
Etiology 420
Acclimatized Persons 421 423
23. Coronary Artery Disease
Summary 424
Acute Effects of Altitude 424 425
Physiologic Effects 425
Exercise 425 428
Elderly 429
Cardiac Arrhythmias 429
Sudden Death 429 430
Prolonged Exposure 430
Cardiac Function 430 431
The Physician s Role 431 433
24. Congenital and Valvular Heart Disease
Summary 435
Congenital Heart Disease 435
Atrial Septal Defects 435
Ventricular Septal Defects 436
Primary Pulmonary Hypertension 436 437
Valvular Heart Disease 437
Pulmonary Artery Abnormalities 437
Cyanotic Congenital Heart Disease 437 438
25. Systemic Hypertension
Summary 439
Normotensives 439 441
Hypertensives 441 443
Case Report 443
Mechanisms 443 445
Clinical Considerations 446
26. Sickle Cell Disease
Summary 448
Occurrence 449
Sickle Cell Crises 449
Symptoms 449 450
Effect of Altitude 450
Non Blacks 450 451
Aircraft Flights 451 452
Acute Episodes Diagnosis 452
Treatment 452
27. Pulmonary Disease
Summary 454
Chronic Obstructive Pulmonary Disease 454 455
Aircraft Travel 455 456
Clinical Considerations 456 457
Primary Pulmonary Hypertension 457
Altitude of Residence 457
High Altitude Throat 458
High Altitude Cough 458
28. Migraine
Summary 460
Clinical Features 460 461
Diagnosis 461
Mechanisms 461 462
Treatment and Prevention 462 463
29. Sea Level Conditions
Summary 465
Age 465 467
Obesity 467
Diabetes 467 468
Patients on Steroids 468
Epilepsy 468
Pregnancy 468 469
Asthma 469
Hemorrhoids 469
Smoking 469 470
30. Women and Altitude
Summary 472
Food Intake and Weight Loss 472 473
Arterial PO2 and PCO2 473
Blood Volume 473 474
Heart Rate 474 475
Pulmonary Function 475
Maximum Exercise Capacity 475 476
Extreme Altitudes 477
Red Cell Mass 477 478
Menstrual Abnormalities 479
Susceptibility to Altitude Illness 479
Acute Mountain Sickness 479 480
High Altitude Pulmonary Edema 480
Chronic Mountain Sickness 480
High Altitude Polycythemia 480
High Altitude Cerebral Edema 480 481
Systemic Edema 480 481
Thromboembolism 481
Retinal Hemorrhage 481
Conclusions 481 483
Appendix 1
Medicolegal Aspects 485
Summary 485 486
The Organization Conducting the Trip 485 486
Trip Leader 486
Trip Physician 486 487
Physicians Who are Clients 487 488
Client s Personal Physician 488 489
Fatalities 489
Estates and Life Insurance 489 490
Disposal of the Body 490
Medicolegal Cases 490 494
Appendix 2
Selected High Altitude Monographs and Proceedings 495
Index 503
|
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| indexdate | 2024-07-09T18:26:11Z |
| institution | BVB |
| isbn | 0965518302 |
| language | English |
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| physical | XVIII, 550 S. Ill., graph. Darst. |
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| spelling | Hultgren, Herbert N. Verfasser aut High altitude medicine Herbert N. Hultgren Stanford, Calif. Hultgren Publ. 1997 XVIII, 550 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Altitude Sickness Altitude, Influence of Anoxemia Anoxia Mountain sickness Höhenmedizin (DE-588)4160356-4 gnd rswk-swf Höhenphysiologie (DE-588)4160358-8 gnd rswk-swf Mensch (DE-588)4038639-9 gnd rswk-swf Höhenmedizin (DE-588)4160356-4 s DE-604 Höhenphysiologie (DE-588)4160358-8 s Mensch (DE-588)4038639-9 s HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008381040&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Hultgren, Herbert N. High altitude medicine Altitude Sickness Altitude, Influence of Anoxemia Anoxia Mountain sickness Höhenmedizin (DE-588)4160356-4 gnd Höhenphysiologie (DE-588)4160358-8 gnd Mensch (DE-588)4038639-9 gnd |
| subject_GND | (DE-588)4160356-4 (DE-588)4160358-8 (DE-588)4038639-9 |
| title | High altitude medicine |
| title_auth | High altitude medicine |
| title_exact_search | High altitude medicine |
| title_full | High altitude medicine Herbert N. Hultgren |
| title_fullStr | High altitude medicine Herbert N. Hultgren |
| title_full_unstemmed | High altitude medicine Herbert N. Hultgren |
| title_short | High altitude medicine |
| title_sort | high altitude medicine |
| topic | Altitude Sickness Altitude, Influence of Anoxemia Anoxia Mountain sickness Höhenmedizin (DE-588)4160356-4 gnd Höhenphysiologie (DE-588)4160358-8 gnd Mensch (DE-588)4038639-9 gnd |
| topic_facet | Altitude Sickness Altitude, Influence of Anoxemia Anoxia Mountain sickness Höhenmedizin Höhenphysiologie Mensch |
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