Extravascular Lung Fluid Accumulation in Élite Climbers at High Altitude Is a Transient Event and Doesn't Preclude a Successful Climbing

Increase in closing volume indicating extravascular lung fluid accumulation has been reported in recreational climbers at 4500m.No information is available about the duration and the effect on climbing capacity of this event.AIM: to indirectly assess the presence of lung interstitial oedema in élite climbers during the acclimatization period of the italian expedition to Mt Everest .We studied 9 climbers (M,32-52 yrs) at sea level(SL),at Base Camp(5200m)1°day(BC1)and 10°day(BC10).Between BC1 and BC10 all subjects climbed up to 7000m.After the study period, all subjects climbed >7000m and 3 reached the summit.We measured maximal (M)and partial (P)flow-volume curve to detect the effect of deep inspiration and the presence of peripheral airways narrowing and urinary microalbumin (overnight collection) as an indirect index of endothelial permeability.Results (see table).We did not found any significant difference in FEV1.At both SL and BC1 no difference in M and P flows at the last part of the volume has been found so the BC1significant MEF decrease(significantly related to FVC and urinary microalbumin)suggests small airways compression due to lung interstitial oedema.After 10 days all values returned similar to SL, except M/P indicating a bronchoconstrictor effect of deep inspiration.We conclude that spirometric changes suggesting extravascular lung fluid accumulation are a transient event in élite climbers not precluding a successful climbing