26 January 2017 by Gabriel Diaz

Pulmonary hypertension (PH) in children in altitude

Introduction

The effect of altitude is significant over 2.500 MOSL. Bogotá, where we made the study, is at 2.640 MOSL.

Objective

To show the effect of hypobaric hypoxia on PH in Children.

Patients

We included new patients studied the last 12 months.  All had clinical evaluation, BNP, hyperoxia test and catheterism. One patient did not have catheterism because he died before the procedure. Necropsy showed IPH with severe PVD. All patients had prolonged hyperoxia test and VRT with NO and oxygen. Living at low altitude was recommended.

Results

We had 20 new patients; 16 females (80%); 8 were 3 years old or less (40%); 12 had IPH (60%), 4 CHD (3 developed PH after surgery); 2 CPD, 1 HAPE and 1 group 5. Majority of patients had severe PH: MPP >60 mm Hg; PR >20WU.

Discussion

Altitude gives special characteristics to PH by hypobaric hypoxia, affecting epidemiology, pathogenesis, diagnostic approach and treatment. Epidemiology: PH is frequent, begins and could be severe at an early age, and IPH is the main cause. Pathogenesis: Hyperreactivity of PV is important and remodeling could be severe very early. Diagnosis and treatment: Oxygen plays important role.

Conclusion

At altitude, Hypobaric Hypoxia gives special characteristics to PH. Because Hypobaric Hypoxia influences not only other pathologies of group 3 but also pathologies of groups 1 and 5 of Nice Classification, maybe PH of altitude deserve to be considered as a subgroup of group 3

Key Contributors

Gabriel Díaz, Alicia Márquez, Roy Sanguino, Miguel Ronderos, Manuel Huertas, Santiago Ucroz, Sandra Matiz Universidad Nacional de Colombia, Clínica De La Mujer, Fundacion HOMI, Fundación CardioInfantil, Universidad Del Bosque


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