Abnormal control of ventilation in high-altitude pulmonary edema

P. H. Hackett, R. C. Roach, R. B. Schoene, G. L. Harrison, W. J. Mills

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We wished to determine the role of hypoxic chemosensitivity in high-altitude pulmonary edema (HAPE) by studying persons when ill and upon recovery. We studied seven males with HAPE and seventeen controls at 4,400 m on Mt. McKinley. We measured ventilatory responses to both O2 breathing and progressive poikilocapnic hypoxia. Hypoxic ventilatory response (HVR) was described by the slope relating minute ventilation to percent arterial O2 saturation (ΔV̇E/ΔSa(O2)%). HAPE subjects were quite hypoxemic (Sa(O2)% 59 ± 6 vs. 85 ± 1, P < 0.01) and showed a high-frequency, low-tidal-volume pattern of breathing. O2 decreased ventilation in controls (-20%, P < 0.01) but not in HAPE subjects. The HAPE group had low HVR values (0.15 ± 0.07 vs. 0.54 ± 0.08, P < 0.01), although six controls had values in the same range. The three HAPE subjects with the lowest HVR values were the most hypoxemic and had a paradoxical increase in ventilation when breathing O2. We conclude that a low HVR plays a permissive rather than causative role in the pathogenesis of HAPE and that the combination of extreme hypoxemia and low HVR may result in hypoxic depression of ventilation.

Original languageEnglish (US)
Pages (from-to)1268-1272
Number of pages5
JournalJournal of Applied Physiology
Issue number3
StatePublished - Jan 1 1988
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Physiology
  • Physiology (medical)

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