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Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients.
High Alt Med Biol. 2015 Jun; 16(2):80-8.HA

Abstract

Luks, Andrew M., and Erik R. Swenson. Clinician's Corner: Evaluating the risks of high altitude travel in chronic liver disease patients. High Alt Med Biol 16:80-88, 2015.--With improvements in the quality of health care, people with chronic medical conditions are experiencing better quality of life and increasingly participating in a wider array of activities, including travel to high altitude. Whenever people with chronic diseases travel to this environment, it is important to consider whether the physiologic responses to hypobaric hypoxia will interact with the underlying medical condition such that the risk of acute altitude illness is increased or the medical condition itself may worsen. This review considers these questions as they pertain to patients with chronic liver disease. While the limited available evidence suggests there is no evidence of liver injury or dysfunction in normal individuals traveling as high as 5000 m, there is reason to suspect that two groups of cirrhosis patients are at increased risk for problems, hepatopulmonary syndrome patients, who are at risk for severe hypoxemia following ascent, and portopulmonary hypertension patients who may be at risk for high altitude pulmonary edema and acute right ventricular dysfunction. While liver transplant patients may tolerate high altitude exposure without difficulty, no information is available regarding the risks of long-term residence at altitude with chronic liver disease. All travelers with cirrhosis require careful pre-travel evaluation to identify conditions that might predispose to problems at altitude and develop risk mitigation strategies for these issues. Patients also require detailed counseling about recognition, prevention, and treatment of acute altitude illness and may require different medication regimens to prevent or treat altitude illness than used in healthy individuals.

Authors+Show Affiliations

1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington , Seattle, Washington.1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington , Seattle, Washington. 2 Division of Pulmonary and Critical Care Medicine. VA Puget Sound Health Care System , Seattle, Washington.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25844541

Citation

Luks, Andrew M., and Erik R. Swenson. "Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients." High Altitude Medicine & Biology, vol. 16, no. 2, 2015, pp. 80-8.
Luks AM, Swenson ER. Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients. High Alt Med Biol. 2015;16(2):80-8.
Luks, A. M., & Swenson, E. R. (2015). Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients. High Altitude Medicine & Biology, 16(2), 80-8. https://doi.org/10.1089/ham.2014.1122
Luks AM, Swenson ER. Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients. High Alt Med Biol. 2015;16(2):80-8. PubMed PMID: 25844541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating the Risks of High Altitude Travel in Chronic Liver Disease Patients. AU - Luks,Andrew M, AU - Swenson,Erik R, Y1 - 2015/04/06/ PY - 2015/4/7/entrez PY - 2015/4/7/pubmed PY - 2016/3/2/medline KW - altitude illness KW - cirrhosis KW - clinical hepatology KW - hepatopulmonary syndrome KW - hypoxia KW - portopulmonary hypertension SP - 80 EP - 8 JF - High altitude medicine & biology JO - High Alt. Med. Biol. VL - 16 IS - 2 N2 - Luks, Andrew M., and Erik R. Swenson. Clinician's Corner: Evaluating the risks of high altitude travel in chronic liver disease patients. High Alt Med Biol 16:80-88, 2015.--With improvements in the quality of health care, people with chronic medical conditions are experiencing better quality of life and increasingly participating in a wider array of activities, including travel to high altitude. Whenever people with chronic diseases travel to this environment, it is important to consider whether the physiologic responses to hypobaric hypoxia will interact with the underlying medical condition such that the risk of acute altitude illness is increased or the medical condition itself may worsen. This review considers these questions as they pertain to patients with chronic liver disease. While the limited available evidence suggests there is no evidence of liver injury or dysfunction in normal individuals traveling as high as 5000 m, there is reason to suspect that two groups of cirrhosis patients are at increased risk for problems, hepatopulmonary syndrome patients, who are at risk for severe hypoxemia following ascent, and portopulmonary hypertension patients who may be at risk for high altitude pulmonary edema and acute right ventricular dysfunction. While liver transplant patients may tolerate high altitude exposure without difficulty, no information is available regarding the risks of long-term residence at altitude with chronic liver disease. All travelers with cirrhosis require careful pre-travel evaluation to identify conditions that might predispose to problems at altitude and develop risk mitigation strategies for these issues. Patients also require detailed counseling about recognition, prevention, and treatment of acute altitude illness and may require different medication regimens to prevent or treat altitude illness than used in healthy individuals. SN - 1557-8682 UR - https://www.unboundmedicine.com/medline/citation/25844541/full_citation L2 - https://www.liebertpub.com/doi/full/10.1089/ham.2014.1122?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -