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Department of Experimental Medicine, the University of Milano-Bicocca
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Introduction INTERSTITIAL EDEMA is the first appearance of water accumulation in the lung and has been reported to affect a large majority of otherwise healthy climbers during acute exposure to high altitude. In the following, we will review the hypoxia-induced changes of the main mechanisms implicated in the regulation of lung fluid homeostasis, the changes induced in lung physiology by interstitial fluid accumulation, and the diagnostic tools available to demonstrate the presence of interstitial edema at high altitude
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We compared the rate of perceived exertion for respiratory (RPE,resp) and leg (RPE,legs) muscles, using a 10-point Borg scale, to their specific power outputs in 10 healthy male subjects during incremental cycle exercise at sea level (SL) and high altitude (HA, 4559 m). Respiratory power output was calculated from breath-by-breath esophageal pressure and chest wall volume changes. At HA ventilation was increased at any leg power output by ? 54%. However, for any given ventilation, breathing pattern was unchanged in terms of tidal volume, respiratory rate and operational volumes of the different chest wall compartments. RPE,resp scaled uniquely with total respiratory power output, irrespectively of SL or HA, while RPE,legs for any leg power output was exacerbated at HA. With increasing respective power outputs, the rate of change of RPE,resp exponentially decreased, while that of RPE,legs increased. We conclude that RPE,resp uniquely relates to respiratory power output, while RPE,legs varies depending on muscle metabolic conditions.