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Travel to high altitude with pre-existing lung disease

¹ Division of Pulmonary and Critical Care Medicine, University of Washington, and ² Division of Pulmonary and Critical Care Medicine, Seattle Veterans Affairs Medical Center, Seattle, WA, USA.

CORRESPONDENCE: A. M. Luks, Division of Pulmonary and Critical Care Medicine, Puget Sound Veterans Affairs Health Care System, 1660 South Columbian Way S111-PULM, Seattle, WA 98108, USA. Fax: 1 2067642659. E-mail: aluks{at}u.washington.edu

Keywords: Acute mountain sickness, high altitude, high-altitude cerebral oedema, high-altitude pulmonary oedema, hypoxia, lung disease

Received: April 17, 2006
Accepted October 1, 2006

The pathophysiology of high-altitude illnesses has been well studied in normal individuals, but little is known about the risks of high-altitude travel in patients with pre-existing lung disease. Although it would seem self-evident that any patient with lung disease might not do well at high altitude, the type and severity of disease will determine the likelihood of difficulty in a high-altitude environment. The present review examines whether these individuals are at risk of developing one of the main forms of acute or chronic high-altitude illness and whether the underlying lung disease itself will get worse at high elevations. Several groups of pulmonary disorders are considered, including obstructive, restrictive, vascular, control of ventilation, pleural and neuromuscular diseases. Attempts will be made to classify the risks faced by each of these groups at high altitude and to provide recommendations regarding evaluation prior to high-altitude travel, advice for or against taking such excursions, and effective prophylactic measures.

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