Pulmonary Edema Fluid Protein in High-Altitude Pulmonary Edema

doi:10.1001/jama.1986.03380010040010

Pulmonary Edema Fluid Protein in High-Altitude Pulmonary Edema

Peter H. Hackett, MD

University of Washington Seattle Centinela Mammoth Hospital Mammoth Lakes, Calif Northern Inyo Hospital Bishop, Calif

Jack Bertman, MD

Centinela Mammoth Hospital Mammoth Lakes, Calif

Gil Rodriguez, MD;
James Tenney, MD

Northern Inyo Hospital Bishop, Calif

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Excerpt

To the Editor.— The ratio of edema fluid protein to serum protein is a measurement used to differentiate hydrostatic from permeability edema. Since it was demonstrated that highaltitude pulmonary edema (HAPE) is noncardiogenic,^1,2 HAPE has been classified as a type of permeability edema. The only previous protein ratio reported in HAPE, however, was 0.6,³ which is between that expected for hydrostatic (<0.5) and permeability (>0.7) edemas.⁴ This measurement may have been flawed, since a tracheal specimen was used, which was probably diluted with other airway secretions. Recently, Schoene et al^5,6 lavaged the lungs of persons with HAPE as well as controls and demonstrated a 60-fold higher total protein level in the HAPE lavage fluid. Because of the lavage technique, the dilution with normal saline precluded determination of the total protein ratio. We wish to report protein measurements of undiluted edema fluid from a patient with HAPE.