A carregar...
Publicação
Adaptações cardiovasculares e renais à altitude
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 1.57 MB | Adobe PDF |
Orientador(es)
Resumo(s)
O estudo da fisiologia em altitudes elevadas apresenta uma importância crescente, uma vez que mais de 140 milhões de pessoas vivem nessas condições e verificou-se um aumento do interesse no turismo em altitude e na prática de alpinismo, sendo este estudo crucial na prevenção e tratamento das várias condições clínicas que se possam observar. A exposição a altitudes elevadas, definidas como altitudes superiores a 2400 metros, obriga o organismo humano a desenvolver uma série de adaptações integradas e bem coordenadas entre os sistemas respiratório, cardiovascular e renal, com o objetivo de melhorar o aporte de oxigénio em ambientes de hipóxia hipobárica. Este trabalho investiga as adaptações agudas e crónicas, que ocorrem especificamente nos sistemas cardiovascular e renal quando expostos à altitude, de forma a obter o estado da arte atualizado neste domínio. Foi realizada uma pesquisa da literatura na base de dados PubMed, sendo aplicadas como palavras-chave “High Altitude”, “Physiological Adaptations” e “Cardiovascular” ou “Renal” e seleção dos artigos. Traduzindo-se numa revisão narrativa da literatura dos vários artigos publicados sobre este tema. Nas adaptações cardiovasculares analisaram-se as variáveis mais relevantes na exposição à altitude, nomeadamente: circulação cerebral, circulação pulmonar, pressão arterial, frequência cardíaca, volume sistólico, débito cardíaco, contractilidade cardíaca, arritmias, finalizando com as alterações eletrocardiográficas. Nas adaptações renais, as variáveis analisadas foram: volume plasmático e concentração de hemoglobina, resposta ácido-base, balanço eletrolítico, taxa de filtração glomerular, terminando com as alterações renais dos nativos das altas montanhas, especificamente a hiperuricemia e proteinúria.
The study of physiology at high altitudes is of increasing importance, as more than 140 million people live in such conditions and there has been an increase in interest in altitude tourism and mountaineering, this study is crucial in the prevention and treatment of the various clinical conditions that can be observed. Exposure to high altitudes, defined as altitudes above 2400 meters, requires the human organism to develop a series of integrated and well-coordinated adaptations between the respiratory, cardiovascular and renal systems, to improve oxygen supply in hypobaric hypoxia environments. This work investigates acute and chronic adaptations, which occur specifically in the cardiovascular and renal systems when exposed to altitude, to obtain the state of the art in this field. A literature survey was conducted in the PubMed database, and applied as keywords "High Altitude", "Physiological Adaptations" and "Cardiovascular" or "Renal" and selection of articles. This translated into a narrative review of the literature of the various articles published on this subject. Cardiovascular adaptations analyzed the most relevant variables in exposure to altitude, namely: cerebral circulation, pulmonary circulation, blood pressure, heart rate, systolic volume, cardiac output, cardiac contractility, arrhythmias, ending with electrocardiographic changes. In the renal adaptations, the variables analyzed were: plasma volume and hemoglobin concentration, acid-base response, electrolyte balance, glomerular filtration rate, ending with renal alterations of the natives of the high mountains, specifically hyperuricemia and proteinuria.This study concludes that, although there is individual variability in altitude adaptations, it is possible to define an adaptation pattern in most of the variables studied. However, in some variables, such as blood pressure, there is so much individual variability that it is not possible to define a single pattern of adaptation and, to clarify these situations, more studies should be carried out.
The study of physiology at high altitudes is of increasing importance, as more than 140 million people live in such conditions and there has been an increase in interest in altitude tourism and mountaineering, this study is crucial in the prevention and treatment of the various clinical conditions that can be observed. Exposure to high altitudes, defined as altitudes above 2400 meters, requires the human organism to develop a series of integrated and well-coordinated adaptations between the respiratory, cardiovascular and renal systems, to improve oxygen supply in hypobaric hypoxia environments. This work investigates acute and chronic adaptations, which occur specifically in the cardiovascular and renal systems when exposed to altitude, to obtain the state of the art in this field. A literature survey was conducted in the PubMed database, and applied as keywords "High Altitude", "Physiological Adaptations" and "Cardiovascular" or "Renal" and selection of articles. This translated into a narrative review of the literature of the various articles published on this subject. Cardiovascular adaptations analyzed the most relevant variables in exposure to altitude, namely: cerebral circulation, pulmonary circulation, blood pressure, heart rate, systolic volume, cardiac output, cardiac contractility, arrhythmias, ending with electrocardiographic changes. In the renal adaptations, the variables analyzed were: plasma volume and hemoglobin concentration, acid-base response, electrolyte balance, glomerular filtration rate, ending with renal alterations of the natives of the high mountains, specifically hyperuricemia and proteinuria.This study concludes that, although there is individual variability in altitude adaptations, it is possible to define an adaptation pattern in most of the variables studied. However, in some variables, such as blood pressure, there is so much individual variability that it is not possible to define a single pattern of adaptation and, to clarify these situations, more studies should be carried out.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Altitudes elevadas Adaptações cardiovasculares Adaptações renais Fisiologia