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Idiopathic Pulmonary Fibrosis

Jeremy Feldman, MD

  • What is Idiopathic Pulmonary Fibrosis?
    • Idiopathic Pulmonary Fibrosis Definition
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and Idiopathic Pulmonary Fibrosis
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy and Prognosis for Idiopathic Pulmonary Fibrosis
  • Diagnosing & Monitoring PF
    • Monitoring Progress of IPF
    • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis
  • PF Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
      • Update on Oxygen Use
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation
  • PF Advocacy & News
  • FAQ’s
    • Respiratory failure, NSIP, diet
    • Leg swelling, lung biopsy, side effects & pets
    • FAQ’s Enzyme Therapy, Progression of IPF & Oxygen
    • FAQ: Diarrhea, Fibrosis Reversal, IPF Symptoms
    • FAQ: Oxygen Flow, Anesthesia & Genetics
    • FAQ: Contagious Cough? Stem Cells, Familial IPF, Flying
    • FAQ: GERD, Fatigue & Environmental Exposure
    • FAQ: How to Travel to Your Doctor’s Office with Oxygen
    • FAQ: Lung Biopsy with Pulmonary Fibrosis
    • FAQ’s: Alcohol, Clinical Trials, Pulmonary Function Testing
    • FAQs: Emphysema, Exercise & Lung Biopsy

Lung Disease at High Altitudes

March 29, 2019 By Dr. Jeremy Feldman

high altitude mountains

A common question we receive from our readers and patients is whether it is safe for patients with chronic lung disease to travel to higher elevations.  For the sake of this discussion we will use 5,000 ft. or greater as high altitude.  This is an important question since many of the tourist attractions are either at higher elevation or require driving across mountains that exceed 5000 ft.

High Altitude Physiology

The lungs have evolved to compensate for changes that occur as elevation increases.  Above 5,000 ft. of elevation, there is less oxygen in the air. This triggers a response to breathe more (increased ventilation). The normal heart also pumps more blood to compensate for the reduced oxygen that is carried in the blood. Over time the body makes more red blood cells which helps increase the amount of oxygen that the blood can carry. The pulmonary arteries respond to high altitude by constricting or squeezing (vasoconstriction).  This leads to the right side of the heart having to work harder.  Additionally there is a tendency for the lungs to accumulate more water with ascent to higher altitude.  This can further affect breathing.

These changes described above have important implications for patients with chronic lung disease. For example, patients with pulmonary hypertension may be particularly sensitive to the vasoconstriction (squeezing more tightly) that occurs.  This leads to increased work for the right side of the heart.  Many patients experience fluid retention and increased fatigue that can take several weeks to improve.  Patients with pulmonary fibrosis (scarring in the lungs) may not be able to increase their breathing rate effectively and they may also experience worsening pulmonary hypertension.

Oxygen, Does it Help?

Many patients with chronic lung disease will need to wear oxygen when they travel to higher elevations. If you drop your oxygen saturation at night or during exercise at lower elevation then you will certainly benefit from oxygen at higher elevation.  For patients who are borderline we have a high altitude simulation test (HAST) that can determine if you will need oxygen.  Patients that do need oxygen with travel to higher elevation will still experience many of the physiologic changes of being at higher elevation. The 1-5 liters/min of oxygen delivered via nasal cannula can blunt the effects of elevation but does not completely reverse these changes.  My advice to patients is to avoid higher elevations if at all possible.  The more severe your lung disease the more important this is.

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What is IPF?

  • What is Idiopathic Pulmonary Fibrosis?
    • Symptoms of Idiopathic Pulmonary Fibrosis
    • Causes of Idiopathic Pulmonary Fibrosis
    • Who Gets Idiopathic Pulmonary Fibrosis
    • Gastro-Esophageal Reflux (GER) and IPF
    • Interstitial Lung Disease vs. Idiopathic Pulmonary Fibrosis
    • Is Pulmonary Fibrosis Hereditary?
    • Research, Life Expectancy & Prognosis for Pulmonary Fibrosis

Diagnosing IPF

  • Idiopathic Pulmonary Fibrosis Diagnosis
    • Chest X-rays Used in IPF
    • CPET used in IPF
    • HRCT Scans Used to Evaluate IPF
    • Lung Biopsy To Diagnose IPF
    • Pulmonary Function Tests (PFTS)
    • Six Minute Walk Test To Monitor IPF
    • Stages of Idiopathic Pulmonary Fibrosis
    • Complications of Idiopathic Pulmonary Fibrosis

Treating IPF

  • Pulmonary Fibrosis Treatment Options
    • Esbriet (pirfenidone) Used to Treat IPF
    • OFEV (nintedanib) Used to Treat IPF
    • Pulmonary Rehab for IPF Patients
    • Lung Transplantation for Pulmonary Fibrosis
    • Oxygen Used to Treat IPF
    • Clinical Trials in Idiopathic Pulmonary Fibrosis
    • IPF & Leg Swelling
    • Pulmonary Hypertension and Idiopathic Pulmonary Fibrosis
    • IPF Exacerbation

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