Study question: Beta-adrenergic agonists upregulate the clearance of alveolar fluid and attenuate pulmonary edema in animal models. The study assessed effects of prophy¬lactic inhalation of salmeterol, a beta-agonist, on the incidence of high-altitude pulmonary edema.
Methods: These included a double-blind, randomized placebo-controlled study in 37 subjects susceptible to high-altitude edema who were assessed during exposure to high altitudes (4559 m). Nasal transepithelial potential difference was used as a marker of the transepithelial sodium and water transport in the distal airways of 33 mountaineers prone to pulmonary edema and 33 who were resistant.
Results: Prophylactic inhalation of salmeterol decreased the incidence of high-altitude pulmonary edema by more than 50%; the nasal transepithelial potential difference was also significantly changed.
Perspective: Prophylactic inhalation of salmeterol, a well-known beta-adrenergic agonist used in the manage¬ment of asthma for more than 25 years, was shown to be sufficiently effective in the study and is advisable.