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High altitude-induced pulmonary oedema.

Marco Maggiorini1

  • 1Intensive Care Unit, Department of Internal Medicine, University Hospital, Rämistrasse 100, CH-8091 Zürich, Switzerland. klinmax@usz.unizh.ch

Cardiovascular Research
|August 15, 2006
PubMed
Summary

High altitude pulmonary oedema (HAPE) affects nearly half of trekkers ascending rapidly above 4000m. Prevention involves slow ascent or medication like nifedipine for susceptible individuals.

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Area of Science:

  • Altitude sickness research
  • Pulmonary medicine
  • Sports medicine

Background:

  • Rapid ascent to high altitudes (>4000m) frequently causes high altitude illness.
  • Individual susceptibility is a key factor in developing high altitude pulmonary oedema (HAPE).

Purpose of the Study:

  • To outline the pathophysiology and clinical presentation of HAPE.
  • To recommend management and prevention strategies for HAPE.

Main Methods:

  • Review of clinical symptoms and physiological markers of HAPE.
  • Analysis of factors contributing to non-cardiogenic pulmonary oedema at altitude.

Main Results:

  • HAPE is characterized by severe fatigue, dyspnoea, and cough, with haemoptysis in advanced stages.
  • Hallmark findings include elevated pulmonary artery pressure and protein-rich oedema fluid.
  • Decreased alveolar fluid clearance may exacerbate HAPE.

Conclusions:

  • Immediate descent, oxygen, or nifedipine are crucial for HAPE treatment.
  • Preventive measures include slow ascent (max 400 m/day above 2500 m) and prophylactic nifedipine when acclimatization is insufficient.

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