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Inflammatory processes may predispose children to high-altitude pulmonary edema
A G Durmowicz1, E Noordeweir, R Nicholas
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80262, USA.
Insights
Pre-existing inflammation-causing illnesses, like viral respiratory infections, may contribute to high-altitude pulmonary edema in children. This condition, affecting children more than adults, appears linked to prior illness and altitude exposure.
Area of Science:
- Pediatric Medicine
- Environmental Health
- Pulmonary Medicine
Background:
- High-altitude pulmonary edema (HAPE) is a serious condition affecting individuals ascending to elevated elevations.
- Factors contributing to HAPE in children, particularly those with pre-existing conditions, require further investigation.
Purpose of the Study:
- To retrospectively examine the association between pre-existing inflammatory illnesses and the development of HAPE in children.
- To identify potential risk factors differentiating pediatric HAPE from adult cases.
Main Methods:
- Retrospective analysis of pediatric and adult patients diagnosed with HAPE after high-altitude travel.
- Review of medical histories to identify evidence of pre-existing inflammation-producing illnesses, such as viral respiratory tract infections.
Main Results:
- A significant majority of native, low-altitude children who developed HAPE at high altitude showed evidence of a pre-existing illness.
- Adult patients with HAPE at high altitude did not exhibit the same strong association with pre-existing illnesses.
- Viral respiratory tract infections were commonly identified pre-existing illnesses in affected children.
Conclusions:
- Pre-existing inflammatory conditions, particularly viral respiratory infections, may increase susceptibility to HAPE in children at high altitudes.
- The interplay of inflammatory mediators, hypoxia, and environmental factors (cold, exercise) may heighten capillary permeability in children, leading to HAPE.
- Findings suggest a distinct pediatric vulnerability to HAPE, potentially influenced by recent or ongoing inflammatory processes.
Abstract:
We investigated retrospectively whether the preexistence of inflammation-producing illnesses such as viral respiratory tract infections contributed to the development of high-attitude pulmonary edema in children. We found that the large majority of native low-attitude children, but not adults, who had this form of edema after traveling to high altitude also had evidence of a preexisting illness. We speculate that the release of inflammatory mediators associated with these illnesses may be tolerated at sea level but may predispose children to increased capillary permeability when superimposed on hypoxia and, possibly, cold and exercise.