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High altitude pulmonary edema

P Bärtsch1

  • 1Department of Medicine, Institute of Sports Medicine, Heidelberg, Germany. sportmedizin@krzmail.krz.uni-heidelberg.de

Medicine and Science in Sports and Exercise
|January 30, 1999
PubMed
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High altitude pulmonary edema (HAPE) is triggered by ascent rate and individual factors, typically appearing days after reaching high elevations. Slow ascent, not exceeding 350m daily above 2500m, is key for prevention.

Area of Science:

  • Physiology
  • Environmental Medicine
  • Sports Medicine

Background:

  • High altitude pulmonary edema (HAPE) is a life-threatening condition affecting individuals exposed to altitudes above 2500-3000 meters.
  • Its occurrence is determined by ascent rate, mode of travel, and individual susceptibility.
  • HAPE typically manifests 2-5 days after acute exposure to high altitudes.

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, and management of high altitude pulmonary edema (HAPE).
  • To identify key determinants and risk factors associated with HAPE development.
  • To outline effective prevention and treatment strategies for HAPE.

Main Methods:

  • Review of existing literature on high altitude pulmonary edema.

Related Experiment Videos

  • Analysis of clinical findings including chest radiographs and CT scans.
  • Examination of hemodynamic data such as pulmonary artery pressure (PAP) and wedge pressure.

    • Main Results:

    • HAPE is characterized by patchy, peripheral edema on imaging, with normal resting wedge pressure and excessive PAP rise preceding edema.
    • An inflammatory response and/or impaired fluid clearance may contribute to noncardiogenic pulmonary edema.
    • Bronchoalveolar lavage in advanced HAPE shows inflammation and increased permeability, though its causal role is unclear.

    Conclusions:

    • Gradual acclimatization, with ascent rates not exceeding 300-350 m/day above 2500m, is crucial for preventing HAPE.
    • Supplemental oxygen is the primary treatment in medical facilities; immediate descent is critical in remote areas.
    • Nifedipine can be used as a temporizing measure until descent is possible when oxygen is unavailable.