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High altitude-induced pulmonary oedema


Maggiorini, M (2006). High altitude-induced pulmonary oedema. Cardiovascular Research, 72(1):41-50.

Abstract

Almost one mountain trekker or climber out of two develops several symptoms of high altitude illness after a rapid ascent (>300m/day) to an altitude above 4000m. Individual susceptibility is the most important determinant for the occurrence of high altitude pulmonary oedema (HAPE). Symptoms associated with HAPE are incapacitating fatigue, chest tightness, dyspnoea at the slightest effort, orthopnoea, and cough with due to haemoptysis in an advanced stage of the disease pink frothy sputum. The hallmark of HAPE is an excessively elevated pulmonary artery pressure (mean pressures of 35 and 55mmHg), which precedes the development of pulmonary oedema. Elevated pulmonary capillary pressure and protein- as well as red blood cell-rich oedema fluid without signs of inflammation in its early stage are characteristic findings. Furthermore, decreased fluid clearance from the alveoli may contribute to this non-cardiogenic pulmonary oedema. Immediate descent or supplemental oxygen and nifedipine are recommended until descent is possible. Susceptible individuals can prevent HAPE by slow ascent: an average gain of altitude not exceeding 400m/day above an altitude of 2500m. If progressive high altitude acclimatization is not possible, a prophylaxis with nifedipine should be recommended

Abstract

Almost one mountain trekker or climber out of two develops several symptoms of high altitude illness after a rapid ascent (>300m/day) to an altitude above 4000m. Individual susceptibility is the most important determinant for the occurrence of high altitude pulmonary oedema (HAPE). Symptoms associated with HAPE are incapacitating fatigue, chest tightness, dyspnoea at the slightest effort, orthopnoea, and cough with due to haemoptysis in an advanced stage of the disease pink frothy sputum. The hallmark of HAPE is an excessively elevated pulmonary artery pressure (mean pressures of 35 and 55mmHg), which precedes the development of pulmonary oedema. Elevated pulmonary capillary pressure and protein- as well as red blood cell-rich oedema fluid without signs of inflammation in its early stage are characteristic findings. Furthermore, decreased fluid clearance from the alveoli may contribute to this non-cardiogenic pulmonary oedema. Immediate descent or supplemental oxygen and nifedipine are recommended until descent is possible. Susceptible individuals can prevent HAPE by slow ascent: an average gain of altitude not exceeding 400m/day above an altitude of 2500m. If progressive high altitude acclimatization is not possible, a prophylaxis with nifedipine should be recommended

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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Scopus Subject Areas:Life Sciences > Physiology
Health Sciences > Cardiology and Cardiovascular Medicine
Health Sciences > Physiology (medical)
Uncontrolled Keywords:High altitude pulmonary oedema, Capillary pressure, Hypoxic pulmonary vasoconstriction, Trans-epithelial Na transport, Nifedipine, Tadalafil, Dexamethasone
Language:English
Date:1 October 2006
Deposited On:29 Oct 2018 15:43
Last Modified:15 Apr 2021 14:49
Publisher:Oxford University Press
ISSN:0008-6363
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.cardiores.2006.07.004

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