High-altitude pulmonary oedema

ESC CardioMed ◽  
2018 ◽  
pp. 1078-1080
Author(s):  
Samuel Verges ◽  
Patrick Levy
Keyword(s):  
High Altitude ◽  
Pulmonary Oedema ◽  
Acute Mountain Sickness ◽  
Arterial Oxygenation ◽  
Lower Altitude ◽  
Vasodilator Drugs ◽  
Oxygen Administration ◽  
Pulmonary Vasoconstriction ◽  
High Altitude Disease ◽  
Alveolar Capillary

At high altitude, the reduction in arterial oxygenation frequently leads to symptoms of acute mountain sickness. While these symptoms generally resolve spontaneously, high-altitude pulmonary oedema can develop and represents a potentially lethal form of high-altitude disease. High-altitude pulmonary oedema is a non-cardiogenic oedema due to exaggerated pulmonary vasoconstriction and altered alveolar–capillary permeability. In addition to descending to lower altitude, it requires specific emergency cares such as oxygen administration, a hyperbaric bag, and vasodilator drugs.

scholarly journals Acute high-altitude sickness

2017 ◽  
Vol 26 (143) ◽  
pp. 160096 ◽  
Author(s):  
Andrew M. Luks ◽  
Erik R. Swenson ◽  
Peter Bärtsch
Keyword(s):  
High Altitude ◽  
Pulmonary Oedema ◽  
Cerebral Oedema ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Acute Mountain Sickness ◽  
Resonance Imaging ◽  
Altitude Sickness ◽  
Pulmonary Vasoconstriction ◽  
Prevention And Treatment ◽  
Mountain Sickness

At any point 1–5 days following ascent to altitudes ≥2500 m, individuals are at risk of developing one of three forms of acute altitude illness: acute mountain sickness, a syndrome of nonspecific symptoms including headache, lassitude, dizziness and nausea; high-altitude cerebral oedema, a potentially fatal illness characterised by ataxia, decreased consciousness and characteristic changes on magnetic resonance imaging; and high-altitude pulmonary oedema, a noncardiogenic form of pulmonary oedema resulting from excessive hypoxic pulmonary vasoconstriction which can be fatal if not recognised and treated promptly. This review provides detailed information about each of these important clinical entities. After reviewing the clinical features, epidemiology and current understanding of the pathophysiology of each disorder, we describe the current pharmacological and nonpharmacological approaches to the prevention and treatment of these diseases.

scholarly journals Doppler assessment of hypoxic pulmonary vasoconstriction and susceptibility to high altitude pulmonary oedema.

Thorax ◽  
1995 ◽  
Vol 50 (1) ◽  
pp. 22-27 ◽  
Author(s):  
J L Vachiery ◽  
T McDonagh ◽  
J J Moraine ◽  
J Berre ◽  
R Naeije ◽  
...  
Keyword(s):  
High Altitude ◽  
Pulmonary Oedema ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Pulmonary Vasoconstriction

DPOAEs in High Altitude Disease at Mount Everest

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P54-P54
Author(s):  
Axel Rolf Behnisch ◽  
Gerd Rasp ◽  
Klaus Mees
Keyword(s):  
Oxygen Saturation ◽  
Intracranial Hypertension ◽  
High Altitude ◽  
Acute Mountain Sickness ◽  
Measurement Data ◽  
Blood Oxygen ◽  
Mount Everest ◽  
Blood Oxygen Saturation ◽  
Distortion Product ◽  
High Altitude Disease

Objective The aim of this study was to measure DPOAEs in climbers on Mount Everest as a criterion for differential diagnosis of high altitude disease. The levels of distortion product otoacoustic emissions (DPOAEs) change at frequencies between 0,75 kHz and 1,5 kH along with intracranial pressure (ICP). DPOAEs are suggested for monitoring ICP changes. Methods In order to determine the etiology of DPOAE-level changes obtained in 6 climbers with severe acute mountain sickness, blood oxygen saturation was measured simultaneously, and a standard request form of Lake-Louis symptoms of high altitude disease was filled in with every DPOAE measurement. Data are presented from DPOAE measurements at frequencies of 1, 1.5, 2, 3 and 4 kHz during an ascent to Mount Everest (8848 m) up to an altitude of 7800 m. Results In all climbers, DPOA levels decreased at 4 kHz and 3 kHz with declining oxygen saturation (SaO2) at high altitude. That has been described in many prior animal studies. On the other hand, DPOAE at 1 kHz showed decreasing levels only with symptoms of high altitude disease (AMS). In one climber with severe symptoms of intracranial hypertension after the ascent to the high camp at 7800 m, decreasing DPOAE levels at 1 kHz were measured in the absence of declining blood oxygen saturation. The most pronounced decline of DPOAEs at 1 kHz was also seen on that occasion. Conclusions DPOAEs are suggested for detection of intracranial hypertension and early detection of high-altitude cerebral edema.

Alternations of Heart Rate Variability at Lower Altitude in the Predication of Trekkers With Acute Mountain Sickness at High Altitude

2010 ◽  
Vol 20 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Hsien-Hao Huang ◽  
Chia-Ying Tseng ◽  
Ju-Sing Fan ◽  
David Hung-Tsang Yen ◽  
Wei-Fong Kao ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Altitude ◽  
Acute Mountain Sickness ◽  
Lower Altitude ◽  
Mountain Sickness

Optic nerve sheath diameter changes at high altitude and in acute mountain sickness: meta-regression analyses

2020 ◽  
pp. bjophthalmol-2020-317717
Author(s):  
Tou-Yuan Tsai ◽  
George Gozari ◽  
Yung-Cheng Su ◽  
Yi-Kung Lee ◽  
Yu-Kang Tu
Keyword(s):  
Optic Nerve ◽  
High Altitude ◽  
Acute Mountain Sickness ◽  
Optic Nerve Sheath Diameter ◽  
Optic Nerve Sheath ◽  
Cochrane Library ◽  
Regression Analyses ◽  
Spline Regression ◽  
Nerve Sheath ◽  
Mountain Sickness

Background/aimsTo assess changes in optic nerve sheath diameter (ONSD) at high altitude and in acute mountain sickness (AMS).MethodsCochrane Library, EMBASE, Google Scholar and PubMed were searched for articles published from their inception to 31st of July 2020. Outcome measures were mean changes of ONSD at high altitude and difference in ONSD change between subjects with and without AMS. Meta-regressions were conducted to investigate the relation of ONSD change to altitude and time spent at that altitude.ResultsEight studies with 248 participants comparing ONSD from sea level to high altitude, and five studies with 454 participants comparing subjects with or without AMS, were included. ONSD increased by 0.14 mm per 1000 m after adjustment for time (95% CI: 0.10 to 0.18; p<0.01). Restricted cubic spline regression revealed an almost linear relation between ONSD change and time within 2 days. ONSD was greater in subjects with AMS (mean difference=0.47; 95% CI: 0.14 to 0.80; p=0.01; I2=89.4%).ConclusionOur analysis shows that ONSD changes correlate with altitude and tend to increase in subjects with AMS. Small study number and high heterogeneity are the limitations of our study. Further large prospective studies are required to verify our findings.

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