Novel drugs in the management of acute mountain sickness and high altitude pulmonary edema

The role of blood rheology in the pathogenesis of acute mountain sickness and high-altitude pulmonary edema was investigated. Twenty-three volunteers, 12 with a history of high-altitude pulmonary edema, were studied at low altitude (490 m) and at 2 h and 18 h after arrival at 4,559 m. Eight subjects remained healthy, seven developed acute mountain sickness, and eight developed high-altitude pulmonary edema. Hematocrit, whole blood viscosity, plasma viscosity, erythrocyte aggregation, and erythrocyte deformability (filtration) were measured. Plasma viscosity and erythrocyte deformability remained unaffected. The hematocrit level was lower 2 h after the arrival at high altitude and higher after 18 h compared with low altitude. The whole blood viscosity changed accordingly. The erythrocyte aggregation was about doubled 18 h after the arrival compared with low-altitude values, which reflects the acute phase reaction. There were, however, no significant differences in any rheological parameters between healthy individuals and subjects with acute mountain sickness or high-altitude pulmonary edema, either before or during the illness. We conclude that rheological abnormalities can be excluded as an initiating event in the development of acute mountain sickness and high-altitude pulmonary edema.

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Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: An enhanced view from the High Andes

10.31219/osf.io/hprxe ◽

2021 ◽

Author(s):

Gustavo Zubieta-Calleja ◽

Natalia Zubieta-DeUrioste

Keyword(s):

Pulmonary Edema ◽

High Altitude ◽

Cerebral Edema ◽

Acute Mountain Sickness ◽

Point Of View ◽

La Paz ◽

Mountain Climbing ◽

High Altitude Pulmonary Edema ◽

High Altitude Cerebral Edema ◽

Mountain Sickness

Background: Travelling to high altitude for entertainment or work is sometimes associated with acute high altitude pathologies. In the past, scientific literature from the lowlander point of view was mostly based on mountain climbing. Nowadays, altitude descent and evacuation are not mandatory in populated highland cities. Methods: We present how to diagnose and treat acute high altitude pathologies based on 50 years of high altitude physiology and medical practice in hypobaric hypoxic diseases in La Paz, Bolivia (3,600m; 11,811ft), at the High Altitude Pulmonary and Pathology Institute (HAPPI – IPPA) altitudeclinic.com.Results: Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema are all medical conditions faced by some travelers. These can occasionally present after flights to high altitude cities, both in lowlanders or high-altitude residents during re-entry, particularly after spending more than 20 days at sea level.Conclusions: Acute high altitude ascent diseases can be adequately diagnosed and treated without altitude descent. Traveling to high altitude should not be feared as it has many benefits;

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Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: A view from the High Andes

10.31219/osf.io/wsqma ◽

2021 ◽

Author(s):

Gustavo Zubieta-Calleja ◽

Natalia Zubieta-DeUrioste

Keyword(s):

Pulmonary Edema ◽

High Altitude ◽

Cerebral Edema ◽

Acute Mountain Sickness ◽

Healthy Children ◽

Number Of Children ◽

High Altitude Pulmonary Edema ◽

High Altitude Cerebral Edema ◽

Potential Risks ◽

Mountain Sickness

Healthy children and those with pre-existing conditions traveling to high altitude may experience diverse physiologic changes. Individuals who are not acclimatized and ascend rapidly are at risk of developing acute high altitude illnesses (HAI), which may occur within a few hours after arrival at high altitudes, being acute mountain sickness (AMS) the most common. In very few cases, serious complications may occur, including High Altitude Pulmonary Edema (HAPE) and very rarely High Altitude Cerebral Edema (HACE). Moreover, the number of children and adolescents traveling on commercial aircrafts is growing and this poses a need for their treating physicians to be aware of the potential risks of hypoxia while air traveling. In this article we present 50 years of medical practice at high altitude treating these pathologies succesfully with no casualties.

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Retraction notice to “Acute Mountain Sickness, High Altitude Pulmonary Edema, and High Altitude Cerebral Edema: A view from the High Andes” [Respir. Physiol. Neurobiol. (2021) 103628]

Respiratory Physiology & Neurobiology ◽

10.1016/j.resp.2021.103778 ◽

2021 ◽

pp. 103778

Author(s):

Gustavo Zubieta-Calleja ◽

Natalia Zubieta-DeUrioste

Keyword(s):

Pulmonary Edema ◽

High Altitude ◽

Cerebral Edema ◽

Acute Mountain Sickness ◽

High Altitude Pulmonary Edema ◽

High Altitude Cerebral Edema ◽

Mountain Sickness ◽

Retraction Notice

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Acute high-altitude illness: updated principles ofpathophysiology, prevention, and treatment

Deutsche Zeitschrift für Sportmedizin ◽

10.5960/dzsm.2020.445 ◽

2020 ◽

Vol 71 (11-12) ◽

pp. 267-274

Author(s):

MM Berger ◽

LM Schiefer ◽

G Treff ◽

M Sareban ◽

ER Swenson ◽

...

Keyword(s):

Pulmonary Edema ◽

High Altitude ◽

Cerebral Edema ◽

Acute Mountain Sickness ◽

High Altitude Pulmonary Edema ◽

Prevention And Treatment ◽

High Altitude Cerebral Edema ◽

Mountain Sickness ◽

High Altitude Illness ◽

Cardinal Symptom

The interest in trekking and mountaineering is increasing, and growing numbers of individuals are travelling to high altitude. Following ascent to high altitude, individuals are at risk of developing one of the three forms of acute high-altitude illness: acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). The cardinal symptom of AMS is headache that occurs with an increase in altitude. Additional symptoms are anorexia, nausea, vomiting, dizziness, and fatigue. HACE is characterized by truncal ataxia and decreased consciousness that generally but not always are preceded by worsening AMS. The typical features of HAPE are a loss of stamina, dyspnea, and dry cough on exertion, followed by dyspnea at rest, rales, cyanosis, cough, and pink, frothy sputum. These diseases can develop at any time from several hours to 5 days following ascent to altitudes above 2,500-3,000 m. Whereas AMS is usually self-limited, HACE and HAPE represent life-threatening emergencies that require timely intervention. For each disease, we review the clinical features, epidemiology and the current understanding of their pathophysiology. We then review the primary pharmacological and non-pharmacological approaches to the management of each form of acute altitude illness and provide practical recommendations for both prevention and treatment. The essential principles for advising travellers prior to high-altitude exposure are summarized. Key Words: Acute Mountain Sickness, High Altitude Cerebral Edema, High Altitude Pulmonary Edema, Hypoxia

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