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High altitude-induced pulmonary oedema.
Cardiovasc Res. 2006 Oct 01; 72(1):41-50.CR

Abstract

Almost one mountain trekker or climber out of two develops several symptoms of high altitude illness after a rapid ascent (> 300 m/day) to an altitude above 4000 m. 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 55 mm Hg), 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 400 m/day above an altitude of 2500 m. If progressive high altitude acclimatization is not possible, a prophylaxis with nifedipine should be recommended.

Authors+Show Affiliations

Intensive Care Unit, Department of Internal Medicine, University Hospital, Rämistrasse 100, CH-8091 Zürich, Switzerland. klinmax@usz.unizh.ch

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16904089

Citation

Maggiorini, Marco. "High Altitude-induced Pulmonary Oedema." Cardiovascular Research, vol. 72, no. 1, 2006, pp. 41-50.
Maggiorini M. High altitude-induced pulmonary oedema. Cardiovasc Res. 2006;72(1):41-50.
Maggiorini, M. (2006). High altitude-induced pulmonary oedema. Cardiovascular Research, 72(1), 41-50.
Maggiorini M. High Altitude-induced Pulmonary Oedema. Cardiovasc Res. 2006 Oct 1;72(1):41-50. PubMed PMID: 16904089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High altitude-induced pulmonary oedema. A1 - Maggiorini,Marco, Y1 - 2006/07/12/ PY - 2006/06/06/received PY - 2006/06/27/revised PY - 2006/07/03/accepted PY - 2006/8/15/pubmed PY - 2007/5/30/medline PY - 2006/8/15/entrez SP - 41 EP - 50 JF - Cardiovascular research JO - Cardiovasc. Res. VL - 72 IS - 1 N2 - Almost one mountain trekker or climber out of two develops several symptoms of high altitude illness after a rapid ascent (> 300 m/day) to an altitude above 4000 m. 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 55 mm Hg), 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 400 m/day above an altitude of 2500 m. If progressive high altitude acclimatization is not possible, a prophylaxis with nifedipine should be recommended. SN - 0008-6363 UR - https://www.unboundmedicine.com/medline/citation/16904089/High_altitude_induced_pulmonary_oedema_ L2 - https://academic.oup.com/cardiovascres/article-lookup/doi/10.1016/j.cardiores.2006.07.004 DB - PRIME DP - Unbound Medicine ER -