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Prevention and treatment of high-altitude pulmonary edema.
Prog Cardiovasc Dis. 2010 May-Jun; 52(6):500-6.PC

Abstract

We distinguish two forms of high altitude illness, a cerebral form called acute mountain sickness and a pulmonary form called high-altitude pulmonary edema (HAPE). Individual susceptibility is the most important determinant for the occurrence of HAPE. The hallmark of HAPE is an excessively elevated pulmonary artery pressure (mean pressure 36-51 mm Hg), caused by an inhomogeneous hypoxic pulmonary vasoconstriction which leads to an elevated pulmonary capillary pressure and protein content as well as red blood cell-rich edema fluid. Furthermore, decreased fluid clearance from the alveoli may contribute to this noncardiogenic pulmonary edema. Immediate descent or supplemental oxygen and nifedipine or sildenafil are recommended until descent is possible. Susceptible individuals can prevent HAPE by slow ascent, average gain of altitude not exceeding 300 m/d above an altitude of 2500 m. If progressive high altitude acclimatization would not be possible, prophylaxis with nifedipine or tadalafil for long sojourns at high altitude or dexamethasone for a short stay of less then 5 days should be recommended.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20417343

Citation

Maggiorini, Marco. "Prevention and Treatment of High-altitude Pulmonary Edema." Progress in Cardiovascular Diseases, vol. 52, no. 6, 2010, pp. 500-6.
Maggiorini M. Prevention and treatment of high-altitude pulmonary edema. Prog Cardiovasc Dis. 2010;52(6):500-6.
Maggiorini, M. (2010). Prevention and treatment of high-altitude pulmonary edema. Progress in Cardiovascular Diseases, 52(6), 500-6. https://doi.org/10.1016/j.pcad.2010.03.001
Maggiorini M. Prevention and Treatment of High-altitude Pulmonary Edema. Prog Cardiovasc Dis. 2010 May-Jun;52(6):500-6. PubMed PMID: 20417343.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention and treatment of high-altitude pulmonary edema. A1 - Maggiorini,Marco, PY - 2010/4/27/entrez PY - 2010/4/27/pubmed PY - 2010/5/14/medline SP - 500 EP - 6 JF - Progress in cardiovascular diseases JO - Prog Cardiovasc Dis VL - 52 IS - 6 N2 - We distinguish two forms of high altitude illness, a cerebral form called acute mountain sickness and a pulmonary form called high-altitude pulmonary edema (HAPE). Individual susceptibility is the most important determinant for the occurrence of HAPE. The hallmark of HAPE is an excessively elevated pulmonary artery pressure (mean pressure 36-51 mm Hg), caused by an inhomogeneous hypoxic pulmonary vasoconstriction which leads to an elevated pulmonary capillary pressure and protein content as well as red blood cell-rich edema fluid. Furthermore, decreased fluid clearance from the alveoli may contribute to this noncardiogenic pulmonary edema. Immediate descent or supplemental oxygen and nifedipine or sildenafil are recommended until descent is possible. Susceptible individuals can prevent HAPE by slow ascent, average gain of altitude not exceeding 300 m/d above an altitude of 2500 m. If progressive high altitude acclimatization would not be possible, prophylaxis with nifedipine or tadalafil for long sojourns at high altitude or dexamethasone for a short stay of less then 5 days should be recommended. SN - 1873-1740 UR - https://www.unboundmedicine.com/medline/citation/20417343/Prevention_and_treatment_of_high_altitude_pulmonary_edema_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0033-0620(10)00048-4 DB - PRIME DP - Unbound Medicine ER -