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High altitude pulmonary oedema.
MedLine Citation:
PMID:  21465914     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
High altitude pulmonary oedema (HAPE) is an important and preventable cause of death at high altitudes. However, little is known about the global incidence of HAPE, in part because most cases occur in remote environments where no records are kept. Furthermore, despite international efforts to achieve consensus, there is wide disparity in the diagnostic criteria in clinical and research use. We have reviewed the literature on the incidence and epidemiology of HAPE. There is broad agreement between studies that HAPE incidence at 2500m is around 0.01%, and increases to 1.9% at 3600m and 2.5-5% at 4300m. Risk factors for HAPE include rate of ascent, intensity of exercise and absolute altitude attained, although an individual pre-disposition to developing the condition is also well described and suggests an underlying genetic susceptibility. It is increasingly recognised that clinically-detectable HAPE is an extreme of a continuous spectrum of excess pulmonary fluid accumulation, which has been demonstrated in asymptomatic individuals. There is a continued need to ensure awareness of the diagnosis and treatment of HAPE among visitors to high altitude. It is likely that HAPE is preventable in all cases by progressive acclimatisation, and we advocate a pragmatic "golden rules" approach. Our understanding of the epidemiology and underlying genetic susceptibility to HAPE may be advanced if susceptible individuals register with the International HAPE Database: http://www.altitude.org/hape.php. HAPE has direct relevance to military training and operations and is likely to be the leading cause of death at high altitude.
Authors:
D P Hall; K Duncan; J K Baillie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Royal Army Medical Corps     Volume:  157     ISSN:  0035-8665     ISO Abbreviation:  J R Army Med Corps     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505627     Medline TA:  J R Army Med Corps     Country:  England    
Other Details:
Languages:  eng     Pagination:  68-72     Citation Subset:  IM    
Affiliation:
Royal Infirmary of Edinburgh, Edinburgh, UK.
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