High-altitude pulmonary edema: pathophysiology and clinical review |
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| Authors: | R B Schoene |
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| Affiliation: | 1. Centre de vaccination et de conseils aux voyageurs, Hôpital Pontchaillou, Rennes, France;2. Service des Maladies Infectieuses et Réanimation Médicale, Hôpital Pontchaillou, Université Rennes I, Rennes, France;3. Département de Médecine Générale, Université Rennes I, Rennes, France;4. Laboratoire de parasitologie, Hôpital Pontchaillou, Université Rennes I, Rennes, France;1. Department of Surgery, University of Washington, 1959 Northeast Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195-6410, USA;2. School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;3. Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana;4. CSIR-Building and Road Research Institute, University PO Box 40, Kumasi, Ghana;5. Secretaria Técnica del CONAPRA, Subsecretaría de Prevención y Promoción Secretaría Salud, Guadalajara 46 3er. Piso Col Roma Norte, CP 06700, Mexico DF, Mexico;6. Center for Injury Policy and Prevention Research, Department of Public Health Informatics, Hanoi School of Public Health, 138 Giảng Võ, Kim Mã, Ba Đình, Hanoi, Vietnam;7. Department of Surgery, University of Washington, Seattle, WA, USA;8. Department of Epidemiology, University of Washington, Seattle, WA, USA;9. Department of Global Health, University of Washington, Seattle, WA, USA;10. Harborview Injury Prevention & Research Center, Patricia Bracelin Steel Memorial Building, 401 Broadway, 4th Floor, Seattle, WA 98122, USA;11. Harborview Medical Center, 325 9th Avenue, Seattle, WA 98104, USA;1. Associate Professor, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, and Private Practice, Amstelland Hospital, Amstelveen, The Netherlands;2. Associate Professor, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, and Private Practice, Amstelland Hospital, Amstelveen, The Netherlands;3. Dental Student, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands;4. Associate Professor, Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam, and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;6. Associate Professor, Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands;1. Laboratory of Clinical Immunology, Wuhan No.1 Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, PR China;2. Department of Pathology, Wuhan No.1 Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, Hubei, PR China;1. Department of Neurobiology, DIPAS, DRDO, Lucknow Road, Timarpur, New Delhi 110054, India;2. Department of Neurophysiology, DIPAS, DRDO, Lucknow Road, Timarpur, New Delhi 110054, India |
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| Abstract: | High-altitude pulmonary edema (HAPE) affects young, healthy climbers in an unpredictable fashion. It is potentially fatal, and its underlying pathophysiology is not thoroughly understood. The history and clinical presentation of HAPE, as well as the known underlying pathophysiology, are reviewed. For instance, in HAPE there is an association with blunted respiratory drives to hypoxia and accentuated hypoxic pulmonary vasoconstriction. Recent data show that HAPE is a high permeability leak of protein into the alveolar space associated with an influx of alveolar macrophages. These data have been obtained recently by fiberoptic bronchoscopy in the field setting of Mt McKinley at 4,400 m. The approach to recognition and treatment that involves primarily descent and/or oxygen is discussed. |
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