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Encyclopedia > High altitude pulmonary edema

High altitude pulmonary edema (HAPE) is a life threatening form of non-cardiogenic pulmonary edema that occurs in otherwise healthy mountaineers at altitudes above 2500m. Some cases have however been reported also at lower altitudes (between 1500 and 2500m in highly vulnerable subjects), although what makes some people susceptible to HAPE is not currently known. HAPE remains the major cause of death related to high altitude exposure with a high mortality in absence of emergency treatment. Pulmonary edema is swelling and/or fluid accumulation in the lungs. ... Mountaineering is an umbrella term that can variously be used to describe the actions of climbing, hillwalking and scrambling. ...

Contents


Aetiology

The initial insult that causes HAPE is a shortage of oxygen which is caused by the lower air pressure at high altitudes.[1] The mechanisms by which this shortage of oxygen causes HAPE are poorly understood, but two processes are believed to be important: General Name, Symbol, Number oxygen, O, 8 Chemical series Nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance transparent (gas) very pale blue (liquid) Atomic mass 15. ...

  1. Increased pulmonary arterial and capillary pressures (pulmonary hypertension) secondary to hypoxic pulmonary vasoconstriction.[2]
  2. An idiopathic non-inflammatory increase in the permeability of the vascular endothelium.[3]

Although higher pulmonary arterial pressures are associated with the development of HAPE, the presence of pulmonary hypertension may not in itself be sufficient to explain the development of oedema: severe pulmonary hypertension can exist in the absence of clinical HAPE in subjects at high altitude.[4] In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery or lung vasculature. ... Permeability has several meanings: In electromagnetism, permeability is the degree of magnetisation of a material in response to a magnetic field. ... The endothelium is the layer of thin, flat cells that lines the interior surface of blood vessels, forming an interface between circulating blood in the lumen and the rest of the vessel wall. ... In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery or lung vasculature. ...


Predisposing factors

Individual susceptibility to HAPE is difficult to predict. The most reliable risk factor is previous susceptibility to HAPE, and there is likely to be a genetic basis to this condition, perhaps involving the gene for angiotensin converting enzyme (ACE). Angiotensin-Converting Enzyme (ACE, EC 3. ...


Research

In order to help understand the factors that make some individuals susceptible to HAPE, the International HAPE Database was set up in 2005.[5]


Footnotes

  1. ^ Kenneth Baillie and Alistair Simpson. Barometric pressure calculator. Apex (Altitude Physiology EXpeditions). Retrieved on 2006-08-10. - Online calculator
  2. ^ Bärtsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O (Oct 31 1991). "Prevention of high-altitude pulmonary edema by nifedipine.". N Engl J Med 325 (18): 1284-9. PMID 1922223.
  3. ^ Swenson E, Maggiorini M, Mongovin S, Gibbs J, Greve I, Mairbäurl H, Bärtsch P (2002). "Pathogenesis of high-altitude pulmonary edema: inflammation is not an etiologic factor.". JAMA 287 (17): 2228-35. PMID 11980523.
  4. ^ Maggiorini M, Mélot C, Pierre S, Pfeiffer F, Greve I, Sartori C, Lepori M, Hauser M, Scherrer U, Naeije R (2001). "High-altitude pulmonary edema is initially caused by an increase in capillary pressure.". Circulation 103 (16): 2078-83. PMID 11319198.
  5. ^ International HAPE database. Apex (Altitude Physiology EXpeditions). Retrieved on 2006-08-10.

2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... August 10 is the 222nd day of the year (223rd in leap years) in the Gregorian Calendar. ... 2006 (MMVI) is a common year starting on Sunday of the Gregorian calendar. ... August 10 is the 222nd day of the year (223rd in leap years) in the Gregorian Calendar. ...

See also


  Results from FactBites:
 
High Altitude Pulmonary Edema (1529 words)
High Altitude Pulmonary Edema (HAPE) is a life threatening medical condition which can occur in the mountains, typically above 8,000 or 10,000 feet elevation.
Current research is attempting to answer the question of whether pulmonary edema is caused by "leaky" capillaries or by high blood pressure in the lungs.
Low altitude residents who have never experienced high elevation tend to have a higher incidence of HAPE compared to others who have previous successful high altitude experience.
MD Travel Health - altitude sickness - symptoms, prevention, and treatment (553 words)
Severe cases may be complicated by breathlessness and chest tightness, which are signs of pulmonary edema (fluid in the lungs), or by confusion, lethargy, and unsteady gait, which indicate cerebral edema (brain swelling).
Altitude sickness may be prevented by taking acetazolamide 125 or 250 mg two or three times daily starting 24 hours before ascent and continuing for 48 hours after arrival at altitude.
Travel to high altitudes is generally not recommended for those with a history of heart disease, lung disease, or sickle cell disease.
  More results at FactBites »


 

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