There are three main types of altitude related disorders: acute mountain sickness (AMS), which may progress to high altitude pulmonary oedema (HAPE) or high altitude cerebral oedema (HACE). All three conditions are due to the chronic hypobaric hypoxia which develops at high altitudes.
Acute mountain sickness is generally a self-limiting condition. Features of AMS start to occur above 2500 and 3000m, developing gradually over 6-12 hours and potentially lasting a number of days.
Headache, nausea, fatigue.
Prevention and treatment of AMS.
The risk of AMS may actually be positively correlated to physical fitness
Gain altitude at no more than 500m per day
Acetazolamide (a carbonic anhydrase inhibitor) is widely used to prevent AMS and has a supporting evidence base
Treatment is descent.
HAPE: Classical pulmonary oedema features.
HACE: Headache, ataxia, papilloedema
Management of HACE: Descent, dexamethasone
Management of HAPE: Descent, nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors, oxygen if available
No comments:
Post a Comment