Abstract
A 40 year old man had an episode of severe pulmonary oedema at 4000-5000 m during the ascent of the Margherita peak (5109 m) of Mount Stanley on the Ruwenzori. He had taken acetazolamide and high dose dexamethasone to treat symptoms of acute mountain sickness. Six years before he had been studied by right heart catheterisation as a healthy volunteer during hypoxic breathing at sea level. His pulmonary vascular reactivity had been within the normal range for 32 healthy subjects. This man had high altitude pulmonary oedema despite currently recommended treatments for acute mountain sickness and normal pulmonary vascular reactivity to hypoxia at sea level.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ellsworth A. J., Larson E. B., Strickland D. A randomized trial of dexamethasone and acetazolamide for acute mountain sickness prophylaxis. Am J Med. 1987 Dec;83(6):1024–1030. doi: 10.1016/0002-9343(87)90937-5. [DOI] [PubMed] [Google Scholar]
- Fasules J. W., Wiggins J. W., Wolfe R. R. Increased lung vasoreactivity in children from Leadville, Colorado, after recovery from high-altitude pulmonary edema. Circulation. 1985 Nov;72(5):957–962. doi: 10.1161/01.cir.72.5.957. [DOI] [PubMed] [Google Scholar]
- Hultgren H. N., Grover R. F., Hartley L. H. Abnormal circulatory responses to high altitude in subjects with a previous history of high-altitude pulmonary edema. Circulation. 1971 Nov;44(5):759–770. doi: 10.1161/01.cir.44.5.759. [DOI] [PubMed] [Google Scholar]
- Johnson T. S., Rock P. B. Current concepts. Acute mountain sickness. N Engl J Med. 1988 Sep 29;319(13):841–845. doi: 10.1056/NEJM198809293191306. [DOI] [PubMed] [Google Scholar]
- Kawashima A., Kubo K., Kobayashi T., Sekiguchi M. Hemodynamic responses to acute hypoxia, hypobaria, and exercise in subjects susceptible to high-altitude pulmonary edema. J Appl Physiol (1985) 1989 Nov;67(5):1982–1989. doi: 10.1152/jappl.1989.67.5.1982. [DOI] [PubMed] [Google Scholar]
- Levine B. D., Yoshimura K., Kobayashi T., Fukushima M., Shibamoto T., Ueda G. Dexamethasone in the treatment of acute mountain sickness. N Engl J Med. 1989 Dec 21;321(25):1707–1713. doi: 10.1056/NEJM198912213212504. [DOI] [PubMed] [Google Scholar]
- Mélot C., Naeije R., Hallemans R., Lejeune P., Mols P. Hypoxic pulmonary vasoconstriction and pulmonary gas exchange in normal man. Respir Physiol. 1987 Apr;68(1):11–27. doi: 10.1016/0034-5687(87)90073-9. [DOI] [PubMed] [Google Scholar]
- Naeije R., Mélot C., Lejeune P. Hypoxic pulmonary vasoconstriction and high altitude pulmonary edema. Am Rev Respir Dis. 1986 Aug;134(2):332–333. doi: 10.1164/arrd.1986.134.2.332. [DOI] [PubMed] [Google Scholar]
- Penaloza D., Sime F. Circulatory dynamics during high altitude pulmonary edema. Am J Cardiol. 1969 Mar;23(3):369–378. doi: 10.1016/0002-9149(69)90517-7. [DOI] [PubMed] [Google Scholar]
- Roy S. B., Guleria J. S., Khanna P. K., Manchanda S. C., Pande J. N., Subba P. S. Haemodynamic studies in high altitude pulmonary oedema. Br Heart J. 1969 Jan;31(1):52–58. doi: 10.1136/hrt.31.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schoene R. B., Hackett P. H., Henderson W. R., Sage E. H., Chow M., Roach R. C., Mills W. J., Jr, Martin T. R. High-altitude pulmonary edema. Characteristics of lung lavage fluid. JAMA. 1986 Jul 4;256(1):63–69. [PubMed] [Google Scholar]
- Viswanathan R., Jain S. K., Subramanian S., Subramanian T. A., Dua G. L., Giri J. Pulmonary edema of high altitude. II. Clinical, aerohemodynamic, and biochemical studies in a group with history of pulmonary edema of high altitude. Am Rev Respir Dis. 1969 Sep;100(3):334–341. doi: 10.1164/arrd.1969.100.3.334. [DOI] [PubMed] [Google Scholar]