Clinical, biochemical, therapeutic, and complication strategy of high-altitude pulmonary edema: Update from Western Himalayas
Krishan Singh1, Santosh Kumar Singh2, Vani Singh3, Ajai Kumar Tentu4, AK Naik5, Nidhi Singh6, Gaurav Joshii7
1 High Altitude Medical Research Center, LEH, 153 General Hospital, Ladakh, India 2 Department of Medicine, Command Hospital, Udhampur, Jammu&Kashmir, India 3 MOIC, ECHS, Udhampur, Jammu&Kashmir, India 4 Department of Pulmonology, Army Institute of Cardiothoracic Sciences (AICTS), Affiliated to Armed Forces Medical College (AFMC), Pune, India 5 Hospital Administration, Brig Med 14 Corps, India 6 Medical Officer, 153 General Hospital, LEH, India 7 MBBS Student, Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
Correspondence Address:
Prof. Ajai Kumar Tentu Department of Pulmonology, Army Institute of Cardio Thoracic Sciences Affiliated to Armed Forces Medical College, Golibar Maidan, Pune - 411 040, Maharashtra India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijrc.ijrc_77_20
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Introduction: People traveling to high altitudes (HAs) for work or pleasure are increasing day by day. The rewards of such travel are generally at the risk of developing of acute altitude illnesses and/or worsening of underlying medical problems. The present study was undertaken in a hospital at 11,500 feet to get updated information on the wide clinical spectrum of patients of high-altitude pulmonary edema (HAPE). Patients and Methods: The study was carried out at a general hospital located at 11,500 feet. The total number of study participants was 151. They were divided into two groups: those who were entering HA for the first time were 17 participants and those who had spent several months at HA 134 patients. All patients in the second group had been completely acclimatized before going down to sea level. The Lake Louis Criteria were taken as the basis for the diagnosis of HAPE. Results: Pulmonary edema was the most common serious illness seen at HA. Majority of the patients presented at 72–96 h after induction to HA. The common symptoms were breathlessness, cough, and headache at rest. In addition, all patients complained to a varying extent of one or more of the following symptoms: dyspnea, cough, fever, chest pain, dizziness, etc., The majority of the patients showed leukocytosis. Pneumonitis may be a predisposing factor or develop secondary to pulmonary edema. Conclusion: Pulmonary edema was the most common serious illness seen at HA. The common symptoms were breathlessness, cough, and headache at rest. The understanding of HAPE has changed since its emergence in the field of diagnosis, pathophysiology, complications, and therapeutic modalities.
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