Acute high-altitude illnesses
P Bärtsch, ER Swenson - New England Journal of Medicine, 2013 - Mass Medical Soc
P Bärtsch, ER Swenson
New England Journal of Medicine, 2013•Mass Medical SocKey Clinical Points Acute High-Altitude Illnesses Acute high-altitude illnesses occur in
persons who are not acclimatized during the first days at an altitude of 2500 m or higher,
with wide variation in the incidence according to patient characteristics and history.
Headache is the major symptom of acute mountain sickness. If acute mountain sickness is
not treated adequately, it can progress to life-threatening high-altitude cerebral or pulmonary
edema. High-altitude illnesses can be prevented by ascending 300 to 500 m per day at …
persons who are not acclimatized during the first days at an altitude of 2500 m or higher,
with wide variation in the incidence according to patient characteristics and history.
Headache is the major symptom of acute mountain sickness. If acute mountain sickness is
not treated adequately, it can progress to life-threatening high-altitude cerebral or pulmonary
edema. High-altitude illnesses can be prevented by ascending 300 to 500 m per day at …
Key Clinical Points
Acute High-Altitude Illnesses
- Acute high-altitude illnesses occur in persons who are not acclimatized during the first days at an altitude of 2500 m or higher, with wide variation in the incidence according to patient characteristics and history.
- Headache is the major symptom of acute mountain sickness. If acute mountain sickness is not treated adequately, it can progress to life-threatening high-altitude cerebral or pulmonary edema.
- High-altitude illnesses can be prevented by ascending 300 to 500 m per day at altitudes above 3000 m and including a rest day every 3 to 4 days.
- Risks of acute mountain sickness and high-altitude cerebral edema are reduced with the use of acetazolamide or dexamethasone; the risk of high-altitude pulmonary edema is reduced with the use of nifedipine, phosphodiesterase-5 inhibitors, or dexamethasone.
- Acute mountain sickness may be treated by a day of rest and nonsteroidal antiinflammatory drugs for headache, but when it is severe, descent or supplemental oxygen is indicated. Dexamethasone is indicated for severe acute mountain sickness or high-altitude cerebral edema, and nifedipine or phosphodiesterase-5 inhibitors are indicated for high-altitude pulmonary edema; treatment with these agents should be followed by descent as soon as possible.
The New England Journal Of Medicine