Severe high altitude pulmonary oedema: a patient managed successfully with non-invasive positive pressure ventilation in the Emergency Department.
High altitude pulmonary oedema (HAPE) is a well-known potential hazard of activities at high altitudes but not a common disease presentation that most emergency physicians have experience treating. The mainstay of treatment is intuitive--early recognition with immediate descent, rest and oxygen--but what does the emergency physician do when a patient is in severe distress from HAPE even after descent to sea level? A case of severe HAPE is presented in a young man; the successful treatment strategy is outlined including non-invasive positive pressure ventilation. The role of calcium antagonists, corticosteroids and phosphodiesterase inhibitors are also discussed in the acute management of this potentially life-threatening condition.
Gregorius
David D
DD
Department of Emergency Medicine, Loma Linda University, 11234 Anderson Street, Room A108, Loma Linda, CA 92354, USA.
Dawood
Ronnie
R
Ruh
Katja
K
Nguyen
H Bryant
HB
D000328:Adult; D000532:Altitude Sickness / Q000150:complications*; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D011859:Radiography