High Altitude Pulmonary Edema: An Update on Omics Data (original) (raw)
Related papers
High altitude pulmonary edema in an experienced mountaineer. possible genetic predisposition
The western journal of emergency medicine, 2014
High altitude pulmonary edema (HAPE) is a form of high altitude illness characterized by cough, dyspnea upon exertion progressing to dyspnea at rest and eventual death, seen in patients who ascend over 2,500 meters, particularly if that ascent is rapid. This case describes a patient with no prior history of HAPE and extensive experience hiking above 2,500 meters who developed progressive dyspnea and cough while ascending to 3,200 meters. His risk factors included rapid ascent, high altitude, male sex, and a possible genetic predisposition for HAPE.
Scientific reports, 2017
HAPE susceptible (HAPE-S, had HAPE episode in past) subjects may have subclinical cardio-pulmonary dysfunction. We compared the results of pulmonary function tests in 25 healthy HAPE-S non-mountaineers and 19 matched HAPE resistant (HAPE-R, no HAPE episode in past). Acute normobaric hypoxia (FIo2 0.12) was administered at sea level to confirm hypoxia intolerance in HAPE-S. Unlike HAPE-R, HAPE-S subjects had elevated baseline and post-hypoxia systolic pulmonary arterial pressures (20.9 ± 3 vs 27.3 ± 5 mm Hg during normoxia and 26.2 ± 6 vs 45.44 ± 10 mm Hg during hypoxia, HAPE-R vs HAPE-S). Forced vital capacity (FVC) and single breath alveolar volume (SBVA) were significantly lower in HAPE-S compared to HAPE-R (FVC: 4.33 ± 0.5 vs 4.6 ± 0.4; SBVA: 5.17 ± 1 vs 5.6 ± 1 Lt; HAPE-S vs HAPE-R). Two subgroups with abnormal pulmonary function could be identified within HAPE-S; HAPE-S1 (n = 4) showed DLCO>140% of predicted, suggestive of asthma and HAPE-S2 (n = 12) showed restrictive patte...
Clinico-epidemiological profile of high altitude pulmonary edema
International Journal Of Community Medicine And Public Health
Background: With increase in the footfall to mountainous areas for occupational and recreational purposes, tackling the burden of high-altitude illnesses is a growing public health challenge. High-altitude pulmonary edema (HAPE) is a serious medical condition with peculiar epidemiological characteristics. HAPE is a significant cause of morbidity and mortality among Indian soldiers posted to high-altitude areas. Aims and objectives of the study were to study the common clinical presentation of HAPE among Indian army soldiers and to study the association between induction patterns and acclimatization status with the onset of HAPE.Methods: An observational study was undertaken to study the clinical and epidemiological characteristics of all cases of HAPE from years 2016 to 2019, among Indian army soldiers posted to high-altitude areas in Ladakh. Diagnosis was made by the Lake-Louise consensus criteria. Data was entered in Microsoft Excel and descriptive and inferential statistical tool...
Indian Journal of Respiratory Care
There is an increase in the number of people traveling to high altitudes (HAs) either for work or pleasure. The rewards of such travel are generally in the form of risk of developing acute altitude illnesses or worsening of underlying medical problems. The purpose of physiology in medicine is to provide scientific information that can be used as a basis for counseling patients for these purposes. It has been seen that the symptoms of HA pulmonary edema (HAPE) ordinarily happen a few days after landing in height, and it involves dyspnea with exertion, advancing to dyspnea at rest, a dry cough, weakness, and poor exercise tolerance. [1] If the disease worsens without treatment, severe dyspnea and frank pulmonary edema are obvious, with coma and death following. Early clinical signs of the condition include tachycardia and tachypnea, mild pyrexia, basal crepitations, and dependent edema. In addition, patients generally have decreased oxygen saturation than unaffected people, but the degree of desaturation by itself has not been taken as the reliable sign of HAPE. [2] HAPE rarely occurs below 2500 m. Generally, residents of low altitudes are susceptible to HAPE if acutely exposed to HA. Some suffer
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 1 ( 2 0 1 5 ) 3 4 5 -3 5 1 a b s t r a c t Background: The criteria used for diagnosing high altitude illnesses are largely based on Western literature. This study was undertaken to define objective, simple and reliable diagnostic criteria for high altitude pulmonary edema (HAPE) in Indian soldiers at altitudes between 2700 m and 3500 m. Methods: Clinical data of 235 cases of HAPE that occurred between 2700 m and 3500 m were analysed. Receiver operator characteristic (ROC) curve analysis was used to select simple clinical parameters suitable for the diagnosis of HAPE at peripheral medical facilities. Cut-off values and their reliability for the diagnosis of HAPE were defined. Results: HAPE occurred 2.8 AE 2.2 days after arrival at altitudes between 2700 m and 3500 m.
Prevention and Treatment of High-Altitude Pulmonary Edema
Progress in Cardiovascular Diseases, 2010
We distinguish two forms of high altitude illness, a cerebral form called acute mountain sickness and a pulmonary form called high-altitude pulmonary edema (HAPE). Individual susceptibility is the most important determinant for the occurrence of HAPE. The hallmark of HAPE is an excessively elevated pulmonary artery pressure (mean pressure 36-51 mm Hg), caused by an inhomogeneous hypoxic pulmonary vasoconstriction which leads to an elevated pulmonary capillary pressure and protein content as well as red blood cell-rich edema fluid. Furthermore, decreased fluid clearance from the alveoli may contribute to this noncardiogenic pulmonary edema. Immediate descent or supplemental oxygen and nifedipine or sildenafil are recommended until descent is possible. Susceptible individuals can prevent HAPE by slow ascent, average gain of altitude not exceeding 300 m/d above an altitude of 2500 m. If progressive high altitude acclimatization would not be possible, prophylaxis with nifedipine or tadalafil for long sojourns at high altitude or dexamethasone for a short stay of less then 5 days should be recommended. (Prog Cardiovasc Dis 2010;52:500-506)
Identification of haptoglobin and apolipoprotein AI as biomarkers for high altitude pulmonary edema
Functional & integrative …, 2011
We have investigated the plasma proteome using 2D gel electrophoresis and matrix-assisted laser desorption/ ionization tandem time of flight from patients with high altitude pulmonary edema (HAPE). A complete proteomic analysis was performed on 20 patients with HAPE and ten healthy sea level controls. In total, we have identified 25 protein spots in human plasma and found that 14 of them showed altered changes in HAPE patients, which mainly were acute phase proteins (APPs), compliment components, and apolipoproteins among others. Among the APPs, haptoglobin α2 chain, haptoglobin β chain, transthyretin, and plasma retinol binding precursor showed overexpression in HAPE patients as compared to controls. To validate the result of proteomic analysis, two proteins were selected for enzyme-linked immunosorbent assay and Western blotting analysis. Our data conclusively shows that two proteins, haptoglobin and apolipoprotein A-I are upregulated in plasma of HAPE patients. These proteins may provide a fast and effective control of inflammatory damage until the subsequent mechanisms can begin to operate. Taken together, our findings further support the hypothesis that inflammatory response system is linked to the pathophysiology of HAPE.
Life sciences, 2018
Lack of zero side-effect, prescription-less prophylactics and diagnostic markers of acclimatization status lead to many suffering from high altitude illnesses. Although not fully translated to the clinical setting, many strategies and interventions are being developed that are aimed at providing an objective and tangible answer regarding the acclimatization status of an individual as well as zero side-effect prophylaxis that is cost-effective and does not require medical supervision. This short review brings together the twin problems associated with high-altitude acclimatization, i.e. acclimatization status and zero side-effect, easy-to-use prophylaxis, for the reader to comprehend as cogs of the same phenomenon. We describe current research aimed at preventing all the high-altitude illnesses by considering them an assault on redox and energy homeostasis at the molecular level. This review also entails some proteins capable of diagnosing either acclimatization or high-altitude illn...
Delayed-Onset High Altitude Pulmonary Edema: A Case Report
Wilderness & Environmental Medicine
High altitude pulmonary edema (HAPE) is a life-threatening altitude illness that usually occurs in insufficiently acclimatized climbers in the first few days at altitudes above 2500 m. Acetazolamide is recommended for prophylaxis of acute mountain sickness, but a role for acetazolamide in the prevention of HAPE has not been established. We report a case of a trekker with previous high altitude experience who developed HAPE 8 d after arrival to altitude despite what was believed to be a conservative ascent profile.