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Acute mountain sickness: pulmonary and cerebral oedema of high altitude

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Abstract

Acute mountain sickness is a condition affecting otherwise healthy individuals on going rapidly to altitude. It is caused by sub-acute hypoxia in susceptible subjects. Its study may provide lessons for the more complicated situation of hypoxia in patients undergoing intensive care. This paper reviews the incidence and aetiology of acute mountain sickness, pulmonary and cerebral oedema of high altitude and possible mechanisms are discussed. Prophylaxis depends on an awareness of the condition in all those venturing to high altitude and guidelines are suggested. The treatment of the established condition is reviewed.

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References

  1. Birmingham Medical Research Expeditionary Society Mountain Sickness Study Group (1981) Acetazolamide in control of acute mountain sickness. Lancet 1:180

    Google Scholar 

  2. Bradwell AR, Delamare JP (1982) The effect of acetazolamide on the proteinuria of altitude. Aviat Space Environ Med 53:40

    Google Scholar 

  3. Cain SM, Dunn JE (1965) Increase of arterial oxygen tension at altitude by carbonic-anhydrase inhibition. J Appl Physiol 20:882

    Google Scholar 

  4. Currie TT, Carter PH, Champion WL (1976) Spironolactone and acute mountain sickness. Med J Aus 2:168

    Google Scholar 

  5. Dickinson JG (1982) Terminology and classification of acute mountain sickness. Br Med J 285:720

    Google Scholar 

  6. Dickinson J, Heath D, Gosney J, Williams D (1983) Altitude related deaths in seven trekkers in the Himalayas. Thorax 38:646

    Google Scholar 

  7. Forwand SA, Landowne M, Follansbee JN, Hansen JE (1968) Effect of acetazolamide on acute mountain sickness. N Engl J Med 279:839

    Google Scholar 

  8. Fred HL, Schmidt AM, Bates T, Hecht HH (1962) Acute pulmonary edema of altitude. Clinical and physiologic observations. Circulation 25:929

    Google Scholar 

  9. Hackett PH, Rennie D (1979) Rales, peripheral edema, retinal hemorrhage and acute mountain sickness. Am J Med 67:214

    Google Scholar 

  10. Hackett PH, Rennie D (1976) The incidence, importance, and prophylaxis of acute mountain sickness. Lancet 2:1149

    Google Scholar 

  11. Hackett PH, Rennie D, Hofmeister SE, Grover RF, Grover EB, Reeves JT (1982) Fluid retention and relative hypoventilation in acute mountain sickness. Respiration 43:321

    Google Scholar 

  12. Hackett PH, Forsling ML, Milledge J, Rennie D (1978) Release of vasopressin in man at altitude. Horm Metab Res 10:571

    Google Scholar 

  13. Harber MJ, Williams JD, Morton JJ (1981) Antidiurectic hormone excretion at high altitude. Aviat Space Environ Med 52:38

    Google Scholar 

  14. Heath D, Williams DR (1981) Man at high altitude, 2nd edn. Churchill Livingstone, London

    Google Scholar 

  15. Houston CS (1960) Acute pulmonary edema of high altitude. N Engl J Med 263:478

    Article  Google Scholar 

  16. Hu S-T, Huang S-Y, Chu S-C, Pa C-F (1982) Chemoreflexive ventilatory response at sea level in subjects with past history of good acclimatization and severe acute mountain sickness. In: Brendel W, Zink RA (eds) High altitude physiology and medicine. Springer Verlag, New York, p 28

    Google Scholar 

  17. Hultgren HN, Marticorena EA (1978) High altitude pulmonary edema. Epidemiologic observations in Peru. Chest 74:372

    Google Scholar 

  18. Hultgren HN, Grover RE, Hartley LH (1971) Abnormal circulatory responses to high altitude in subjects with a previous history of high altitude pulmonary edema. Circulation 44:759

    Google Scholar 

  19. Hultgen EN, Robison MC, Wuerflein RD (1966) Over perfusion pulmonary edema. Circulation 34 (Suppl 3):132

    Google Scholar 

  20. Hyers TM, Scoggin CH, Will DH, Grover RF, Reeves JT (1979) Accentuated hypoxemia at high altitude in subjects susceptible to high-altitude pulmonary edema. J Appl Physiol 46:41

    Google Scholar 

  21. Lakshimarayan S, Pierson DJ (1975) Recurrent high altitude pulmonary edema with blunted chemosensitivity. Am Res Respir Dis 111:869

    Google Scholar 

  22. Leuenberger PJ, Stalcup SA, Mellins RB, Greenbaum LM, Turino GM (1978) Decrease in angiotensin I conversion by acute hypoxia in dogs. Proc Soc Exp Biol Med 158:586

    Google Scholar 

  23. Larson EB, Roach RC, Schoene RB, Hornbein TF (1982) Acute mountain sickness and acetazolamide. Clinical efficacy and effect on ventilation. JAMA 248:328

    Google Scholar 

  24. Menon ND (1965) High-altitude pulmonary edema. A clinical study. N Engl J Med 273:66

    Google Scholar 

  25. Milledge JS, Catley DM (1982) Renin, aldosterone, and angiotensin converting enzyme during exercise and acute hypoxia in humans. J Appl Physiol Respir 52:320

    Google Scholar 

  26. Milledge JS, Bryson EI, Catley DM et al (1982) Sodium balance, fluid homeostasis and the renin-aldosterone system during the prolonged exercise of hill walking. Clin Sci 62:595

    Google Scholar 

  27. Milledge JS, Catley DM, Williams ES, Withey WR, Minty BD (1983) Effect of prolonged exercise at altitude on the reninaldosterone system. J Appl Physiol Respir 55:413

    Google Scholar 

  28. Penaloza D, Sime F (1969) Circulatory dynamics during high altitude pulmonary edema. Am J Cardiol 23:369

    Google Scholar 

  29. Pines A (1978) High altitude acclimatization and proteinuria in East Africa. Br J Dis Chest 72:196

    Google Scholar 

  30. Ravenhill TH (1913) Some experience of mountain sickness in the Andes. J Trop Med Hyg 16:314

    Google Scholar 

  31. Roy SB, Guleria JS, Khanna PK, Manchanda SC, Pande JN, Subba PS (1969) Haemodynamic studies in high altitude pulmonary oedema. Br Heart J 31:52

    Google Scholar 

  32. Singh I, Khanna PK, Srivastava MC, Lal M, Roy SB, Subramanyan CSV (1969) Acute mountain sickness. N Engl J Med 280:175

    Google Scholar 

  33. Singh I, Chohan IS (1972b) Blood coagulation changes at high altitude predisposing to pulmonary hypertension. Br Heart J 34:611

    Google Scholar 

  34. Sutton JR, Bryan AC, Gray GW (1976) Pulmonary gas exchange in acute mountain sickness. Aviat Space Environ Med 47:1032

    Google Scholar 

  35. Sutton JR, Gray GW, Houston CS (1980) Effects of duration at altitude and acetazolamide on ventilation and oxygenation during sleep. Sleep 3:455

    Google Scholar 

  36. Whayne TF, Severinghaus JW (1968) Experimental hypoxic pulmonary edema in the rat. J Appl Physiol 25:729

    Google Scholar 

  37. Williams ES, Ward MP, Milledge JS, Withey WR, Older MWJ, Forsling ML (1979) Effect of the exercise of seven consecutive days hill-walking on fluid homeostasis. Clin Sci 56:305

    Google Scholar 

  38. Zimmerman GA, Crapo RO (1980) Adult respiratory distress syndrome secondary to high altitude pulmonary edema. West J Med 133:335

    Google Scholar 

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Authors and Affiliations

  1. Clinical Research Centre, Northwick Park Hospital, Harrow, Middlesex, UK

    J. S. Milledge

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  1. J. S. Milledge
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Milledge, J.S. Acute mountain sickness: pulmonary and cerebral oedema of high altitude. Intensive Care Med 11, 110–114 (1985). https://doi.org/10.1007/BF00258534

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