Research advances in pathogenesis and prophylactic measures of acute high altitude illness

Respir Med. 2018 Dec:145:145-152. doi: 10.1016/j.rmed.2018.11.004. Epub 2018 Nov 8.

Abstract

After ascent to high altitude (≥2500 m), the inability of the human body to adapt to the hypobaric and hypoxia environment can induce tissue hypoxia, then a series of high altitude illnesses including acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE) would develop. Symptoms of AMS include headache, dizziness, nausea, and vomiting; HAPE is characterized by orthopnea, breathlessness at rest, cough, pink frothy sputum, and results in obvious pulmonary edema that poses significant harm to people; HACE is characterized by ataxia and decreased consciousness, leading to coma and brain herniation which would be fatal if not treated promptly. This review article provides a current understanding of the pathophysiology of these three forms of high altitude illness and elaborates the current prevention and treatment measures of these diseases.

Keywords: Acute high-altitude illness; Acute mountain sickness; High altitude pulmonary edema; High-altitude cerebral edema; Prophylactic measures.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acetazolamide / therapeutic use
  • Acute Disease
  • Altitude Sickness / etiology*
  • Altitude Sickness / physiopathology
  • Altitude Sickness / prevention & control*
  • Altitude Sickness / therapy
  • Calcium Channel Blockers / therapeutic use
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Cytokines / metabolism
  • Dexamethasone / therapeutic use
  • Endothelin-1 / metabolism
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary
  • Inflammation Mediators / metabolism
  • Nifedipine / therapeutic use
  • Nitric Oxide / metabolism
  • Phosphodiesterase 5 Inhibitors / therapeutic use
  • Pulmonary Alveoli / metabolism
  • Sildenafil Citrate / therapeutic use

Substances

  • Calcium Channel Blockers
  • Carbonic Anhydrase Inhibitors
  • Cytokines
  • Endothelin-1
  • Inflammation Mediators
  • Phosphodiesterase 5 Inhibitors
  • Nitric Oxide
  • Dexamethasone
  • Sildenafil Citrate
  • Nifedipine
  • Acetazolamide

Supplementary concepts

  • Pulmonary edema of mountaineers