A practical approach to high-altitude illness

Abstract

At high altitudes, the human body is exposed to low partial pressure of inhaled oxygen, the condition known as hypobaric hypoxia. When the ability of the human body to adapt to these conditions is exceeded, Acute Altitude Illness (AAI) develops. In the AAI spectrum, Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE) and High-Altitude Cerebral Edema (HACE) are usually described. Due to the high incidence of AAI and potentially high mortality in HAPE and HACE patients, a series of prophylactic and therapeutic measures are introduced as proposed by the current guidelines. The most important prevention of AAI is the low speed of ascent. The treatment of choice for HAPE and HACE is quick descent, supplemental oxygen if available, and medications such as acetazolamide, dexamethasone, nifedipine, and phosphodiesterase inhibitors.