Acute high-altitude illness: a clinically orientated review

Tom Smedley, Michael Pw Grocott, Tom Smedley, Michael Pw Grocott

Abstract

Acute high-altitude illness is an encompassing term for the range of pathology that the unacclimatised individual can develop at increased altitude. This includes acute mountain sickness, high-altitude cerebral oedema and high-altitude pulmonary oedema. These conditions represent an increasing clinical problem as more individuals are exposed to the hypobaric hypoxic environment of high altitude for both work and leisure. In this review of acute high-altitude illness, the epidemiology, risk factors and pathophysiology are explored, before their prevention and treatment are discussed. Appropriate ascent rate remains the most effective acute high-altitude illness prevention, with pharmacological prophylaxis indicated in selected individuals. Descent is the definitive treatment for acute high-altitude illness, with the adjuncts of oxygen and specific drug therapies.

Keywords: Acute high-altitude illness; acute mountain sickness; high-altitude cerebral oedema; high-altitude pulmonary oedema; hypoxia.

Conflict of interest statement

Conflict of interest: MPWG holds the British Oxygen Company Chair of Anaesthesia at the Royal College of Anaesthetists. MPWG is funded in part by the University Hospitals Southampton NHS Foundation Trust – University of Southampton Respiratory Biomedical Research Unit that received a portion of its funding from the UK Department of Health’s National Institute of Health Research (NIHR) Biomedical Research Unit funding scheme.

Figures

Figure 1.
Figure 1.
Acute high-altitude illness: relations in clinical presentation and pathophysiology.

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