We undertook a computer-aided search of PubMed, and used the key words altitude, acute mountain sickness, high-altitude pulmonary edema, high-altitude pulmonary oedema, high-altitude cerebral edema, high-altitude cerebral oedema, hypoxia, and mountaineering. We also reviewed journal reference lists and abstracts from international scientific meetings, and used our existing knowledge of primary publications in the field. Priority was given to recent reports covering topical issues and
SeminarHigh-altitude illness
Section snippets
Epidemiology
The most important risk factors for the development of high-altitude illness are rate of ascent, altitude reached (especially the sleeping altitude), and individual susceptibility. The rate of AMS among conference delegates to moderate altitudes (1920–2957 m) in Colorado, USA, was 25%.2 In the Mount Everest region of Nepal, about 50% of trekkers who walk to altitudes higher than 4000 m over 5 or more days develop AMS,3, 4 and 84% of people who fly directly to 3860 m are affected.5 High-altitude
Clinical presentation
AMS is characterised by non-specific symptoms and a paucity of physical findings. The main symptoms are headache, anorexia, nausea, vomiting, fatigue, dizziness, and sleep disturbance, but not all need to be present. Headache is deemed the cardinal symptom, but the characteristics are not sufficiently distinctive to differentiate it from other causes of headache.20 Symptoms of AMS typically appear 6–12 h after arrival at high altitude. Diagnostic signs are absent, and the presence of abnormal
Clinical presentation
HAPE typically occurs in the first 2–4 days after arrival at altitudes higher than 2500 m, and is not necessarily preceded by AMS. Risk factors for HAPE are the same as for AMS and HACE. In addition, HAPE may be over-represented in men compared with women, and cold is a risk factor.85 People with abnormalities of the cardiopulmonary circulation that are associated with increased pulmonary blood-flow pressure, such as unilateral absence of a pulmonary artery or primary pulmonary hypertension, or
Search strategy and selection criteria
References (135)
- et al.
The incidence, importance, and prophylaxis of acute mountain sickness
Lancet
(1976) - et al.
Rales, peripheral edema, retinal hemorrhage and acute mountain sickness
Am J Med
(1979) - et al.
High-altitude pulmonary edema at moderate altitude (< 2400 m; 7870 feet): a series of 52 patients
Chest
(2003) - et al.
Relationship of mountain sickness to physical fitness and exercise intensity during ascent
J Wilderness Med
(1994) Acute mountain sickness in western tourists around the Thorongpass (5400 m) in Nepal
J Wilderness Med
(1991)- et al.
Inflammatory processes may predispose children to high-altitude pulmonary edema
J Pediatrics
(1997) - et al.
Medical problems of porters and trekkers in the Nepal Himalaya
Wild Environ Med
(1997) - et al.
Disoriented and ataxic pilgrims: an epidemiological study of acute mountain sickness and high-altitude cerebral edema at a sacred lake at 4300 m in the Nepal Himalayas
Wild Environ Med
(2000) The cerebral etiology of high-altitude cerebral edema and acute mountain sickness
Wild Environ Med
(1999)- et al.
Low pulmonary diffusing capacity in subjects with acute mountain sickness
Chest
(1997)
Cerebral form of high altitude illness
Lancet
Plasma vascular endothelial growth factor in acute mountain sickness
Chest
Volumetric quantification of brain swelling after hypobaric hypoxia exposure
Exp Neurol
Sumatriptan for high-altitude headache
Lancet
Ibuprofen versus sumatriptan for high-altitude headache
Lancet
Nocturnal periodic breathing and arterial oxygen desaturation in acute mountain sickness
J Wilderness Med
The random nature of cerebral mountain sickness
Lancet
Treatment of acute mountain sickness: hyperbaric versus oxygen therapy
Ann Emerg Med
High-altitude pulmonary edema with primary pulmonary hypertension
Chest
Variable radiomorphologic data of high altitude pulmonary edema: features from 60 patients
Chest
Pulmonary extravascular fluid accumulation in recreational climbers: a prospective study
Lancet
Nifedipine for high altitude pulmonary oedema
Lancet
World health statistics annual 1995
Acute mountain sickness in a general tourist population at moderate altitudes
Ann Intern Med
Altitude illness among tourists flying to 3740 meters elevation in the Nepal Himalayas
J Travel Med
Exercise exacerbates acute mountain sickness at simulated high altitude
J Appl Physiol
Acute mountain sickness susceptibility, fitness and hypoxic ventilatory response
Eur Respir J
Children at high altitude: an international consensus statement by an ad hoc committee of the International Society for Mountain Medicine, March 12, 2001
High Alt Med Biol
How well do older persons tolerate moderate altitude?
West J Med
Acute mountain sickness in the Southern Alps of New Zealand
NZ Med J
Neck irradiation or surgery may predispose to severe acute mountain sickness
J Travel Med
Symptoms of infection and altitude illness among hikers in the Mount Everest region of Nepal
Aviat Space Environ Med
Acute mountain sickness, dehydration, and bicarbonate clearance: preliminary field data from the Nepal Himalaya
Aviat Space Environ Med
Clinical features of headache at altitude: a prospective study
Neurology
Acute medical problems in the Himalayas outside the setting of altitude sickness
High Alt Med Biol
High altitude cerebral edema and acute mountain sickness: a pathophysiology update
Adv Exp Med Biol
Frontiers of hypoxia research: acute mountain sickness
J Exp Biol
Acute mountain sickness and high-altitude cerebral edema
Low acute hypoxic ventilatory response and hypoxic depression in acute altitude sickness
J Appl Physiol
Enhanced exercise-induced rise of aldosterone and vasopressin preceding mountain sickness
J Appl Physiol
High altitude diuresis: fact or fancy
Acute mountain sickness
N Engl J Med
Cerebral edema in acute mountain sickness
High-altitude cerebral edema evaluated with magnetic resonance imaging: clinical correlation and pathophysiology
JAMA
Cerebral hemodynamics and high altitude cerebral edema
Brain edema
N Engl J Med
Role of veins and cerebral venous pressure in disruption of the blood-brain barrier
Circ Res
Dynamic cerebral autoregulation at high altitude
Adv Exp Med Biol
Mediators of cerebral edema
Adv Exp Med Biol
Rat brain VEGF expression in alveolar hypoxia: possible role in high-altitude cerebral edema
J Appl Physiol
Cited by (441)
Role of neutrophil myeloperoxidase in the development and progression of high-altitude pulmonary edema
2024, Biochemical and Biophysical Research CommunicationsHigh altitude retinopathy: An overview and new insights
2024, Travel Medicine and Infectious DiseaseIntegrating network pharmacology and experimental verification to explore the mechanisms of salidroside against myocardial fibrosis
2023, Biochemical and Biophysical Research CommunicationsTemporal changes in biomarkers in individuals with and without acute mountain sickness following rapid ascent
2023, American Journal of the Medical SciencesPharmaceutical treatment of bone loss: From animal models and drug development to future treatment strategies
2023, Pharmacology and TherapeuticsA slow feature based LSTM network for susceptibility assessment of acute mountain sickness with heterogeneous data
2023, Biomedical Signal Processing and Control