High Altitude Pulmonary Edema (HAPE) (HB)

The pressure differential (higher on the inside) causes the lungs’ blood vessels to leak fluid in conjunction with the same mechanisms that are created by hypoxia—tissues swell and leak fluid into surrounding spaces.

What makes HAPE dangerous is that the fluid in the lungs interferes with the exchange of oxygen and further accelerates the problem. Not only are you fighting against lower concentrations of oxygen, but you cannot exchange what is available.

Signs and Symptoms

Patients with HAPE will have severe difficulty breathing (shortness of breath) with productive cough or fluid sounds in the lungs. The shortness of breath will be really noticeable with any exertion.

If you listen to their lungs you may hear wet bubbling sounds called “crackles”.

Patients in severe HAPE may exhibit a white or pink frothy sputum and appear cyanotic.

Prevention

Immediate descent to a lower altitude at the first signs. Waiting can actually make sense in some cases since exertion makes the edema worse.

Acetazolamide is a medication that can be taken ahead of time that can help prevent the onset of HAPE.

Treatment

The primary treatment the patient needs is more oxygen, positive pressure ventilations, and to descend.

The use of a Gamow bag (a device the patient can be put in and pressurized) could help. There are also some medications that can help.