高血壓 高尿酸 慢性腎病 胰島素 https://2019medicinenote.blogspot.com/2019/12/blog-post_57.html . 糖尿病相關筆記~目錄 https://2019medicinenote.blogspot.com/2020/01/blog-post_4.html

2020年4月27日 星期一

野外與登山醫學----27--WMS 2019 update HAPE PREVENTION SUGGESTED APPROACH

Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Acute Altitude Illness: 2019 Update
統一名詞翻譯
AMS 急性高山病
HACE 高海拔腦水腫
HAPE 高海拔肺水腫
acute altitude illness 急性高海拔疾病

SUGGESTED APPROACH TO HAPE PREVENTION
As noted earlier, because the rates of acclimatization and physiologic responses to high altitude vary considerably among individuals, the recommendations that follow, although generally effective, do not guarantee prevention in all high altitude travelers. A gradual ascent profile is the primary method for preventing HAPE; the recommendations provided for AMS and HACE prevention also apply to HAPE prevention. Pharmacologic prophylaxis should only be considered for individuals with a history of HAPE, especially multiple episodes. Nifedipine is the preferred drug in such situations; it should be started the day before ascent and continued either until descent is initiated or the individual has spent 4 d at the highest elevation, perhaps up to 7 d if the individual’s rate of ascent was faster than recommended. Note that these durations are longer than use of acetazolamide for AMS prevention. For individuals ascending to a high point and then descending toward the trailhead (eg, descending from the summit of Kilimanjaro), prophylactic medications should be stopped when descent is initiated. Further research is needed before tadalafil or dexamethasone can be recommended over nifedipine for prevention. Acetazolamide facilitates acclimatization in general but should not be relied upon as the sole preventive agent in known HAPE-susceptible individuals.

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