野外與登山醫學~~---34--WMS 2019 update HAPE TREATMENT Phosphodiesterase inhibitors 34

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

Phosphodiesterase inhibitors
By virtue of their ability to cause pulmonary vasodilation and decrease pulmonary artery pressure, there is a strong physiologic rationale for using phosphodiesterase inhibitors in HAPE treatment. Although reports document their use for this purpose,97,98 no systematic study has examined the role of tadalafil or sildenafil in HAPE treatment as either mono- or adjunctive therapy. Combined use of nifedipine and sildenafil or tadalafil should be avoided because of risk of hypotension. Recommendation. Tadalafil or sildenafil can be used for HAPE treatment when descent is impossible or delayed, access to supplemental oxygen or portable hyperbaric therapy is impossible, and nifedipine is unavailable. Recommendation Grade: 2C