相關筆記
高海拔肺水腫 High Altitude Pulmonary Edema (HAPE). 下面都用HAPE代替
丹木斯 acetazolamide 使用google翻譯會變成"乙醯唑胺"
重點
1. HAPE 通常發生在到達高海拔 2-5 天內, 通常發生於海拔3000公尺以上
2. 風險因子包括: 體質, 高度, 速率, 時間(下面有詳述)
個體因素, 到達的海拔, 快速上升, 男性, 使用安眠藥, 過度攝取鹽分, 低溫, 高強度體力活動,
其他前置因素會造成肺血流上升, 肺高壓., 肺血管反應增加, 開放性卵圓窗,
3. 下降 1000 公尺海拔是主要的治療方式(或降到HAPE 症狀緩解)
3. 下降 1000 公尺海拔是主要的治療方式(或降到HAPE 症狀緩解)
4. 給氧氣治療目標. 血氧濃度 > 90% (HAPE使用氧氣治療之後會很快改善症狀)
(另一篇曾發生HAPE患者如何預防HAPE/HAPE危險因子筆記連結在這)
註 pearls 在醫學上通常是指珍貴的小知識, 或要訣, 或訣竅
uptodate
HAPE又分兩類
1. 典型HAPE, 指居住在低海拔的民眾快速爬升至高海拔引發
2. 再進入高海拔的HAPE: 指平常住在高海拔的民眾, 在低海拔地區停留之後, 又回到高海拔地區發生HAPE
HAPE is divided into two types:
●Classic HAPE, involving acute ascent of those normally residing at low altitude
●Re-entry HAPE, involving re-ascent of those normally residing at high altitude after a stay at low altitude
Another category has been suggested for children living at high altitude who develop pulmonary edema with respiratory infection but without a change in altitude [7].
HAPE 雖在海拔 2500 公尺以上就可能發生, 但海拔低於 3000 公尺較不常見
HAPE發生風險與下列因素有關
體質 1. 身體因素(對海拔變化反應較敏感)
高度 2. 到達多高海拔
速率 3. 高度上升速率
時間 4. 到達高海拔的停留時間
相同海拔比較發生率.
不曾發生HAPE的人, 四天內從低海拔爬升到海拔 4500 公尺, 發生HAPE機率 0.2%
但若在1-2天內爬升到相同高度, 發生HAPE機率增加為 6%
過去曾發生HAPE的人, 兩天內爬升到海拔 4500 公尺時, 再發生機率是 60%
海拔 5500 公尺, HAPE發生率介於 2-15% 之間, 取決於上升速率.
HAPE generally occurs above 2500 meters (8000 feet) and is uncommon below 3000 meters (10,000 feet) (table 1 and table 2) [8,9]. The risk depends upon individual susceptibility, altitude attained, rate of ascent, and time spent at high altitude. In those without a history of HAPE, the incidence is 0.2 percent with ascent to 4500 meters (14,800 feet) over four days but 6 percent when ascent occurs over one to two days. In those with a history of HAPE, recurrence is 60 percent with an ascent to 4500 meters over two days. At 5500 meters (18,000 feet), the incidence ranges between 2 and 15 percent, again depending upon rate of ascent.
發生HAPE的人, 有較高的AMS發生率, HAPE和HACE是兩種不同生理機轉的疾病, 可同時發生 (HAPE造成缺氧更惡化而引發HACE)
Symptoms of acute mountain sickness develop in a high percentage of those with HAPE [10,11]. HAPE and high-altitude cerebral edema (HACE) may also occur concomitantly due to the severe hypoxemia of HAPE.
(另一篇曾發生HAPE患者如何預防HAPE/HAPE危險因子筆記連結在這)
註 pearls 在醫學上通常是指珍貴的小知識, 或要訣, 或訣竅
uptodate
HAPE 的流行病學及風險因子
HAPE EPIDEMIOLOGY AND RISK FACTORS
HAPE EPIDEMIOLOGY AND RISK FACTORS
HAPE又分兩類
1. 典型HAPE, 指居住在低海拔的民眾快速爬升至高海拔引發
2. 再進入高海拔的HAPE: 指平常住在高海拔的民眾, 在低海拔地區停留之後, 又回到高海拔地區發生HAPE
HAPE is divided into two types:
●Classic HAPE, involving acute ascent of those normally residing at low altitude
●Re-entry HAPE, involving re-ascent of those normally residing at high altitude after a stay at low altitude
Another category has been suggested for children living at high altitude who develop pulmonary edema with respiratory infection but without a change in altitude [7].
HAPE 雖在海拔 2500 公尺以上就可能發生, 但海拔低於 3000 公尺較不常見
HAPE發生風險與下列因素有關
體質 1. 身體因素(對海拔變化反應較敏感)
高度 2. 到達多高海拔
速率 3. 高度上升速率
時間 4. 到達高海拔的停留時間
相同海拔比較發生率.
不曾發生HAPE的人, 四天內從低海拔爬升到海拔 4500 公尺, 發生HAPE機率 0.2%
但若在1-2天內爬升到相同高度, 發生HAPE機率增加為 6%
過去曾發生HAPE的人, 兩天內爬升到海拔 4500 公尺時, 再發生機率是 60%
海拔 5500 公尺, HAPE發生率介於 2-15% 之間, 取決於上升速率.
HAPE generally occurs above 2500 meters (8000 feet) and is uncommon below 3000 meters (10,000 feet) (table 1 and table 2) [8,9]. The risk depends upon individual susceptibility, altitude attained, rate of ascent, and time spent at high altitude. In those without a history of HAPE, the incidence is 0.2 percent with ascent to 4500 meters (14,800 feet) over four days but 6 percent when ascent occurs over one to two days. In those with a history of HAPE, recurrence is 60 percent with an ascent to 4500 meters over two days. At 5500 meters (18,000 feet), the incidence ranges between 2 and 15 percent, again depending upon rate of ascent.
發生HAPE的人, 有較高的AMS發生率, HAPE和HACE是兩種不同生理機轉的疾病, 可同時發生 (HAPE造成缺氧更惡化而引發HACE)
Symptoms of acute mountain sickness develop in a high percentage of those with HAPE [10,11]. HAPE and high-altitude cerebral edema (HACE) may also occur concomitantly due to the severe hypoxemia of HAPE.
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