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Severe high altitude pulmonary oedema: a patient managed successfully with non-invasive positive pressure ventilation in the Emergency Department
  1. David D Gregorius1,
  2. Ronnie Dawood2,
  3. Katja Ruh3,
  4. H Bryant Nguyen1,3
  1. 1
    Department of Emergency Medicine, Loma Linda University, Loma Linda, California, USA
  2. 2
    Department of Medicine, Loma Linda University, Loma Linda, California, USA
  3. 3
    Division of Pulmonary and Critical Care Medicine, Loma Linda University, Loma Linda, California, USA
  1. Dr H Bryant Nguyen, Department of Emergency Medicine, Loma Linda University, 11234 Anderson Street, Room A108, Loma Linda, CA 92354, USA; hbnguyen{at}llu.edu

Abstract

High altitude pulmonary oedema (HAPE) is a well-known potential hazard of activities at high altitudes but not a common disease presentation that most emergency physicians have experience treating. The mainstay of treatment is intuitive—early recognition with immediate descent, rest and oxygen—but what does the emergency physician do when a patient is in severe distress from HAPE even after descent to sea level? A case of severe HAPE is presented in a young man; the successful treatment strategy is outlined including non-invasive positive pressure ventilation. The role of calcium antagonists, corticosteroids and phosphodiesterase inhibitors are also discussed in the acute management of this potentially life-threatening condition.

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Footnotes

  • Competing interests: None declared.

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