domingo, 8 de febrero de 2009

High Altitude Pulmonary Edema in Chulec Hospital


CLINICAL FEATURES REVIEW IN 24 PATIENTS WITH HIGH ALTITUDE PULMONARY EDEMA IN CHULEC HOSPITAL

Objetives:
High Altitude Pulmonary Edema (HAPE) described and studied since 1937 is an acute illness wich migth be fatal if promt treatment is not given. HAPE has been reported in people that ascend to altitude above 2500 m The clinical features of HAPE have been reviewed.


Methods:
We reviewed clinical and radiological features of 24 patients who were attended in Chulec Hospital La Oroya (3730 m) between 1994 to 1997.


Results:
18 were children (2-13 years old) and 6 adults (16-23 years old)
In children 50 % were males and 50 % females. In adults all of them were males.
In children all of them were native highlanders with a brief visit to low altitud. In adults 2 were native higlanders 3 foreingers and 1 was from sea level.
In children 14 patients (77%) began the symptoms before 24 hours. In adults 4 patients (66%) began the symptoms after 24 hour they arrived high altitude.
The comonest symptoms in both groups were dyspnoea and cough. Tachycardia, tachipnoea, cyanosis, paleness and pulmonary rales were described in examination.
Radiological examination demostrated II-IV grade in 77 % in clildren and II-III grade in adults.
Radiological remission was at 48 hours in both children and adults.
The treatment in all of them was absolute rest and oxygen.
There were not fatal cases. In children 12 patiens had more than one atack of HAPE, but no one in adults.


Conclusions:
HAPE affects children predominantly. It occurs on reentry to high altitude mainly. Its not rare in young adults whom ascend for first time. This is a dangerous illness from Peruvian Andes. The symptoms are usually dyspnoea ang cough. They need an X Ray plane to get a diagnosis
Patiens usually improve in an average 48 hours with absolute rest and oxigen but need early diagnosis to get succesful results.

“24th International Congress of Internal Medicine. Lima 1998”
Author: Aquiles Monroy, Gina Santos and others, Page 70

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