Treatment of high-altitude pulmonary edema by bed rest and supplemental oxygen.

STUDY OBJECTIVES

We evaluated the safety and efficacy of treating high-altitude pulmonary edema (HAPE) by bed rest and supplemental oxygen at moderate altitudes. We also characterized clinical parameters in HAPE before and after treatment.

DESIGN

Case series.

SETTING

Two primary care centers at about 9,200 feet (2,800 meters) above sea level.

TYPE OF PARTICIPANTS

All patients aged 16-69 years who had been diagnosed with HAPE and were treated with bed rest and supplemental oxygen. Patients were seen on a follow-up visit.

INTERVENTIONS

Selected patients were treated with bed rest and supplemental oxygen rather than hospital admission or descent.

MAIN OUTCOME MEASURE

Patients were considered improved on follow-up if room air arterial oxygen saturation was increased by 10 percentage points or if their symptoms had improved.

RESULTS

Of 58 patients with confirmed HAPE, 25 (43%) were treated by bed rest and supplemental oxygen and were seen on return visits to the clinic. All of the treated patients improved at the return visit. Systolic blood pressure, heart rate, respiratory rate, and temperature decreased significantly between the first visit and the return visit. Oxygen saturation improved between visits.

CONCLUSION

Some patients with HAPE at moderate altitudes where medical facilities are available can be safely treated with bed rest and oxygen without descent.