HWN Suggests

What are HAPE and HACE?

Our body is flexible and is known for successfully habituating itself and accustoming to altered environmental conditions. However, acclimatization is a slow process and requires time. It is when you steal away this time and rapidly expose your body to high altitudes you begin to notice symptoms of mountain sickness or altitude sickness. Although the initial symptoms are light and bearable it is necessary to take the required precautions because mild altitude sickness is known to gradually mount up to a more serious form of the sickness known as high-altitude pulmonary edema or HAPE.

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  Tips for Spotting and Treating High-Altitude Illness

The treatment of stable patients with HAPE involves simply giving oxygen via high-flow nasal cannula and decreasing cold exposure to resolve the elevation in pulmonary artery pressure. Unstable patients should descend as soon as possible, and if that is not possible, use hyperbaric therapy as indicated.1 Medications can be used for treatment. However, they are more effective as preventative measures.

Articles of Interest

High Altitude Pulmonary Edema in an Experienced Mountaineer. Possible Genetic Predisposition

HAPE is believed to be precipitated by the hypobaric hypoxemia of ascent resulting in a poor ventilatory response and increased sympathetic tone with mean pulmonary artery pressures above 35mmHg.

High Altitude Pulmonary Edema: Diagnosis, Management, and Preventive Strategies

Acetazolamide has no demonstrated role in HAPE prevention but reduces the incidence of HACE and AMS and assists with acclimatization by inducing hyperventilation to compensate for a metabolic acidosis induced by the diuresis of bicarbonate. The recommended dose is 125mg twice a day.18

Resources

Emergency Field Management of ACS, HAPE and HACE

Lay persons should always treat mountaineers for AMS, HAPE, HACE first, unless they are absolutely sure that there is another reason for the symptoms. Doctors should also always consider AMS, HAPE, or HACE at (high) altitude first, but they should always take other diagnoses into account,