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Oedemas
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If serious symptoms are ignored and the affected person does not descend, as a consequence the person could develop a high altitude cerebral oedema (HACE) and/or a high altitude pulmonary oedema (HAPO). If this happens, in most cases the descent will not be possible without external help, and the person is in danger of dying.
High Altitude Pulmonary Oedema (HAPE)
Starting at 3500 m, the blood pressure in the lungs increases. This facilitates the passage of blood plasma into the alveoli if there is a damaged membrane. Typical additional symptoms of HAPE are noisy breathing, coughing, bluish lips (cyanosis) and exhaustion. The noisy breathing symptom is due to the accumulation of fluids in the alveoli. After climbing too fast, the body doesn’t develop an oedema immediately, but there is a latency period of up to a day. According to our experience, oedemas often appear during the night and even while sleeping.
Measures
If at all possible, the descent must be undertaken immediately or at least to transport the affected person until he or she gets better. The descent can be backed by oxygen administration (4-6 lt/min) or medication (20 mg sublingual Nifedipin, each 6 hours). If for climatic reasons the person cannot be transported, there exists the possibility of using a hyperbaric chamber. If there is not one available, the only alternative is the continuous administering of oxygen (5 lt/min).
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High Altitude Cerebral Oedema (HACE)
Not only HACE is rarer than HAPE, but in most cases, it appears higher than 5 000 m. HACE begins with the symptoms of acute mountain sickness (AMS) extending for several days. Because of the increased brain pressure, the oedema causes a strong headache, strange behavior, somnolence, speech trouble and confusion. The effects of cortisone preparations come from the diminution of brain pressure. As with HAPE, HACE often appears by night, even during sleep. Unlike HAPO, the affected person can no longer react or control the body movements. The person can no longer descend by himself, which elevates the mortality rate over 40%.
Measures
Administer cortisone as soon as possible (if you don’t know how to, the best way is by inhalation) followed by tablets of 4 mg, each 6 hours. Then transport the affected person with oxygen administration (4-6 lt/min). The person should get better within a few days.
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