Mountain sickness.

  1. Hello everyone reading it, can you just help me understanding why pulmonary oedema
    occurs during mountain climbing ,when there is rapid ascent?
    Also why Dexamethasone is used ,although not curative but palliative?
     
  2. jcsd
  3. No one knows for sure what causes or predispose a person to HAPE.

    As far as dexamethasone here is an article that briefly touches on that: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907615/

    I've never heard of using it for pulmonary or cerebral edema before, it isn't well studied.

    The rule of thumb is that descending to a lower alltuide is the best course of action.
     
  4. Really? I don't know your qualifications, but the fact that you never heard of it being used for cerebral edema indicates your lack of knowledge of the subject matter. Dexamethasone is fairly standard for cerebral edema in patients with brain tumors and has been for some time.

    http://www.medscape.com/viewarticle/498465_3
     
    Last edited: Jul 4, 2014
  5. Can't see the article, are we talking about the same condition, HACE/HAPE?
     
  6. Last edited: Jul 4, 2014
  7. How much is that just belief in it works and how much is hard science? I don't think it's well studied at all. I still stand by descent being the only real curative treatment.

    https://blogs.commons.georgetown.ed...1-february-2006/high-altitude-cerebral-edema/

    And the 9 or other studies all show mixed results.
     
  8. It's very difficult to study acute conditions like HAPE/HACE. The point is that it's known to work in cerebral edema generally. Here's a quote from your last link, just before conclusions.

    "Though effective, dexamethasone is now rarely used prophylactically due to the significant dysphoria and the likelihood of a rebound case of altitude illness occurring with discontinued use of the drug.5 Nowadays it has a valuable role as an adjunctive therapy in the treatment of HACE. Johnson et al.12 theorized that dexamethasone may stabilize cerebral vascular integrity, thereby reducing vasogenic edema and lowering intracranial pressure, processes that both contribute to the clinical entity of HACE."

    I do agree that getting the patient to a safe lower altitude quickly is the best treatment if it's possible.

    EDIT: BTW, your statement was to the effect that you weren't aware of dexamethasone being used for pulmonary or cerebral edema. (bold mine).
     
    Last edited: Jul 4, 2014
  9. Buck Tilton in his 2002 fourth edition of Backcountry First Aid and Extended Care states the following about Severe Altitude Illness
     
  10. From http://www.mayoclinic.org/diseases-conditions/pulmonary-edema/basics/prevention/con-20022485 states the following:
     
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