The discussion centers on the causes of pulmonary edema during rapid ascent in mountain climbing, specifically focusing on High Altitude Pulmonary Edema (HAPE) and the use of Dexamethasone as a treatment option. Participants explore the theoretical and practical implications of these topics, including the efficacy and understanding of Dexamethasone in relation to altitude sickness.
Participants do not reach a consensus on the efficacy of Dexamethasone for treating HAPE or HACE, with multiple competing views presented regarding its use and the best treatment approaches for altitude sickness.
Limitations in the discussion include the lack of consensus on the effectiveness of Dexamethasone, varying interpretations of its role in treatment, and the challenges associated with studying acute conditions like HAPE and HACE.
Student100 said:I've never heard of using it for pulmonary or cerebral edema before, it isn't well studied.
SW VandeCarr said: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
Student100 said:Can't see the article, are we talking about the same condition, HACE/HAPE?
SW VandeCarr said:Dexamethasone is indicated for HACE as well. Go to the first paragraph of Diagnosis and Treatment in this link. I don't know why you can't see my first link. It works for me.
http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-2-the-pre-travel-consultation/altitude-illness
Student100 said: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.
Severe altitude illness may show up as High Altitude Pulmonary Edema (HAPE): constant shortness of breath, chest pain, productive cough, very fast heart rate. Or it may show up as High Altitude Cerebral Edema (HACE): severe headache unrelieved by rest or medication, bizarre changes in personality, perhaps coma. Or it may show up as both. The patient needs to Go Down. In addition to descent, the best treatment is supplemental oxygen. Treatment may also include:
1) the drug nifedipine (sold often as Procardia®) for HAPE
2) The drug dexamethasone (sold often as Decadron®) for HACE.
Consult your physician. If descent is delayed, use of the Gamow Bag®, a portable hyperbaric chamber that simulate descent, may save the patient's life. Do not use a Gamow Bag® instead of descent.
Preventing HAPE
If you travel or climb at high altitudes, acclimate yourself slowly. Although recommendations vary, most experts advise ascending no more than 1,000 or 2,000 feet (300 to 600 meters) a day once you reach 8,000 feet (about 2,400 meters). In addition, it's important to drink plenty of water to stay hydrated. The higher you ascend the more rapidly you breathe, which means you lose larger amounts of water in the air you exhale from your lungs.
Finally, although being physically fit won't necessarily prevent HAPE, people in good condition tend to be less stressed at high altitudes. However, just because you have hiked or skied at high altitude before doesn't protect you from HAPE. Taken 12 to 72 hours before you travel to a high altitude, the medication acetazolamide (Diamox) can help prevent HAPE. Consider continuing the medication for an additional few days if any signs of altitude sickness, especially headache or insomnia, occur.