Initial Treatment of High-Altitude Pulmonary Edema: Comparison of Oxygen and Auto-PEEP.

Abstract

BACKGROUND:

Improvement of oxygenation is the aim in the therapy of high-altitude pulmonary edema (HAPE). However, descent is often difficult and hyperbaric chambers, as well as bottled oxygen, are often not available. We compare Auto-PEEP (AP-Pat), a special kind of pursed lips breathing, against the application of bottled oxygen (O2-Pat) in two patients suffering from HAPE.

METHODS:

We compare the effect of these two different therapies on oxygen saturation measured by pulse oximetry (SpO2) over time.

RESULT:

In both patients SpO2 increased significantly from 65-70% to 95%. Above 80% this increase was slower in AP-Pat compared with O2-Pat. Therapy started immediately in AP-Pat but was delayed in O2-Pat because of organizational and logistic reasons.

CONCLUSIONS:

The well-established therapies of HAPE are always the option of choice, if available, and should be started as soon as possible. The advantage of Auto-PEEP is its all-time availability. It improves SpO2 nearly as well as 3 L/min oxygen and furthermore has a positive effect on oxygenation lasting for approximately 120 min after stopping. Auto-PEEP treatment does not appear inferior to oxygen treatment, at least in this cross-case comparison. Its immediate application after diagnosis probably plays an important role here.

• Authors: Markus Tannheimer, Raimund Lechner
• Journal: International journal of environmental research and public health (Int J Environ Res Public Health) Vol. 19 Issue 23 (Dec 03 2022) ISSN: 1660-4601 [Electronic] Switzerland
• PMID: 36498257 (Publication Type: Journal Article)

Chemical References

• Oxygen

Topics

• Humans
• Oxygen (therapeutic use)
• Pulmonary Edema (therapy, etiology)
• Altitude Sickness (therapy, complications)
• Oximetry (adverse effects)
• Altitude