TREATMENT OF HIGH-ALTITUDE PULMONARY-EDEMA BY BED REST AND SUPPLEMENTAL OXYGEN

Study objectives: We evaluated the safety and efficacy of treating hig h-altitude pulmonary edema (HAPE) by bed rest and supplemental oxygen at moderate altitudes, We also characterized clinical parameters in HA PE before and after treatment. Design: Case series. Setting: Two prima ry care centers at about 9200 feet (2800 meters) above sea level, Type of participants: All patients aged 16-69 years who had been diagnosed with HAPE and were treated with bed rest and supplemental oxygen. Pat ients were seen on a follow-up visit. Interventions: Selected patients were treated with bed rest and supplemental oxygen rather than hospit al admission or descent. Main outcome measure: Patients were considere d improved on follow-up if room air arterial oxygen saturation was inc reased by 10 percentage points or if their symptoms had improved. Resu lts: Of 58 patients with confirmed HAPE, 25 (43%) were treated by bed rest and supplemental oxygen and were seen on return visits to the cli nic. All of the treated patients improved at the return visit. Systoli c blood pressure, heart rate, respiratory rate, and temperature decrea sed significantly between the first visit and the return visit. Oxygen saturation improved between visits,Conclusion: Some patients with HAP E at moderate altitudes where medical facilities are available can be safely treated with bed rest and oxygen without descent.