Treatment of moderate acute mountain sickness with pressurization in a portable hyperbaric (Gamow™) Bag

Robertson, J.; Shlim, David R.

doi:10.1580/0953-9859-2.4.268

Cited by 15 publications

(2 citation statements)

References 7 publications

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“…Further, numerous clinical observations revealed a relationship between the occurrence of HAPE and the degree of PAP elevation [ 61 , 62 ], suggesting an essential role of pulmonary hypertension in the pathogenesis of this condition. This view is further supported by the reduced HAPE incidence in susceptible subjects [ 63 , 64 ] and clinical improvement in HAPE patients by drugs lowering PAP [ 64 , 65 , 66 ] or treatment in hypobaric chambers [ 67 , 68 ]; development of HAPE at lower altitudes in patients with various anomalies and diseases, predisposing them to pulmonary hypertension [ 69 , 70 , 71 , 72 ]; individual susceptibility to HAPE, which is associated with an exaggerated pulmonary vascular response to hypoxia [ 53 , 55 ] and during exercise in normoxia [ 28 , 54 ].…”

Section: Pulmonary Circulation In Sea Level Residents Upon Acute Ementioning

confidence: 99%

Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Sydykov

Mamazhakypov

Maripov

et al. 2021

IJERPH

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Alveolar hypoxia is the most prominent feature of high altitude environment with well-known consequences for the cardio-pulmonary system, including development of pulmonary hypertension. Pulmonary hypertension due to an exaggerated hypoxic pulmonary vasoconstriction contributes to high altitude pulmonary edema (HAPE), a life-threatening disorder, occurring at high altitudes in non-acclimatized healthy individuals. Despite a strong physiologic rationale for using vasodilators for prevention and treatment of HAPE, no systematic studies of their efficacy have been conducted to date. Calcium-channel blockers are currently recommended for drug prophylaxis in high-risk individuals with a clear history of recurrent HAPE based on the extensive clinical experience with nifedipine in HAPE prevention in susceptible individuals. Chronic exposure to hypoxia induces pulmonary vascular remodeling and development of pulmonary hypertension, which places an increased pressure load on the right ventricle leading to right heart failure. Further, pulmonary hypertension along with excessive erythrocytosis may complicate chronic mountain sickness, another high altitude maladaptation disorder. Importantly, other causes than hypoxia may potentially underlie and/or contribute to pulmonary hypertension at high altitude, such as chronic heart and lung diseases, thrombotic or embolic diseases. Extensive clinical experience with drugs in patients with pulmonary arterial hypertension suggests their potential for treatment of high altitude pulmonary hypertension. Small studies have demonstrated their efficacy in reducing pulmonary artery pressure in high altitude residents. However, no drugs have been approved to date for the therapy of chronic high altitude pulmonary hypertension. This work provides a literature review on the role of pulmonary hypertension in the pathogenesis of acute and chronic high altitude maladaptation disorders and summarizes current knowledge regarding potential treatment options.

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Section: Pulmonary Circulation In Sea Level Residents Upon Acute Ementioning

confidence: 99%

Pulmonary Hypertension in Acute and Chronic High Altitude Maladaptation Disorders

Sydykov

Mamazhakypov

Maripov

et al. 2021

IJERPH

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“…The Gamow bag (Chinook Medical Gear, 100 Arapoe Avenue, Boulder, Colorado, 80302) is a portable (5.5 kg) recompression chamber which can be inflated in two minutes with a foot pump and has been reported to be effective for treating acute mountain sickness and pulmonary and cerebral oedema 8 9 10. It raises the ambient pressure by 140-220 millibar, equivalent to a descent of 1000-2800 m depending on the initial altitude, and reoxygenates victims without the need for stored oxygen.…”

Section: Common Disorders At Altitudementioning

confidence: 99%

How To Do It: Doctor on a mountaineering expedition

A’Court

Stables²,

Travis

1995

BMJ

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Doctors are welcome members on mountaineering expeditions to remote areas, but practical advice on how to prepare and what kit to take can be difficult to find. This article is a ragbag of useful advice on diverse topics. It explains the necessary preparation, provides tips for a healthy expedition, and summarises the common disorders encountered at high altitude. The comprehensive drug and equipment lists and first aid kit for climbers were used for the 1992 Everest in winter expedition. They are there to be sacrificed to personal preference and the experience and size of individual expeditions.

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