High altitude illness
Summary
Definición
Anamnesis y examen
Principales factores de diagnóstico
- headache
- ataxia
- change in mental state: for example, tired, irritable, confused, forgetful, irrational
- abnormal tone, power, and reflexes
Otros factores de diagnóstico
- nausea, vomiting, and loss of appetite
- fatigue and weakness
- dizziness or lightheadedness
- difficulty sleeping
- visual disturbance
- shortness of breath
- cough with or without sputum
- rales
- peripheral edema
- accentuated pulmonary second sound
- pyrexia
- elevated respiratory rate
- elevated heart rate
- low arterial oxygen saturation
- cyanosis
- urinary incontinence or retention
- retinal hemorrhages and papilledema on fundoscopy
- chest pain
- cranial nerve palsies (III, IV, and VI)
- visual and auditory hallucinations, seizures, tinnitus, vertigo, tremors, speech disturbance, and deafness
Factores de riesgo
- high altitude
- rapid ascent
- low-altitude residence
- history of previous altitude illness
- younger age
- exertion
- poor awareness of high-altitude illness prior to travel
- existing medical condition
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- arterial blood gases
- chest radiography
- ECG
- chest ultrasound and echocardiography
- WBC count
- lumbar puncture
- CT head
- MRI head
Algoritmo de tratamiento
high-altitude ascent planned
AMS
HAPE only
HACE only
concurrent HAPE and HACE
Colaboradores
Autores
Jeremy S. Windsor, MBChB, DCH, FCARCSI
Specialist Registrar
Anaesthetics and Intensive Care Medicine
University College Hospital
London
UK
Divulgaciones
JSW is an author of a number of references cited in this topic.
Revisores por pares
James S. Milledge, MBBS
Honorary Professor
Department of Physiology
University College London
London
UK
Divulgaciones
JSM declares that he has no competing interests.
Mike Grocott, MD
Senior Lecturer
Intensive Care Medicine
University College Hospital
London
UK
Divulgaciones
MG declares that he has no competing interests.
Haibo Wang, MD, PhD
Assistant Professor
LSU Health Sciences Center
Shreveport
LA
Divulgaciones
HW declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 4: environmental hazards & risks - high elevation travel & altitude illness. May 2023 [internet publication].Texto completo
Roach RC, Hackett PH, Oelz O, et al. The 2018 lake louise acute mountain sickness score. High Alt Med Biol. 2018 Mar;19(1):4-6.Texto completo Resumen
Luks AM, Auerbach PS, Freer L, et al. Wilderness medical society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019 Dec;30(4s):S3-18.Texto completo Resumen
Donegani E, Paal P, Küpper T, et al. Drug use and misuse in the mountains: a UIAA MedCom consensus guide for medical professionals. High Alt Med Biol. 2016 Sep;17(3):157-84. Resumen
Ritchie ND, Baggott AV, Andrew Todd WT. Acetazolamide for the prevention of acute mountain sickness - a systematic review and meta-analysis. J Travel Med. 2012 Sep-Oct;19(5):298-307.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Asthma, acute exacerbation
- Community-acquired pneumonia
- Acute exacerbation of chronic heart failure (CHF)
Más DiferencialesGuías de práctica clínica
- CDC Yellow Book: health information for international travel - high elevation travel & altitude illness
- Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2019 update
Más Guías de práctica clínica
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