Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- headache
- ataxia
- change in mental state: for example, tired, irritable, confused, forgetful, irrational
- abnormal tone, power, and reflexes
Другие диагностические факторы
- 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
Факторы риска
- 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
Диагностические исследования
Исследования, которые показаны в первую очередь
- clinical diagnosis
Исследования, проведение которых нужно рассмотреть
- arterial blood gases
- chest radiography
- ECG
- chest ultrasound and echocardiography
- WBC count
- lumbar puncture
- CT head
- MRI head
Алгоритм лечения
high-altitude ascent planned
AMS
HAPE only
HACE only
concurrent HAPE and HACE
Составители
Авторы
Jeremy S. Windsor, MBChB, DCH, FCARCSI
Specialist Registrar
Anaesthetics and Intensive Care Medicine
University College Hospital
London
UK
Раскрытие информации
JSW is an author of a number of references cited in this topic.
Рецензенты
James S. Milledge, MBBS
Honorary Professor
Department of Physiology
University College London
London
UK
Раскрытие информации
JSM declares that he has no competing interests.
Mike Grocott, MD
Senior Lecturer
Intensive Care Medicine
University College Hospital
London
UK
Раскрытие информации
MG declares that he has no competing interests.
Haibo Wang, MD, PhD
Assistant Professor
LSU Health Sciences Center
Shreveport
LA
Раскрытие информации
HW declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
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].Полный текст
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.Полный текст Аннотация
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.Полный текст Аннотация
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. Аннотация
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.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Asthma, acute exacerbation
- Community-acquired pneumonia
- Acute exacerbation of chronic heart failure (CHF)
Больше ОтличияGuidelines
- 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
Больше Guidelines
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