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Reentry High Altitude Pulmonary Edema After Chest Trauma
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A7062 - Reentry High Altitude Pulmonary Edema After Chest Trauma
Author Block: C. Ebert-Santos; Ebert Family Clinic, Frisco, CO, United States.
High altitude pulmonary edema is a life threatening condition that affects visitors and residents living above 8000 feet. Inflammation, such as respiratory illnesses, present on arrival increase the susceptibility to HAPE. Herein, I report a case of fulminant HAPE with bilateral rales on chest exam diagnosed by the physician in the emergency department in a mountain resident returning to 9100 feet after having been hospitalized at 5280 feet for chest trauma. The patient had oxygen saturation levels documented at 94% on room air at the time of discharge at 1300. When brought to the emergency room at 2200 his saturation was 49%.
It is common for mountain residents to travel to lower altitude for surgical procedures. Post-operative pain medication may cause sedation and blunt the respiratory drive. The hypoxia of high altitude and inflammation from tissue trauma and surgical interventions predisposes certain individuals to pulmonary edema. Surgeons caring for these patients at discharge need to advise mountain residents of the risks of possible reentry high altitude pulmonary edema upon returning to their home altitudes. Providing a pulse oximeter, training in its use and ensuring access to home oxygen, if necessary, may prevent readmission to the emergency department, hospital, and intensive care unit, as occurred in this case report.
Author Block: C. Ebert-Santos; Ebert Family Clinic, Frisco, CO, United States.
High altitude pulmonary edema is a life threatening condition that affects visitors and residents living above 8000 feet. Inflammation, such as respiratory illnesses, present on arrival increase the susceptibility to HAPE. Herein, I report a case of fulminant HAPE with bilateral rales on chest exam diagnosed by the physician in the emergency department in a mountain resident returning to 9100 feet after having been hospitalized at 5280 feet for chest trauma. The patient had oxygen saturation levels documented at 94% on room air at the time of discharge at 1300. When brought to the emergency room at 2200 his saturation was 49%.
It is common for mountain residents to travel to lower altitude for surgical procedures. Post-operative pain medication may cause sedation and blunt the respiratory drive. The hypoxia of high altitude and inflammation from tissue trauma and surgical interventions predisposes certain individuals to pulmonary edema. Surgeons caring for these patients at discharge need to advise mountain residents of the risks of possible reentry high altitude pulmonary edema upon returning to their home altitudes. Providing a pulse oximeter, training in its use and ensuring access to home oxygen, if necessary, may prevent readmission to the emergency department, hospital, and intensive care unit, as occurred in this case report.
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