Initial Treatment of High-Altitude Pulmonary Edema: Comparison of Oxygen and Auto-PEEP

Markus Tannheimer () and Raimund Lechner
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Markus Tannheimer: Department of Sport and Rehabilitation Medicine, University of Ulm, Leimgrubenweg 14, 89075 Ulm, Germany
Raimund Lechner: Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany

IJERPH, 2022, vol. 19, issue 23, 1-9

Abstract: Background: Improvement of oxygenation is the aim in the therapy of high-altitude pulmonary edema (HAPE). However, descent is often difficult and hyperbaric chambers, as well as bottled oxygen, are often not available. We compare Auto-PEEP (AP-Pat), a special kind of pursed lips breathing, against the application of bottled oxygen (O 2 -Pat) in two patients suffering from HAPE. Methods: We compare the effect of these two different therapies on oxygen saturation measured by pulse oximetry (SpO 2 ) over time. Result: In both patients SpO 2 increased significantly from 65–70% to 95%. Above 80% this increase was slower in AP-Pat compared with O 2 -Pat. Therapy started immediately in AP-Pat but was delayed in O 2 -Pat because of organizational and logistic reasons. Conclusions: The well-established therapies of HAPE are always the option of choice, if available, and should be started as soon as possible. The advantage of Auto-PEEP is its all-time availability. It improves SpO 2 nearly as well as 3 L/min oxygen and furthermore has a positive effect on oxygenation lasting for approximately 120 min after stopping. Auto-PEEP treatment does not appear inferior to oxygen treatment, at least in this cross-case comparison. Its immediate application after diagnosis probably plays an important role here.

Keywords: high-altitude; acute mountain sickness (AMS); Denali; Mount Everest; pursed lips breathing; expiratory positive airway pressure (EPAP) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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