- Email: [email protected]
Extreme altitude pulmonary oedema (EAPO) in acclimatized soldiers
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Available online at www.sciencedirect.com
j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / m j a fi
Original article
Extreme altitude pulmonary oedema (EAPO) in acclimatized soldiers Maj Inam Danish Khan* Resident (Pathology and Molecular Medicine), Army Hospital Research and Referral, Delhi Cantt 110010, India
article info
abstract
Article history:
Background: High Altitude Pulmonary Oedema (HAPO) is the most common challenging
Received 21 September 2011
emergency at Siachen Glacier. This study was aimed at studying various aspects of
Accepted 3 April 2012
Extreme Altitude Pulmonary Oedema (>5500 m/18,000 ft) while correlating it with acclimatization and post acclimatization duration of stay in retrospect and response to HAPO
Keywords:
Bag nursing prospectively.
Extreme altitude
Methods: All clinical cases of HAPO on Siachen were included. Cases were diagnosed using
Acclimatization
Lake Louis criteria, standard treatment given and response monitored. Data was retro-
Extreme Altitude
spectively correlated for acclimatization and post acclimatization duration of stay on
Pulmonary Oedema (EAPO)
glacier and prospectively for response to HAPO Bag nursing.
HAPO Bag
Results: Extreme Altitude Pulmonary Oedema presented in fully acclimatized, temporarily resident, mountain trained soldiers and also among native highlanders. HAPO Bag ensued dramatic improvement in the absence of oxygen. Extreme altitude presentation of HAPO with such findings has not been reported in literature earlier. Conclusion: HAPO cannot be prevented at extreme altitudes beyond 5500 m (18,000 ft) by scheduled pre-induction acclimatization, mountain training or prolonged stay at such altitudes. The dictum ‘Every day is a new day beyond 18,000 ft’ needs to be emphasized and due care needs to be taken in ventures at extreme altitudes. HAPO Bag is an indispensable device to save precious lives and prolong survival at such altitudes due to paucity of available oxygen. Easy availability and universal know how should be ensured. ª 2012, Armed Forces Medical Services (AFMS). All rights reserved.
* Tel.: þ91 8860179989 (mobile). E-mail address: [email protected]. 0377-1237/$ e see front matter ª 2012, Armed Forces Medical Services (AFMS). All rights reserved. http://dx.doi.org/10.1016/j.mjafi.2012.04.018
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
340
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
341
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
342
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
343
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
344
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
345
Available online at www.sciencedirect.com
j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / m j a fi
Original article
Extreme altitude pulmonary oedema (EAPO) in acclimatized soldiers Maj Inam Danish Khan* Resident (Pathology and Molecular Medicine), Army Hospital Research and Referral, Delhi Cantt 110010, India
article info
abstract
Article history:
Background: High Altitude Pulmonary Oedema (HAPO) is the most common challenging
Received 21 September 2011
emergency at Siachen Glacier. This study was aimed at studying various aspects of
Accepted 3 April 2012
Extreme Altitude Pulmonary Oedema (>5500 m/18,000 ft) while correlating it with acclimatization and post acclimatization duration of stay in retrospect and response to HAPO
Keywords:
Bag nursing prospectively.
Extreme altitude
Methods: All clinical cases of HAPO on Siachen were included. Cases were diagnosed using
Acclimatization
Lake Louis criteria, standard treatment given and response monitored. Data was retro-
Extreme Altitude
spectively correlated for acclimatization and post acclimatization duration of stay on
Pulmonary Oedema (EAPO)
glacier and prospectively for response to HAPO Bag nursing.
HAPO Bag
Results: Extreme Altitude Pulmonary Oedema presented in fully acclimatized, temporarily resident, mountain trained soldiers and also among native highlanders. HAPO Bag ensued dramatic improvement in the absence of oxygen. Extreme altitude presentation of HAPO with such findings has not been reported in literature earlier. Conclusion: HAPO cannot be prevented at extreme altitudes beyond 5500 m (18,000 ft) by scheduled pre-induction acclimatization, mountain training or prolonged stay at such altitudes. The dictum ‘Every day is a new day beyond 18,000 ft’ needs to be emphasized and due care needs to be taken in ventures at extreme altitudes. HAPO Bag is an indispensable device to save precious lives and prolong survival at such altitudes due to paucity of available oxygen. Easy availability and universal know how should be ensured. ª 2012, Armed Forces Medical Services (AFMS). All rights reserved.
* Tel.: þ91 8860179989 (mobile). E-mail address: [email protected]. 0377-1237/$ e see front matter ª 2012, Armed Forces Medical Services (AFMS). All rights reserved. http://dx.doi.org/10.1016/j.mjafi.2012.04.018
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
340
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
341
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
342
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
343
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
Fu
344
Fu
ll
te
xt
is
no
ta
va
ila
bl
e
fo
ro
nl
in
e
vi
ew in
g
m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 6 8 ( 2 0 1 2 ) 3 3 9 e3 4 5
345