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

Author

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  • Markus Tannheimer

    (Department of Sport and Rehabilitation Medicine, University of Ulm, Leimgrubenweg 14, 89075 Ulm, Germany
    Department of General and Visceral Surgery, Krankenhaus Blaubeuren, Ulmer Straße 26, 89143 Blaubeuren, Germany)

  • Raimund Lechner

    (Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany)

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.

Suggested Citation

  • Markus Tannheimer & Raimund Lechner, 2022. "Initial Treatment of High-Altitude Pulmonary Edema: Comparison of Oxygen and Auto-PEEP," IJERPH, MDPI, vol. 19(23), pages 1-9, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:16185-:d:992473
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    References listed on IDEAS

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    1. Nina Hundt & Christian Apel & Daniela Bertsch & Carina Cerfontaine & Michael van der Giet & Simone van der Giet & Maren Graß & Miriam Haunolder & Nikole M. Heussen & Julia Jäger & Christian Kühn & Aud, 2022. "Variables Influencing the Pressure and Volume of the Pulmonary Circulation as Risk Factors for Developing High Altitude Pulmonary Edema (HAPE)," IJERPH, MDPI, vol. 19(21), pages 1-10, October.
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