Acute high-altitude pathologies and their treatment

Ascent to high altitude triggers a wide range of physiological changes. However, ascent is also associated with three acute pathologies: acute mountain sickness, high-altitude cerebral oedema (HACE) and high-altitude pulmonary oedema (HAPE). Awareness and understanding of these conditions allows measures to be taken to reduce the risk of them developing through careful planning and, where appropriate, pharmacological prophylaxis. Both HACE and HAPE are life threatening, necessitating prompt diagnosis and management. Acute mountain sickness, although usually benign, may progress, to HACE or HAPE, if not managed appropriately. This review examines each pathology providing options for risk reduction, diagnosis and management, as well as considering comorbidity at altitude, drawing upon recent advances and consensus guidelines in the field.