High-Altitude Pulmonary Edema

Abstract

To the EditorWe were very interested in reading the comments of Dr. Fiorenzano et al on our study.1Gabry AL Ledoux X Mozziconacci M et al.High-altitude pulmonary edema at moderate altitude (< 2,400 m; 7,870 feet): a series of 52 patients.Chest. 2003; 123: 49-53Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar As discussed in our study, we agree with the fact that the incidence of high-altitude pulmonary edema (HAPE) is certainly underestimated, one reason being that some patients return at lower altitude and recover without consulting a physician. We read with interest that in the Italian experience, patients slept at higher altitudes than in the French experience. Whether or not this difference in the sleeping altitude has some consequence on the incidence of HAPE remains to be determined by further studies. We also noticed a difference in the two populations of patients. Most subjects seemed to have previous experience of ski and physical activity at high altitude (≥ 3,000 m) in the Italian series. In our case series, most patients had no specific physical training and started physical activities the same day or the day after their arrival at the ski resorts. In any case, these discrepancies between different experiences from different countries emphasize the need for more epidemiologic studies on HAPE. To the EditorWe were very interested in reading the comments of Dr. Fiorenzano et al on our study.1Gabry AL Ledoux X Mozziconacci M et al.High-altitude pulmonary edema at moderate altitude (< 2,400 m; 7,870 feet): a series of 52 patients.Chest. 2003; 123: 49-53Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar As discussed in our study, we agree with the fact that the incidence of high-altitude pulmonary edema (HAPE) is certainly underestimated, one reason being that some patients return at lower altitude and recover without consulting a physician. We read with interest that in the Italian experience, patients slept at higher altitudes than in the French experience. Whether or not this difference in the sleeping altitude has some consequence on the incidence of HAPE remains to be determined by further studies. We also noticed a difference in the two populations of patients. Most subjects seemed to have previous experience of ski and physical activity at high altitude (≥ 3,000 m) in the Italian series. In our case series, most patients had no specific physical training and started physical activities the same day or the day after their arrival at the ski resorts. In any case, these discrepancies between different experiences from different countries emphasize the need for more epidemiologic studies on HAPE. We were very interested in reading the comments of Dr. Fiorenzano et al on our study.1Gabry AL Ledoux X Mozziconacci M et al.High-altitude pulmonary edema at moderate altitude (< 2,400 m; 7,870 feet): a series of 52 patients.Chest. 2003; 123: 49-53Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar As discussed in our study, we agree with the fact that the incidence of high-altitude pulmonary edema (HAPE) is certainly underestimated, one reason being that some patients return at lower altitude and recover without consulting a physician. We read with interest that in the Italian experience, patients slept at higher altitudes than in the French experience. Whether or not this difference in the sleeping altitude has some consequence on the incidence of HAPE remains to be determined by further studies. We also noticed a difference in the two populations of patients. Most subjects seemed to have previous experience of ski and physical activity at high altitude (≥ 3,000 m) in the Italian series. In our case series, most patients had no specific physical training and started physical activities the same day or the day after their arrival at the ski resorts. In any case, these discrepancies between different experiences from different countries emphasize the need for more epidemiologic studies on HAPE. High-Altitude Pulmonary EdemaCHESTVol. 124Issue 4PreviewWe read with great interest the article by Gabry et al (January 2003)1 about high-altitude pulmonary edema (HAPE) in the French Alps and would like to add some considerations based on our experience in the Italian Alps.2 In the Sondalo Hospital (approximately 1,000 m above sea level), located near Stelvio Pass (2,760 m), we observed 10 cases of radiologically proven HAPE between 1989 and 1995 (1 or 2 cases per year). The lower incidence of HAPE may be explained by the fact that Stelvio Pass is closed during the winter season. Full-Text PDF