Role of point-of-care ultrasound in grading the severity and early diagnosis of high-altitude pulmonary edema at a peripheral hospital

Abstract

Background and Aims: Troops deployed at high-altitude area (HAA) suffer from various high-altitude illnesses (HAIs) including high-altitude pulmonary edema (HAPE). There are various criteria to diagnose and assess the severity of HAPE, but point-of-care ultrasound (POCUS) of the lung has also been used in isolation by physicians. The aim is to assess whether POCUS of the lung improves the ability to diagnose the severity of HAPE. Methodology: A retrospective, cross-sectional descriptive study was planned for the patients treated for HAPE (n = 46) at our hospital from January 2019 to March 2020. Prehospital admission data, hospital admission data, and discharge data for the first-time inductees and reinductees were collected from the central hospital admission registry and central database of the medical department and intensive care unit. Results: The incidence of HAPE was 2.2 per 1000. First-time inductees (n = 30) were affected more when compared to reinductees (n = 16) and the maximum were at the third stage of HAA. POCUS of the lung facilitated the diagnosis of the six patients with mild HAPE with no positive radiological features. Conclusions: POCUS of the lung should be routinely used by the medical officers deployed at high altitudes. It will increase the diagnostic rate of HAPE with meticulous grading of the severity, thereby aiding in formulating the case-specific treatment protocol.