HAPE “High Altitude Pulmonary Edema,” A Deadly Complication of Altitude Sickness

Logan Stout | | BrainsBrains
Trekking Up Galena Peak in Sun Valley, Idaho (Elevation 8,701ft) Credit: Sun Valley Trekking Blog

High Altitude Pulmonary Edema or “HAPE” is a fairly unknown consequence of rapid ascent to high altitudes which can be fatal if not caught and treated properly. According to the International HAPE Database the illness is one of the top killers in individuals and recreationalists exposed to high altitudes. Many put themselves at risk of the illness frequently and have no idea what it is, the symptoms or risks. The illness may occur in otherwise healthy people without any known issues or illnesses. However ones physical shape, living altitude and many other variables play a role in the illnesses development.

HAPE occurs when there is a lack of oxygen and pressure thus causing fluid to rush from the intravascular to extravascular space in the lung. Ultimately this process fills our lungs air sacs with fluid, decreasing lung capacity and the ability to supply our body with necessary oxygen. As one ascends into higher altitudes the percent of atmospheric oxygen, based off of the amounts at sea-level, begin to deplete which is displayed in the Figure below. Most cases of HAPE occur at altitudes above 2,500 meters (8200ft) with the risk rising as one continues to ascend. However depending on the individual and circumstances, cases have been recorded between 1,500-2,500meters (4,900-8,200ft), which are elevations quite common at many of our beloved ski resorts. The illness typically occurs in individuals who have not acclimated properly and spend 48 hours or more at altitude.

Oxygen Availability As a Percentage at Elevation  Credit: Penn State

Although there is no exact test or diagnosis for the illness, if one begins to feel unwell while at altitude or during an ascension into higher altitudes, there are some common symptoms of HAPE to be aware of:

  • Difficulty Breathing at Rest
  • Cough
  • Weakness or Decreased Exercise Performance
  • Chest Congestion or Tightness
  • Bluing of the Skin
  • Rapid Shallow Breathing
  • Increased Heart Rate
  • Headache
  • Possible Nausea or Vomiting

If an individual does start to exhibit any of these symptoms or signs and they persist without getting better the suggested course of action is to descend as quickly as possible, stay hydrated and acquire oxygen and medical attention if necessary. The suggested distance to descend is 1000 meters (3,280ft) and with this descent ones condition should begin to quickly improve. While many symptoms will fade and disappear other more severe symptoms may linger for several days.

Take Away: Plan your adventure, know your change in elevation, understand your risks, educate yourself, be prepared for anything and then most of all have fun and be safe out there!




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One thought on “HAPE “High Altitude Pulmonary Edema,” A Deadly Complication of Altitude Sickness

  1. I had a TBI and lived at 17ft above sea level and went straight to 5,500 ft and had severe swelling of my brain and severe nuerological problems, could hold self up or stand and lost almost 75% of cognitive and couldn’t feel cold temp, fingers and toes purple attips and coundnt put feet in proper place I had to swing body to make it go forward and they were like rag dolls. I stopped understanding english, people had to hold me up extremetes swelled, not hungry and the thought made me ill, I had hands hurt like severe numbing pain and coudnt close hands and woke me at night and I could only sleep a few hours and when I got walker i turned to the right , right into wall, and trying tomove cart of luggage it weight a million pounds and I was going unconscious and that was just a few feet and my eyes rolled back and I was not in reality I was not aware of things that are around and I would not know why I was holding an object and it got worse, i was ordered to ER for HBOT ASAP from my brain specialist and I told them if they dont do something right away and I stay like this or get worse. I will have to live in a facility with 24 hour care for the rest of my life!!! the girl in er said “NO YOU ARE NOT GOING TO GET THAT TODAY” and no er doctor came in for hous and the workers woud not call the brain specialist to even talk to him. I knew I was in critical condition and I would not make it . I found HBOT and got codes from bcbs fed to cover it and dr. at HBOT was looking forward to helping me. they have day time hoursbut in hospital and the night before they opened I was so far gone and I did not believe I would survive the night and I needed to get medical oversight to bring me back and I took uber to the hosp. ER MD and TWOstudent doctors and I did not get any accessment or look in eyesears, no oxygen. the doctor said first thing “no one at this altitude goes without oxygen and He told me I hadto leave and I couldnt even walk and he said “you can’t stay in the lobby either and no one got me a wheel chair and I had no mental capacity to move or know how to get a hotel and I asked for help aand they did not offer to call a place and get a uber. the next day in the wee hours of the day bcbs called me and woke me and said he wont give a code and I cant get my HYpobaric Oxygen Therapy that would have reduched the swelling and get the oxygen to all of my brain because it was not getting sufficient pressure and my brain was dying off in major function my brain specialists had Nuclear Spect scans of my brain and know every place that over or underperforms . only they could definitively state the only thing that would have saved my life and stop the severe brain damage and swelling of my entire brain. No one cared or even took any fast action to get my brain oxygen. No they did nothing for hours and they mistreated me when I asked for some accomidation for my mental state t help me and was yelled at. I went to so many places and told all of them I was in critical condition and I was starting to loss my fight to stay awake as I was havinf tiny blackouts that came when my eyes rolled back in my brain and I felt I was on going to fall into a very deep sleep and I would no longer be aware of anything ever. I had to crawl on frozen cement on forarms to get my body just to theneighborscreen door and hit the bottom. I would be out of my mind and had now muscles to move or talk, I was limp and my eyes rolling and, I couldnt, focus on people, my eyes woud jerk fastly left and right and I couldnt look at someone but if I held my head and tried thy seemed inbetween double and triple vision only when a doctor knew I was telling the truth he sent me for test and put me on oxygen at 2 but I was slippimg fastly into a coma I guess from what people said it was but dr upped 2 to 4 and that ended ne ever goimg to the very edge and that would have been my death. my brain specialists worked so hard to find someone to explain why His patient did not get the immediate oxygen in a hyperbaric chamber that he knew was the only way to save my life because I was lucky that I was even holding on, my medicalrecords state that he not only knew I was in critical shape. He also put in my medical records stating their attempt to speak to each hospital to find out why they did not give me the treatment that would have stopped the crissis immediatelyand they could arrange for my immediate transport with oxygen and treatment as they had to get me to sesa level goig down 1000ft with 2 day acclimation until I was in a medical facility to take over it low altitude. No they have left me 3 months and have covered up and falsely reported why I came in and would not help me see that the record was a true accountinng of events. They lied and covered it up and the newly licensed doctor the sent me to has only seen me 3 times and He never asked any thing abut getting help for my immediate needs H was ONLY FOCUSED on having me taken by an ambulance to a mental facility and tod me I had schitafrinia (sorry) and wouldnt acknowledge me trying to get him to come into reality and have a real talk, he told me I had to take thid medication that WAS very bad if I was taking 3 of my brain medications and I would be severely brain damaged and definitely not able to be normal and heknew that this altitude and oxygen would cause me to die if I was put into a facilityfor people who are a dangerto society and it is on it I read my hospital records and his strong urge that any one reading this paper he strongly urges them to do an M1 hold on me. and I have no mental illness at all and now I can not goget any medical care from any hosp, doctor, clinic because it instuctsthem to call for me to be put into a place with the most dangerous mental patience and I would have died do to no care for the altitudeandbrain swelling and I would not have lived more than a few days or week with no life supportand the petrified state I have been put in that no where in the country can I ever seek a doctr or if ill get taken to a hospital without being treated like I have a disorder or mental condition that I have never suffered from. they leave meto slowly get worse and worse and incapable of decending in the mental state that they are responsible for do to lack ofany care and they are using this new doctor to see I never get to help because this altitude situation deprives any surving person toplan and facilitate the only cure possible that has been growing worse and worse and I cant even care for myself or find someone to plan to transfer me to sea altitude and I have no family willing to comesave my life. they all know but they are justletting nature take my life and no one has to answer for neglect and not having human empathy for another humans life. I have been very proactive in seeking care from anyone and everyone, senator, state healthboard any organizations and even calledthe president yes I am not concerned in anything but finding one human that can’t live with their concious if they let someone beg for help and beg to get oxygen and they just say we dom’t do that. No one that I knew could not help because they would do what God would say they should do. but, christians arenot the christians Iremembered. I am going to tell everyone and anyone so this never happens toanother TBIpatient EVER, NEVER EVER. I dedicated the rest of my life to see TBI people get the care they need but isn’t offered toany of us. I will some how survive because God has always saved my life so many times and If I cant get help for myself, then how can I help change our futures. the thing we need the most doesn’t even exist in our health system but I will seeit gets to the forfront and it will change the way we liveandour brains do grow and do maraculous things that people dont realize is possible. Please record my story and bring awarenesso of what happens to a tbi brain and the treatment that is needed. how many people were not heard because they heard they had a brain injury and when that happens you are not someone who is in the realworld. that is the truth, we are abused and hung up on and your just not considered reliable and that is not true at all, that is so sad. how you move, walk talk anything that doesnt do the exact same thing as people around you, it is always a measure of what your brain thinks and is aware of. that is the biggiest lie we allow people to think. it is absolutly false, just because wecant make our brain signal the ability to sit in a chair and hold up our head and seem responsive, does nothing to our mind and thinking I always am accutlly aware of what I must look like and what others are thinking but I hear every word anyone says and I wish I could say, hey, guys, Im really embarrassed and I hate you see me this way but, hey, can someone atleast acknowledge Iam right inide here but I just cant move or talk and im a rag doll, it has not touched my thinking one bit. God if just one person actually spoke to me and said I know its tough but its going away in a while and we can have time out andthen back to that discussion we werein the middle of. wow, that would be so nice for people to know that we would feel really good to be acknowledged we know exactly everything going on and how bad we fill knowing we appear incompatent just because our brain is not doing the signals to control the elegant flow of our body movements. anyway, back to my serious condition, i’m not going to make it much further if anyone can see that I need to be cared for medicaly and accend slowly to sea level and a truck to get my stuff and some attorney or something to fix this doctors order for everyone to call and get somene to removeme from society. Im just a tiny little thing with a tiny voice and everyone knows I couldn’t hurt a fly. I am a sweet nicechristian woman , i dont do drugs or smoke and i dont use bad words. I am soft spoken and I would never not help anyonein need. thats what christians do because we love one another but I don.t know christians anymore they dont act or live the life of Christ and fear the Lord like they should which is a super strong incentive to always do what you knw God woud tell you to do. maybe you people know a lawyer to secure my safety and see that attention is put on what happened to me , I shouldnt be alive but Im barely able to talk and get my basic care and I dont want to die, Id like to help people like me not ever go through what we all go through, not if I am alive, it is going to be better and fixed, it’s so simply and easy and hardly costs a drop in a bucket for all the money that does nothing to fix the problems we suffer from. Please ask anyone to stand up and fight for me and my human rights to care like any normal person, God loves me and I am blessed even now and so grateful to God for just loving me and protecting me so many times.If its His will for me to die alone with no one and it’s my time than I will do my best to get my story out so others can help people that had an unexpected accident one day out of the blue and forever changed everyones life that knew me but we deserve the treatment that does not exist for us but I know exactly what it is andits so easy and so inexpensive. Please help me I need a village to see I am protected andget transported and get a doctor andthe help to see how bad my brain will permanently remain for at least a while, but I think I need someone to watch over me till I have ny old brain back to what it was before I traveled to colrado. Please don;t forget me, Im a real person and Ihave a life that I want to keep tillI can make a difference for people like me, a Tramatic Brain Injury Survivor and I was perfectly functional until I arrived here I have video to proveit snd tons ofpeople were eye witness to all of it. Thank you forreading my desperate plea for help.

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