HighHigh--Altitude IllnessAltitude Illness

(acute mountain sickness, AMS)(acute mountain sickness, AMS)

(high altitude cerebral edema, HACE)(high altitude cerebral edema, HACE)

(high altitude pulmonary edema, HAPE)(high altitude pulmonary edema, HAPE)

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(Rocky Mountains)(Rocky Mountains)2,4002,4002,5002,500

2,400~3,600m 2,400~3,600m Moderate altitudeModerate altitude3,600~5,500m 3,600~5,500m high altitudehigh altitude5,500~8,800m 5,500~8,800m extreme altitudeextreme altitude

29,028 feet8,848m253 mmHg34%

3,952m 460 mmHg 60%At 3,000m 515 mmHg 68%

Keep in mind:60~70%

1971~20001971~2000# # --1.51.5 ((--5.05.0~2.9 ~2.9 ))

88# # 7.77.7 (4.2 (4.2 ~13.2 ~13.2 ))

1818

20072007Jan : Jan : --0.6 0.6 Jul : 8.2 Jul : 8.2

AMS AMS

::~~

-- -- -- --

AMS in AMS in JadeJade Mountain climbers of Taiwan Mountain climbers of Taiwan Aviation Space & Environmental Medicine. 2002 Apr.Aviation Space & Environmental Medicine. 2002 Apr.

METHODS & RESULTSMETHODS & RESULTS939344 (18 (18 7171) ) 20 ~ 6820 ~ 68 41.1 41.1 11.2 11.2 2525 (28%)~3400m~3400m2659m2659m

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(())

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()

()

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HACEHACE

(AMS)(AMS)

- : - : Tandem gait

Questions ?Questions ?

2500m2500m600m600m

Acetazolamide 125mg~250mg (0.5~1#)125mg~250mg (0.5~1#)diamoxdiamox//

500500Acetazolamide

((2L/min)2L/min)

4L/min4L/minDexamethasone, 4mg, ()

100%100%NOTE! &

2,500~3,000m2,500~3,000m3,0003,000300m300m3,0003,0003,0003,0002~32~3

In Taiwan:In Taiwan:1,500~2,000m)1,500~2,000m)

-- AcclimatizationAcclimatization 5~105~10 extreme altitude, > 5,500mextreme altitude, > 5,500m5,3005,300

2,32,3--DPGDPG

-- AcclimatizationAcclimatizationAcetazolamideAcetazolamide

---- (HCO(HCO33--))---- pHpH

COCO22

extreme altitudeextreme altitude---- Siege tacticsSiege tactics (() ) Climb high / Sleep lowClimb high / Sleep low---- Alpine styleAlpine style 4~64~6

Questions ?Questions ?

HAPEHAPE : 2~4

- - - -

- - - - (!)

(()),,

(())

60%60%

4~6L/min4~6L/min

---- AdalatAdalat ((nifedipinenifedipine,,) 10mg ) 10mg

AdalatAdalat OROS (OROS () 30mg) 30mg---- Viagra (Viagra ()) (())

NOTE! &

At 0At 0,1atm, 1 mole,1atm, 1 mole22.4At 24, 1atm, 1 mole, 1atm, 1 mole24.524.51 mole324L

240L10mole320

,3.2

-- GamowGamow BagBag

,,105mmHg105mmHg1000m (1000m ())Cost ~ 2,400 USD (~80,000 NTD)Cost ~ 2,400 USD (~80,000 NTD)Weight ~ 7 KgWeight ~ 7 Kg

HACE or HAPEHACE or HAPE4~64~6

1122

RhodiolaRhodiola rosearosea9090

3000~54003000~5400

----

RosavinRosavin

ChronicChronic Mountain SicknessMountain SicknessMongeMongess disease (Peru,1928)disease (Peru,1928)----,,,,----

---- 3000m3000m---- ---- ---- (3658m): (3658m): ,,

17%,17%,29%29%

benzodiazepambenzodiazepam

DiamoxDiamox 75mg 75mg

Golden RulesGolden RulesIf one is ill at altitude, symptoms are caused by the altitude until proven otherwise

If one has altitude symptoms, dont go any higher

If one is feeling very ill or is getting worse, or ifone cannot walk heel-to-toe in a straight line, descend immediately.

A person ill with altitude illness must always be accompanied by a responsible companion who can accomplish or arrange for descent should it be necessary.

Thanks !Thanks !