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Initial Treatment of High-Altitude Pulmonary Edema: Comparison of Oxygen and Auto-PEEP
Ist Teil von
International journal of environmental research and public health, 2022-12, Vol.19 (23), p.16185
Ort / Verlag
Switzerland: MDPI AG
Erscheinungsjahr
2022
Quelle
MEDLINE
Beschreibungen/Notizen
Improvement of oxygenation is the aim in the therapy of high-altitude pulmonary edema (HAPE). However, descent is often difficult and hyperbaric chambers, as well as bottled oxygen, are often not available. We compare Auto-PEEP (AP-Pat), a special kind of pursed lips breathing, against the application of bottled oxygen (O
-Pat) in two patients suffering from HAPE.
We compare the effect of these two different therapies on oxygen saturation measured by pulse oximetry (SpO
) over time.
In both patients SpO
increased significantly from 65-70% to 95%. Above 80% this increase was slower in AP-Pat compared with O
-Pat. Therapy started immediately in AP-Pat but was delayed in O
-Pat because of organizational and logistic reasons.
The well-established therapies of HAPE are always the option of choice, if available, and should be started as soon as possible. The advantage of Auto-PEEP is its all-time availability. It improves SpO
nearly as well as 3 L/min oxygen and furthermore has a positive effect on oxygenation lasting for approximately 120 min after stopping. Auto-PEEP treatment does not appear inferior to oxygen treatment, at least in this cross-case comparison. Its immediate application after diagnosis probably plays an important role here.