Treatment of high-altitude pulmonary edema by bed rest and supplemental oxygen

Study objectives: We evaluated the safety and efficacy of treating high- altitude pulmonary edema (HAPE) by bed rest and supplemental oxygen at moderate altitude. We also characterized clinical parameters in HAPE before and after treatment. Design: Case series. Setting: Two primary care centers at about 9200 feet (2800 meters) above sea level. Type of participants: All patients aged 16-69 years who had been diagnosed with HAPE and were treated with bed rest and supplemental oxygen. Patients were seen on a follow-up visit. Interventions: Selected patients were treated with bed rest and supplemental oxygen rather than hospital admission or descent. Main outcome measure: Patients were considered improved on follow-up if room air arterial oxygen saturation was increased by 10 percentage points or if their symptoms had improved. Results: Of 58 patients with confirmed HAPE, 25 (43%) were treated by bed rest and supplemental oxygen and were seen on return visits to the clinic. All of the treated patients improved at the return visit. Systolic blood pressure, heart rate, respiratory rate, and temperature decreased significantly between the first visit and the return visit. Oxygen saturation improved between visits. Conclusion: Some patients with HAPE at moderate altitudes where medical facilities are available can be safely treated with bed rest and oxygen without descent.