High altitude pulmonary edema in children: A systematic review
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Date
2022
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Abstract
Abstract Introduction: High altitude pulmonary edema (HAPE) is a form of acutenoncardiogenic pulmonary edema caused by altitude‐related hypoxia seen inchildren as well as in adults. In this systematic review we focus in HAPE occurringin children and adolescents.Methods:A systematic review was conducted including publications in children0–18 years of age from three databases up to June 2022.Results:Thirty‐five studies representing 210 cases were found. The mean age was9.8 ± 3.6 years with a male/female ratio of 2.6. The peak age incidence was seen inchildren between 6 and 10 years old. Only two children (0.9%) were≤2 years old.The mean altitude in 166 cases was 2861 masl. Only 17 cases (8.1%) occurred ataltitudes below 2500 masl. Regarding the different HAPE subtypes there was apredominance of re‐entry HAPE (R‐HAPE) with 58%, followed by classic HAPE(C‐HAPE) with 37.6%. The mean time between arrival and onset of symptoms was16.5 h. The mortality rate was 1.4%. In 10/28 (36%) of C‐HAPE cases there was astructural cardiac/pulmonary anomaly compared to 1/19 (5%) in R‐HAPE (p< 0.01).HAPE recurrence was found in 46 cases (21.9%). The involvement in the chest X‐rays was seen predominantly in the apices and in the right lung.Conclusions:R‐HAPE was the most common HAPE subtype; HAPE peak age wasfound between 6 and 10 years of age; HAPE was more frequent in males and wasrare in children under 2 years old; associated HAPE structural abnormalities weremore common in C‐HAPE than in R‐HAPE.
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Altitude, Children, High altitude, Pulmonary hypertension, Mountain sickness, Pulmonary edema