PMID- 26663962
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20151215
LR  - 20201001
IS  - 0377-1237 (Print)
IS  - 0377-1237 (Linking)
VI  - 71
IP  - 4
DP  - 2015 Oct
TI  - Objective criteria for diagnosing high altitude pulmonary edema in acclimatized 
      patients at altitudes between 2700 m and 3500 m.
PG  - 345-51
LID - 10.1016/j.mjafi.2015.09.002 [doi]
AB  - BACKGROUND: The criteria used for diagnosing high altitude illnesses are largely 
      based on Western literature. This study was undertaken to define objective, 
      simple and reliable diagnostic criteria for high altitude pulmonary edema (HAPE) 
      in Indian soldiers at altitudes between 2700 m and 3500 m. METHODS: Clinical data 
      of 235 cases of HAPE that occurred between 2700 m and 3500 m were analysed. 
      Receiver operator characteristic (ROC) curve analysis was used to select simple 
      clinical parameters suitable for the diagnosis of HAPE at peripheral medical 
      facilities. Cut-off values and their reliability for the diagnosis of HAPE were 
      defined. RESULTS: HAPE occurred 2.8 +/- 2.2 days after arrival at altitudes between 
      2700 m and 3500 m. Breathlessness, cough, chest discomfort and headache were the 
      commonest symptoms. Low pulse oximetry (SPO2) values than normal for this 
      altitude were seen in 89% of patients. ROC analysis of clinical parameters 
      identified a heart rate more than 95 beats per minute (bpm), respiratory rate 
      more than 21 per minute and SPO2 less than 86% while breathing ambient air at 
      this altitude as diagnostic of HAPE. The sensitivity and specificity of these 
      cut-offs was 0.66, 0.83 and 0.82 and 0.94, 0.95 and 0.93 respectively. 
      CONCLUSION: A heart rate of more than 95 bpm, respiratory rate more than 21 per 
      minute and SPO2 less than 86% breathing room air in individuals complaining of 
      breathlessness, cough, chest discomfort or headache within the first 5 days of 
      arrival at altitudes between 2700 m and 3500 m is highly suggestive of HAPE.
FAU - Chawla, Anuj
AU  - Chawla A
AD  - Professor and Head, Department of Physiology, Armed Forces Medical College, Pune 
      411040, India.
FAU - Tripathi, K K
AU  - Tripathi KK
AD  - Chief Research Officer, Institute of Aerospace Medicine, Indian Air Force, 
      Bengaluru 560017, India.
LA  - eng
PT  - Journal Article
DEP - 20151021
PL  - India
TA  - Med J Armed Forces India
JT  - Medical journal, Armed Forces India
JID - 7602492
PMC - PMC4646906
OTO - NOTNLM
OT  - Altitude sickness
OT  - Pulmonary edema
OT  - ROC curve
EDAT- 2015/12/15 06:00
MHDA- 2015/12/15 06:01
PMCR- 2016/10/01
CRDT- 2015/12/15 06:00
PHST- 2013/04/18 00:00 [received]
PHST- 2015/09/08 00:00 [accepted]
PHST- 2015/12/15 06:00 [entrez]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2015/12/15 06:01 [medline]
PHST- 2016/10/01 00:00 [pmc-release]
AID - S0377-1237(15)00144-6 [pii]
AID - 10.1016/j.mjafi.2015.09.002 [doi]
PST - ppublish
SO  - Med J Armed Forces India. 2015 Oct;71(4):345-51. doi: 
      10.1016/j.mjafi.2015.09.002. Epub 2015 Oct 21.