ALTITUDE AND LUNG DISEASE

Disorders associated with altitude can happen in healthy travellers, usually after rapid ascent to at least 2500m above sea level. Potentially fatal. Can be given prophylactic meds acetazolamide, dexa and nifedipine:

• Acute mountain sickness
• High Altitude Cerebral Oedema (HACE)
• High Altitude Pulmonary Oedema (HAPE)

• Less known about patients with pre-existing lung disease
  • Likely that they have a higher risk of HAPE and RHF
  • If COPD, further falls in PaO2 if walking at altitude. 
  • Anyone with significant pulmonary hypertension should be advised against high altitude travel, and if necessary, should be given 20mg nifedipine BD.
• Short term effects of altitude on asthma = more exacerbations. 
• Travelling to altitude with lung bullae is generally safe (based on small studies).

ALTITUDE AND OSA

• Continue to use CPAP at altitude
• Patients with obesity hypoventilation syndrome should be advised against high altitude travel due to increased risk of HAPE, RHF etc.