High altitude disease: Unique pediatric considerations
- Erin E Endom, MD
Erin E Endom, MD
- Assistant Professor of Pediatrics
- Baylor College of Medicine
- Peter Hackett, MD
Peter Hackett, MD
- Clinical Professor of Emergency Medicine
- University of Colorado Denver School of Medicine
- Director, Institute for Altitude Medicine, Telluride, Colorado
- Scott A Gallagher, MD
Scott A Gallagher, MD
- Senior Clinical Instructor, Department of Surgery
- University of Colorado Denver School of Medicine
- Section Editor
- Daniel F Danzl, MD
Daniel F Danzl, MD
- Section Editor — Environmental Emergencies
- Professor of Emergency Medicine
- University of Louisville School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
This topic will review the unique pediatric aspects of high altitude illness (HAI).
The different types of HAI, their pathophysiology, and methods for prevention and treatment are discussed separately. (See "High altitude illness: Physiology, risk factors, and general prevention" and "Acute mountain sickness and high altitude cerebral edema" and "High altitude pulmonary edema" and "High altitude, air travel, and heart disease".)
Every year the beauty and recreational opportunities of the mountains attract millions of visitors from lowland elevations to high-altitude destinations worldwide. Resort towns in the Western United States alone attract over 30 million visitors annually, generally to sleeping elevations of 2000 to 3000 m (6560 to 9840 feet). Many more millions visit cities at these elevations, including several large cities in South America and Asia situated above 3000 m (9840 feet) . Most of these destinations can be reached within a day using modern means of transportation. Many of these mountain travelers are children.
Rapid ascents to high altitude place the unacclimatized child at risk for developing high altitude illness (HAI). Clinicians working in mountainous areas must familiarize themselves with the presentation and management of HAI in children, while all health care workers who advise travelers need to understand the best prevention strategies and treatment options.
HIGH ALTITUDE PHYSIOLOGY
Diminished inspired partial pressure of oxygen (PIO2) at altitude is the direct result of lower barometric pressure. As PIO2 decreases, so does the partial pressure of alveolar oxygen (PAO2), arterial PO2 (PaO2), and arterial oxygen saturation (SpO2), resulting in tissue hypoxia. This form of hypoxia is termed hypobaric hypoxia, and it represents the initial cause of high altitude illness (HAI). The physiology of HAI is discussed in more detail separately. (See "High altitude illness: Physiology, risk factors, and general prevention", section on 'High altitude physiology'.)
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- HIGH ALTITUDE PHYSIOLOGY
- Susceptibility of infants and children
- Risk factors
- Recommendations for ascent
- HIGH ALTITUDE ILLNESS IN CHILDREN
- Acute mountain sickness
- - Clinical manifestations
- - High altitude cerebral edema
- - Treatment
- - Prevention and pharmacologic prophylaxis
- Acetazolamide prophylaxis
- Other altitude-related illness
- - High altitude retinal hemorrhage (HARH)
- - High altitude periodic breathing of sleep
- HIGH ALTITUDE PULMONARY HYPERTENSION
- HIGH ALTITUDE PULMONARY EDEMA
- Clinical manifestations
- TRAVEL ADVICE FOR PARENTS
- Healthy infants and children
- Susceptible infants and children
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS