Prevention and treatment of high altitude cerebral edema (HACE)

Abstract

High altitude cerebral edema (HACE) is often a severe and potentially fatal manifestation of acute mountain sickness (AMS). It usually develops within the first 2 in individuals rapidly ascending at altitudes above 4000 m. The main cause of HACE is hypoxia, because of reduced oxygen level at high altitude.The aim of this study was to to assess the methods of prevention and treatment of high altitude cerebral edema (HACE).  Our study material consisted of publications, which were found in PubMed, ResearchGate and Google Scholar databases. The first step was to find proper publications from the last 30 years. The second step was to carry out an overview of the found publications.Methods of prevention of acute mountain sickness are highly effective in high altitude cerebral edema prevention. Many studies estabilished the role of gradual ascent and staged ascent as well as administration of acetazolamide and dexamethasone in AMS prevention, and therefore in HACE prevention. Methods of treatments of acute mountain sickness are highly effective in high altitude cerebral edema treatment. Several researches proved the role of descent, administration of acetazolamide and dexamethasone, oxygen therapy as well as use of portable hyperbaric chamber in AMS treatment, and therefore in HACE treatment. However HACE treatment requires greater descent and larger doses of dexamethasone. Also duration of recovery is longer.