Nifedipine for Treatment of High Altitude Pulmonary Edema

摘要

In 12 subjects with high altitude pulmonary edema, we studied the effects of 10mgnifedipine on pulmonary and systemic hemodynamics and arterial oxygen saturation. In five of these, repeated dosing was done over 3 hours and spirometry and clinical HAPE scores were also obtained. A single 10mg nifedipine dose lowered pulmonary vascular resistance and pulmonary arterial pressures, as well as systemic arterial pressure and increased SaO2%. Multiple dosing sustained the drug effect, but with a smaller increase SaO2% Clinical scores improved slightly, and within 3 hours there was no consistent effect on spirometry. In addition, we undertook a survey of pulmonary hypertension (PHT) at high altitude, and surprisingly discovered excessive PHT in asymptomatic individuals. We conclude that nifedipine vasodilates the pulmonary bed in persons with HAPE, and that this appears to be beneficial, although short-term improvement was minimal. Since asymptomatic PHT is common, factors other than PHT are critical in HAPE pathogenesis, and by extension, could be important in prevention and treatment. Altitude, High Altitude Pulmonary Edema, HAPE, Nifedipine, Hypoxic Pulmonary Hypertension, RA III, Volunteers.