From the Guidelines
HAPE stands for High-Altitude Pulmonary Edema, which is an acute increase in pulmonary artery pressure with normal left atrial pressure, stimulated by exposure to hypoxia in susceptible individuals. This condition results in pulmonary edema caused by the transudation of protein-rich fluid from small pulmonary vessels into the airspaces, as described in the guidelines from the American Heart Association and American Thoracic Society 1.
Key Characteristics of HAPE
- HAPE occurs more often in males than females in adults, but has a roughly equal sex distribution in children
- It tends to recur in susceptible individuals, suggesting an unidentified genetic diathesis
- Children are at risk of HAPE, especially when rapidly ascending to altitudes above 2500 m
- The incidence of HAPE increases with the rate of ascent and the altitude reached, with an estimated incidence of 7% in mountaineers without previous HAPE at 4559 m, but 62% in those with a prior episode
Diagnosis and Prevention
- The onset of HAPE typically occurs 2 to 4 days after rapid ascent to altitude, with presenting symptoms including cough, exertional dyspnea, and reduced exercise performance
- Slow ascent is the first-line preventive measure, with recommendations for a maximum rate of ascent above 2500 m to minimize the risk of HAPE, as outlined in the study 1
- Criteria for diagnosing HAPE in previously healthy children include rapid ascent to altitude above 2500 m, symptoms, and specific x-ray findings, while considering other possible conditions such as pneumonia and asthma.
From the Research
Definition of Haip
- A Haip, or Hepatic Artery Infusion Pump, is a specialized therapy for patients with unresectable colorectal liver metastases (uCRLM) 2.
Key Characteristics
- Haip chemotherapy is effective in managing uCRLM, with a high response rate and potential for curative liver resection 2.
- The safety and feasibility of Haip programs have been demonstrated in multiple centers, including those with limited experience 2.
Comparison to Other Conditions
- Haip is not related to migraine, a condition affecting an estimated 12% of the population, characterized by chronic migraine and associated with cardiovascular disease, psychiatric disease, and sleep disorders 3.
- Haip is also not related to chronic myeloid leukemia (CML), a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome, which can be effectively treated with tyrosine kinase inhibitors (TKIs) 4.