Höhennotfälle

Zusammenfassung

Die höhenassoziierten Erkrankungen akute Bergkrankheit (ABK), Höhenhirnödem (HHÖ) und Höhenlungenödem (HLÖ) stellen ein medizinisches Problem oberhalb von 2500 – 4000 Höhenmetern dar. Während die ABK bereits oberhalb von 2500 m auftreten kann, treten das HHÖ meist in Höhen > 4000 m und das HLÖ > 3000 – 4000 m auf. Die Krankheitsbilder sind hier mit dem Schwerpunkt auf Differenzialdiagnose und medikamentöse Therapie zusammengefasst. Die an sich harmlose ABK sollte erkannt werden, da ein Übergang zum lebensbedrohlichen HHÖ eintreten kann. Die Behandlung des ebenfalls lebensbedrohlichen HLÖ unterscheidet sich von der Therapie kardial bedingter Lungenödeme. Die Verbesserung der Sauerstoffversorgung hat bei allen Krankheitsbildern höchste Priorität, die wichtigsten Notfallmedikamente sind Nifedipin für das HLÖ und Dexamethason für schwere ABK und das HHÖ.

Abstract

With increasing numbers of people going to altitudes above 2500 m, the “high altitude illness” has become a public health problem. The term “high altitude illness” describes the cerebral – i. e. acute mountain sickness (AMS) and high altitude cerebral edema (HACE) – and the pulmonary – i. e. high altitude pulmonary edema (HAPE)-syndroms, which occure in unacclimatised people travelling to high altitude. AMS is the most frequent problem and occurs already at altitudes above 2500 m, whereas HACE and HAPE usually occur not until altitudes > 4000 m and > 3000 – 4000 m, respectively. The main focus of this article is on the differential diagnosis and the treatment of AMS, HACE and HAPE. Symptoms of AMS, which is usually harmless, can indicate a progress to the potentially lethal HACE. The treatment of HAPE differs from the treatment of any other cardiac edema. In every high altitude illness, the improvement of oxygen delivery has got the highest priority. The most important drugs are nifedipine for HAPE and dexamethasone for severe AMS and HACE, respectively.

Schlüsselwörter

akute Bergkrankheit - Höhenhirnödem - Höhenlungenödem

Keywords

acute mountain illness - high altitude cerebral edema - high altitude pulmonary edema

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