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高山病予防・治療のための薬剤推奨用量

Wilderness Medical Society の推奨する高所障害に対する薬剤の適応・投与経路・投与量
出典
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1: Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness.
著者: Andrew M Luks, Scott E McIntosh, Colin K Grissom, Paul S Auerbach, George W Rodway, Robert B Schoene, Ken Zafren, Peter H Hackett, Wilderness Medical Society
雑誌名: Wilderness Environ Med. 2010 Jun;21(2):146-55. doi: 10.1016/j.wem.2010.03.002. Epub 2010 Mar 10.
Abstract/Text: To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the prevention and treatment of acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to the prevention and management of each disorder that incorporate these recommendations.

Copyright (c) 2010. Published by Elsevier Inc.
Wilderness Environ Med. 2010 Jun;21(2):146-55. doi: 10.1016/j.wem.2010...

高所脳浮腫患者のMRI所見

脳梁、両側淡蒼球に浮腫を認める。
a:MRIT2強調
b:FLAIR画像
出典
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1: Serhat Avcu, Harun Arslan, Uğur Göktaş, Mehmet Deniz Bulut, and Özkan Ünal:Acute mountain sickness occurring with corpus callosum, globus pallidus and cerebellar peduncle involvement: MRI findings.European Journal of Radiology Extra, 2010;76(1):e7-e10.

高所肺水腫患者の胸部X線写真

a:標高2,450mで発症した29歳女性の高所肺水腫の胸部X線写真
b:aと同一患者の下山し酸素投与された翌日の写真。急速な改善を認める。
c:下山した後の重症高所肺水腫の患者の写真。両側の肺水腫を認める。
出典
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1: Paul S. Auerbach:Wilderness Medicine , Sixth Edition.Chapter 1 High-Altitude Medicine and Physiology 2-33.e11,FIGURE 1-17,Mosby,2012

加圧バッグ

エベレスト山で重症高山病の治療に用いられる加圧バッグ。2psiの加圧はおよそ標高 1,600 m(5249 feet)の下降に相当する。
出典
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1: Paul S. Auerbach:Wilderness Medicine , Sixth Edition.Chapter 1 High-Altitude Medicine and Physiology 2-33.e11,FIGURE 1-13,Mosby,2012

レイクルイーズ急性高山病スコアシステム

急性高山病の診断は、以下を満たした場合とする。
 
1.過去4日以内の高度上昇
2.頭痛
3.上記の他に1つ以上の症状
4.レイクルーズ急性高山病スコアシステム3点以上
出典
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1: The 2018 Lake Louise Acute Mountain Sickness Score.
著者: Robert C Roach, Peter H Hackett, Oswald Oelz, Peter Bärtsch, Andrew M Luks, Martin J MacInnis, J Kenneth Baillie, Lake Louise AMS Score Consensus Committee
雑誌名: High Alt Med Biol. 2018 Mar;19(1):4-6. doi: 10.1089/ham.2017.0164. Epub 2018 Mar 13.
Abstract/Text: Roach, Robert C., Peter H. Hackett, Oswald Oelz, Peter Bärtsch, Andrew M. Luks, Martin J. MacInnis, J. Kenneth Baillie, and The Lake Louise AMS Score Consensus Committee. The 2018 Lake Louise Acute Mountain Sickness Score. High Alt Med Biol 19:1-4, 2018.- The Lake Louise Acute Mountain Sickness (AMS) scoring system has been a useful research tool since first published in 1991. Recent studies have shown that disturbed sleep at altitude, one of the five symptoms scored for AMS, is more likely due to altitude hypoxia per se, and is not closely related to AMS. To address this issue, and also to evaluate the Lake Louise AMS score in light of decades of experience, experts in high altitude research undertook to revise the score. We here present an international consensus statement resulting from online discussions and meetings at the International Society of Mountain Medicine World Congress in Bolzano, Italy, in May 2014 and at the International Hypoxia Symposium in Lake Louise, Canada, in February 2015. The consensus group has revised the score to eliminate disturbed sleep as a questionnaire item, and has updated instructions for use of the score.
High Alt Med Biol. 2018 Mar;19(1):4-6. doi: 10.1089/ham.2017.0164. Epu...

急性高山病のリスク分類

出典
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1: Wilderness Medical Society practice guidelines for the prevention and treatment of acute altitude illness: 2014 update.
著者: Andrew M Luks, Scott E McIntosh, Colin K Grissom, Paul S Auerbach, George W Rodway, Robert B Schoene, Ken Zafren, Peter H Hackett, Wilderness Medical Society
雑誌名: Wilderness Environ Med. 2014 Dec;25(4 Suppl):S4-14. doi: 10.1016/j.wem.2014.06.017.
Abstract/Text: To provide guidance to clinicians about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for prevention and treatment of acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations about their role in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to prevention and management of each disorder that incorporate these recommendations. This is an updated version of the original WMS Consensus Guidelines for the Prevention and Treatment of Acute Altitude Illness published in Wilderness & Environmental Medicine 2010;21(2):146-155.

Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Wilderness Environ Med. 2014 Dec;25(4 Suppl):S4-14. doi: 10.1016/j.wem...

高山病予防・治療のための薬剤推奨用量

Wilderness Medical Society の推奨する高所障害に対する薬剤の適応・投与経路・投与量
出典
imgimg
1: Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness.
著者: Andrew M Luks, Scott E McIntosh, Colin K Grissom, Paul S Auerbach, George W Rodway, Robert B Schoene, Ken Zafren, Peter H Hackett, Wilderness Medical Society
雑誌名: Wilderness Environ Med. 2010 Jun;21(2):146-55. doi: 10.1016/j.wem.2010.03.002. Epub 2010 Mar 10.
Abstract/Text: To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the prevention and treatment of acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to the prevention and management of each disorder that incorporate these recommendations.

Copyright (c) 2010. Published by Elsevier Inc.
Wilderness Environ Med. 2010 Jun;21(2):146-55. doi: 10.1016/j.wem.2010...

高所脳浮腫患者のMRI所見

脳梁、両側淡蒼球に浮腫を認める。
a:MRIT2強調
b:FLAIR画像
出典
img
1: Serhat Avcu, Harun Arslan, Uğur Göktaş, Mehmet Deniz Bulut, and Özkan Ünal:Acute mountain sickness occurring with corpus callosum, globus pallidus and cerebellar peduncle involvement: MRI findings.European Journal of Radiology Extra, 2010;76(1):e7-e10.