Altitude Illness
                        ================
þ Decadron Helps HACE:
 - [Bernhard WN, Schalick LM, Delaney PA, Bernhard TM, Barnas GM.
   Acetazolamide plus low-dose dexamethasone is better than acetazolamide
   alone to ameliorate symptoms of acute mountain sickness. Aviat Space
   Environ Med. 1998 Sep;69(9):883-6.]

þ Diamox helps both HAPE and HACE prevention:
  [Burki NK, Khan SA, Hameed MA. The effects of acetazolamide on the
  ventilatory response to high altitude hypoxia. Chest. 1992
  Mar;101(3):736-41.]

þ Good Review
  [Hackett PH, Roach RC. Medical therapy of altitude illness. Ann Emerg Med.
  1987 Sep;16(9):980-6.]

þ HAPE
 - HAPE Diagnosis:
   The diagnosis of HAPE requires at least two of the four cardinal symptoms
   (weakness or decreased exercise performance, cough, dyspnea at rest, and
   chest tightness or congestion).  It also requires at least two of the four
   cardinal signs (crackles or wheezing, central cyanosis or oxygen
   desaturation out of proportion to that expected for the altitude,
   tachycardia, and tachypnea).  Fever, orthopnea and pink or frothy sputum
   can also be seen.
   emedicine.com - http://www.emedicine.com/emerg/topic795.htm

þ Rigella (?sp), Ann Intern Med -- alcohol decreased pO2 and thus
probably predisposes to AMS.

The ultra-fit athlete have a low hypoxic drive to breathe, which may
predispose to altitude illness, at least anecdotally.

fluids don't make much difference.

dose:  62.5 mg (1/4 of a 250 mg tablet) BID for 1-2 days.
5 mg/kg/day divided BID

Lake Louise criteria as appendix?

Peter's diagram of altitude vs.time?

Severinghouse, UCLA, 1996? suggests that cause of HACE is beginning of
angiogenesis, which is blocked by dexamethasone.

Canadian Neurologist named Ross thought maybe related to brain size
related to cranial vault size.

Do we have enough understanding to say a bit more about
pathophysiology, especially as to the effects of dexamethasone on
HACE?