{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T08:00:17Z","timestamp":1784793617630,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Morbidity and mortality in cardiogenic pulmonary edema have been reduced by noninvasive positive\u2010pressure airway maneuvers. The value of continuous positive airway pressure (CPAP) for the treatment of high\u2010altitude pulmonary edema (HAPE) is uncertain. The purpose of this study was to evaluate the efficacy and speed of CPAP for HAPE resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, investigator\u2010initiated, multicenter, randomized, double\u2010blind controlled trial of high\u2010flow oxygen with CPAP versus sham CPAP with high\u2010flow oxygen (oxygen\u2010only group) was conducted. Sixty\u2010four dyspneic adults with maximum oxygen saturation &lt;\u200985%, recent arrival at high altitude, and noncardiogenic pulmonary edema on chest radiography were randomized to receive CPAP treatment plus usual care or usual care (oxygen\u2010only) delivered through a sham CPAP mask. The primary endpoint was the clinical resolution of HAPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HAPE resolution in the CPAP plus high FiO\n                      <jats:sub>2<\/jats:sub>\n                      group and the high flow oxygen alone group was similar. However, this finding should be interpreted cautiously due to this study being slightly underpowered. There was no significant difference in time to resolution (CPAP ~158\u2009min vs. oxygen ~178\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.297). Both therapies were effective, with a mean time to resolution of HAPE of approximately 2.5 to 3\u2009h. No treatment\u2010related adverse outcomes, intubations, or mortality were observed in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both CPAP with high\u2010flow oxygen and high\u2010flow oxygen alone are highly effective for the treatment of HAPE. CPAP conferred no improvement in the time to resolution of HAPE. High\u2010flow oxygen therapy requires significantly less resource utilization for similar benefits in the treatment of HAPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT04186598<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70126","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:52:19Z","timestamp":1757688739000},"page":"1215-1223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High Altitude Pulmonary Edema Response to Continuous Airway Positive Pressure: A Randomized Controlled Trial: The\n                    <scp>HAPER CAPER<\/scp>\n                    Trial"],"prefix":"10.1111","volume":"32","author":[{"given":"Todd","family":"Bolotin","sequence":"first","affiliation":[{"name":"Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Lake Erie College of Osteopathic Medicine  Erie Pennsylvania USA"},{"name":"Department of Emergency Medicine St. Elizabeth Youngstown Hospital  Youngstown Ohio USA"},{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"},{"name":"Centura Health Emergency and Urgent Care Breckenridge  Keystone Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Subedi","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil","family":"Dahal","sequence":"additional","affiliation":[{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Walker","sequence":"additional","affiliation":[{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"},{"name":"Marian Regional Medical Center  Santa Maria California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Chung","sequence":"additional","affiliation":[{"name":"Centura Health Emergency and Urgent Care Breckenridge  Keystone Colorado USA"},{"name":"CommonSpirit Emergency and Urgent Care  Keystone Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Martz","sequence":"additional","affiliation":[{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gemmel","sequence":"additional","affiliation":[{"name":"Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Department of Research St. Elizabeth Youngstown Hospital  Youngstown Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6348-4658","authenticated-orcid":false,"given":"Quincy","family":"Chopra","sequence":"additional","affiliation":[{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"},{"name":"Clinton Memorial Hospital  Wilmington Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Donley","sequence":"additional","affiliation":[{"name":"Northeast Ohio Medical University  Rootstown Ohio USA"},{"name":"Lake Erie College of Osteopathic Medicine  Erie Pennsylvania USA"},{"name":"Department of Emergency Medicine St. Elizabeth Youngstown Hospital  Youngstown Ohio USA"},{"name":"St. Elizabeth Boardman Emergency Medicine Residency  Boardman Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/arm91050034"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2005.07.005"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1214870"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/OAEM.S297752"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1580\/07\u2010WEME\u2010REV\u2010173.1"},{"key":"e_1_2_12_7_1","unstructured":"U.S. Department of Transportation \u201cTravel Time to Work \u201daccessed February 5 2025 https:\/\/geodata.bts.gov\/datasets\/usdot%3A%3Atravel\u2010time\u2010to\u2010work\/about."},{"key":"e_1_2_12_8_1","unstructured":"Magellan Strategies \u201cColorado Ski & Snowboard Survey 2020 \u201daccessed February 5 2025 https:\/\/magellanstrategies.com\/colorado\u2010ski\u2010snowboard\u2010survey\u20102020\/."},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780197570944.001.0001"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"569","article-title":"High\u2010Altitude Pulmonary Edema in Vail, Colorado, 1975\u20131982","volume":"144","author":"Sophocles A. 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