Children's Hospital Colorado

High-Altitude Pulmonary Edema

What is high-altitude pulmonary edema in children?

High-altitude pulmonary edema (HAPE) is a condition in which a child's lungs fill with fluid at high elevation (or rarely, moderate elevation). Children complain of trouble breathing, and they have a cough that starts out dry and becomes wet. They may also cough up blood. Their oxygen levels are also low.

There are three types of HAPE:

  • Classic HAPE occurs in children who live at a lower elevation and develop symptoms after traveling to high elevation.
  • Re-entry HAPE occurs in children who live at high elevation, travel to low elevation and then develop symptoms after they return home.
  • High-altitude resident pulmonary edema (HARPE) occurs in children who live at high elevation and develop symptoms without a change in elevation.

HAPE can happen more than once in many children. At Children's Hospital Colorado, we have vast experience helping children who are affected by altitude and can provide helpful advice on preventing it in the future.

What causes high-altitude pulmonary edema?

There is less oxygen at high altitude, which causes blood vessels in the lungs to constrict or tighten. This leads to fluid leaking into the lungs.

Who gets high-altitude pulmonary edema?

HAPE appears to run in some families and is more common in males before puberty. Children with certain underlying heart or lung conditions, such as obstructive sleep apnea, pulmonary hypertension, atrial septal defect and ventricular septal defect, are more likely to develop HAPE. Respiratory infections often trigger HAPE in children.

Get to know our pediatric experts.

Heather Hoch De Keyser, MD

Heather Hoch De Keyser, MD

Pulmonology - Pediatric, Pediatrics

Susan Hines, PNP

Susan Hines, PNP

Certified Pediatric Nurse Practitioner

Monica Federico, MD

Monica Federico, MD

Pulmonology - Pediatric

Naomi Miyazawa, PA-C

Naomi Miyazawa, PA-C

Physician Assistant