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Altitude medicine

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21 papers 0 to 25 followers
https://www.readbyqxmd.com/read/22441084/peripheral-arterial-desaturation-is-further-exacerbated-by-exercise-in-adolescents-with-acute-mountain-sickness
#1
Sarah A Major, Ryan J K Hogan, Elizabeth Yeates, Chris H E Imray
OBJECTIVE: Rapid ascent to altitude can result in the development of high altitude illnesses such as acute mountain sickness (AMS). This study aimed to investigate AMS symptoms in adolescents and study basic cardiopulmonary measurements at altitude. METHODS: Thirty-eight adolescents aged 16 to 19 years flew to 3500 m from 215 m and continued over a 23-day period to ascend to a maximum altitude of 5200 m. Each member of the expedition completed a Lake Louise Self-Assessment Questionnaire (LLSAQ) on a daily basis, and AMS was defined as a score of ≥ 3, with an associated headache...
March 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/23062322/predictive-value-of-basal-exhaled-nitric-oxide-and-carbon-monoxide-for-acute-mountain-sickness
#2
Haiyan You, Xiaoxiao Li, Tao Pei, Qingyuan Huang, Fuyu Liu, Yuqi Gao
OBJECTIVE: The purpose of this study was to examine the relationship between acute mountain sickness (AMS) and the fraction of exhaled nitric oxide (Fe(NO)) and carbon monoxide (Fe(CO)) before ascent to high altitude and to evaluate their predictive value for AMS. METHODS: A total of 314 healthy young male recruits were voluntarily enrolled. Before ascent to an elevation of 4300 m, their Fe(NO) and Fe(CO) values, demographic factors, drinking and smoking history, vital capacity, and forced vital capacity were obtained...
December 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22000548/conduit-vessel-blood-flow-during-the-trek-to-mount-everest-base-camp
#3
Valerie Dumais, Patrice Nault, Alexander Tsertsvadze, Thomas L Forbes
OBJECTIVE: Hemodynamic changes in response to the hypoxic environment of high altitude are vascular bed-specific. The aim of the present study was to investigate diameter and blood flow changes in conduit vessels in response to hypobaric hypoxia. METHODS: Eleven healthy subjects ascending Mount Everest to base camp participated in this study. Vessel diameter and blood velocity for brachial, carotid, common femoral, superficial femoral, and deep femoral arteries were measured by portable Doppler ultrasound...
December 2011: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/21962045/a-comparison-of-the-incidence-and-understanding-of-altitude-illness-between-porters-and-trekkers-in-the-solu-khumbu-region-of-nepal
#4
Lauren Newcomb, Chhewang Sherpa, Annabel Nickol, Jeremy Windsor
OBJECTIVE: Altitude illness can occur in anyone who ascends to high altitude. Better understanding of altitude illness is associated with a lower incidence of acute mountain sickness (AMS). The purpose of this study is to compare, for the first time, the incidence and understanding of altitude illness between foreign trekkers and indigenous porters in Nepal. METHODS: Interviews and questionnaires were completed at the International Porter Protection Group Rescue Post at Machermo (4470 m)...
September 2011: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/23098412/altitude-sickness-in-climbers-and-efficacy-of-nsaids-trial-ascent-randomized-controlled-trial-of-ibuprofen-versus-placebo-for-prevention-of-altitude-illness
#5
RANDOMIZED CONTROLLED TRIAL
Jeffrey H Gertsch, Bryan Corbett, Peter S Holck, Allison Mulcahy, Melanie Watts, Nathan Thomas Stillwagon, Amanda Morgan Casto, Charles Hessel Abramson, Charles Peter Aloysius Vaughan, Christopher Macguire, Neda Nicole Farzan, Baotran Nguyen Vo, Rebecca Jean Norvelle, Kerstin May, Jessica Elizabeth Holly, Hillary Irons, Aaron Michael Stutz, Pradip Chapagain, Siddhartha Yadav, Matiram Pun, Jeremy Farrar, Buddha Basnyat
OBJECTIVE: To study the effectiveness of ibuprofen versus placebo in preventing acute mountain sickness (AMS) and high altitude headache (HAH). METHODS: Double-blind, randomized, placebo-controlled trial. RESULTS: Two hundred ninety-four healthy Western trekkers were recruited on the Everest approach at 4280 m or 4358 m and randomly assigned to receive either 600 mg of ibuprofen or placebo 3 times daily before and during ascent to 4928 m. One hundred eighty-three of 294 participants completed the trial...
December 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/23434169/measuring-arterial-oxygenation-in-a-high-altitude-field-environment-comparing-portable-pulse-oximetry-with-blood-gas-analysis
#6
COMPARATIVE STUDY
Elliot M Ross, Michael J Matteucci, Matthew Shepherd, Matthew Barker, Lance Orr
OBJECTIVE: High altitude environments present unique medical treatment challenges. Medical providers often use small portable pulse oximetry devices to help guide their clinical decision making. A significant body of high altitude research is based on the use of these devices to monitor hypoxia, yet there is a paucity of evidence that these devices are accurate in these environments. We studied whether these devices perform accurately and reliably under true mountain conditions. METHODS: Healthy unacclimatized active-duty military volunteers participating in mountain warfare training at 2100 m (6900 feet) above sea level were evaluated with several different pulse oximetry devices while in a cold weather, high altitude field environment and then had arterial blood gases (ABG) drawn using an i-STAT for comparison...
June 2013: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/20591379/wilderness-medical-society-consensus-guidelines-for-the-prevention-and-treatment-of-acute-altitude-illness
#7
Andrew M Luks, Scott E McIntosh, Colin K Grissom, Paul S Auerbach, George W Rodway, Robert B Schoene, Ken Zafren, Peter H Hackett
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...
June 2010: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/25443761/high-intensity-intermittent-exercise-increases-pulmonary-interstitial-edema-at-altitude-but-not-at-simulated-altitude
#8
Mark E Edsell, Yashvi H Wimalasena, William L Malein, Kimberly M Ashdown, Carla A Gallagher, Chris H Imray, Alex D Wright, Stephen D Myers
OBJECTIVE: Ascent to high altitude leads to a reduction in ambient pressure and a subsequent fall in available oxygen. The resulting hypoxia can lead to elevated pulmonary artery (PA) pressure, capillary stress, and an increase in interstitial fluid. This fluid can be assessed on lung ultrasound (LUS) by the presence of B-lines. We undertook a chamber and field study to assess the impact of high-intensity exercise in hypoxia on the development of pulmonary interstitial edema in healthy lowlanders...
December 2014: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/25747540/smoking-increases-the-risk-of-acute-mountain-sickness
#9
Denis Vinnikov, Nurlan Brimkulov, Paul D Blanc
OBJECTIVE: We aimed to ascertain risk factors for acute mountain sickness (AMS) in miners exposed to chronic intermittent high altitude conditions. METHODS: All new hires (2009-2012) for mine employment (4000 m above sea level) were followed up for 12 months after first ascent. Demographics, physiologic data, and cigarette smoking were assessed at preemployment screening. Mine site clinic care for AMS defined incident events. Cox regression analysis estimated risk of AMS associated with smoking and selected covariates...
June 2015: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/24864065/risk-determinants-of-acute-mountain-sickness-in-trekkers-in-the-nepali-himalaya-a-24-year-follow-up
#10
Marion McDevitt, Scott E McIntosh, George Rodway, Jitsupa Peelay, Doug L Adams, Bengt Kayser
OBJECTIVE: Exposure to altitude may lead to acute mountain sickness (AMS) in nonacclimatized individuals. We surveyed AMS prevalence and potential risk factors in trekkers crossing a 5400-m pass in Nepal and compared the results with those of 2 similar studies conducted 12 and 24 years earlier. METHODS: In April 2010, 500 surveys were distributed to English-speaking trekkers at 3500 m on their way to 5400 m, of which 332 (66%) surveys were returned complete. Acute mountain sickness was quantified with the Lake Louise Scoring System (LLSS, cutoff ≥3 and ≥5) and the Environmental Statistical Questionnaire III AMS-C score (ESQ-III, cutoff ≥0...
June 2014: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/22656656/oximetry-fails-to-predict-acute-mountain-sickness-or-summit-success-during-a-rapid-ascent-to-5640-meters
#11
Dale R Wagner, Jonathan R Knott, Jack P Fry
OBJECTIVE: The purpose of this study was to determine whether arterial oxygen saturation (Spo(2)) and heart rate (HR), as measured by a finger pulse oximeter on rapid arrival to 4260 m, could be predictive of acute mountain sickness (AMS) or summit success on a climb to 5640 m. METHODS: Climbers (35.0 ± 10.1 years; 51 men, 5 women) were transported from 2650 m to the Piedra Grande hut at 4260 m on Pico de Orizaba within 2 hours. After a median time of 10 hours at the hut, they climbed toward the summit (5640 m) and returned, with a median trip time of 14 hours...
June 2012: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/23062320/management-of-high-altitude-pulmonary-edema-in-the-himalaya-a-review-of-56-cases-presenting-at-pheriche-medical-aid-post-4240-m
#12
Barbara E Jones, Suzy Stokes, Suzi McKenzie, Eric Nilles, Gregory J Stoddard
OBJECTIVE: The purpose of this study was to review the patient characteristics and management of 56 cases of high altitude pulmonary edema at the Pheriche Himalayan Rescue Association Medical Aid Post, and to measure the use of medications in addition to descent and oxygen. METHODS: In a retrospective case series, we reviewed all patients diagnosed clinically with high altitude pulmonary edema during the 2010 Spring and Fall seasons. Nationality, altitude at onset of symptoms, physical examination findings, therapies administered, and evacuation methods were evaluated...
March 2013: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/25712298/the-effect-of-acetazolamide-on-saccadic-latency-at-3459-meters
#13
RANDOMIZED CONTROLLED TRIAL
Olivia K Faull, Josephine Robertson, Owen Thomas, Arthur R Bradwell, Chrystalina A Antoniades, Kyle T S Pattinson
OBJECTIVE: The effect of altitude on brain function is not yet well understood, nor is the influence of height and speed of ascent. Additionally, the relationship between acute mountain sickness (AMS) symptoms and brain function at altitude is unclear. We hypothesized that a deterioration from baseline measures of brain function occurs after rapid, mechanical ascent to 3459 m and would be less pronounced in persons taking acetazolamide. METHODS: In this double blind, randomized, placebo-controlled study, 20 healthy volunteers (14 men, 6 women; mean age [±SD] 43 ± 16 years) were alternately allocated to acetazolamide 250 mg or to placebo, taken every 12 hours commencing 3 days before ascent...
March 2015: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/19099331/update-on-high-altitude-pulmonary-edema-pathogenesis-prevention-and-treatment
#14
REVIEW
Joshua O Stream, Colin K Grissom
High-altitude pulmonary edema (HAPE) is a life-threatening noncardiogenic form of pulmonary edema (PE) that afflicts susceptible persons after rapid ascent to high altitude above 2500 m. Its pathogenesis is related to increased sympathetic tone, exaggerated hypoxic pulmonary vasoconstriction, uneven hypoxic pulmonary vasoconstriction with overperfusion of some regions of the pulmonary vascular bed, increased pulmonary capillary pressure, stress failure of pulmonary capillaries, and alveolar fluid leak across capillary endothelium resulting in interstitial and alveolar edema...
2008: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/24931591/sleeping-in-moderate-hypoxia-at-home-for-prevention-of-acute-mountain-sickness-ams-a-placebo-controlled-randomized-double-blind-study
#15
RANDOMIZED CONTROLLED TRIAL
Christoph Dehnert, Astrid Böhm, Igor Grigoriev, Elmar Menold, Peter Bärtsch
OBJECTIVE: Acclimatization at natural altitude effectively prevents acute mountain sickness (AMS). It is, however, unknown whether prevention of AMS is also possible by only sleeping in normobaric hypoxia. METHODS: In a placebo-controlled, double-blind study 76 healthy unacclimatized male subjects, aged 18 to 50 years, slept for 14 consecutive nights at either a fractional inspired oxygen (Fio2) of 0.14 to 0.15 (average target altitude 3043 m; treatment group) or 0...
September 2014: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/26118450/brain-natriuretic-peptide-levels-and-the-occurrence-of-subclinical-pulmonary-edema-in-healthy-lowlanders-at-high-altitude
#16
Maude Pagé, Christine Henri, Pierre Pagé, Claude Sauvé, Erick Schampaert
BACKGROUND: High altitude (HA) pulmonary edema (PE) results from complex and misunderstood interactions between adaptation mechanisms. We assessed the occurrence of subclinical PE and brain natriuretic peptide (BNP) levels among nonacclimatized individuals during an expedition on Mount Elbrus (5642 m). METHODS: Seven subjects underwent assessment of vital signs, Lake Louise Score, ultrasound lung comets using handheld echography and circulating BNP using capillary testing at different stages of ascension, in addition to baseline echocardiography...
August 2015: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/17426204/chest-ultrasonography-for-the-diagnosis-and-monitoring-of-high-altitude-pulmonary-edema
#17
Peter J Fagenholz, Jonathan A Gutman, Alice F Murray, Vicki E Noble, Stephen H Thomas, N Stuart Harris
BACKGROUND: The comet-tail technique of chest ultrasonography has been described for the diagnosis of cardiogenic pulmonary edema. This is the first report describing its use for the diagnosis and monitoring of high-altitude pulmonary edema (HAPE), the leading cause of death from altitude illness. METHODS: Eleven consecutive patients presenting to the Himalayan Rescue Association clinic in Pheriche, Nepal (4,240 m) with a clinical diagnosis of HAPE underwent one to three chest ultrasound examinations using the comet-tail technique to determine the presence of extravascular lung water (EVLW)...
April 2007: Chest
https://www.readbyqxmd.com/read/23871437/echocardiographic-assessment-of-cardiac-performance-in-response-to-high-altitude-and-development-of-subclinical-pulmonary-edema-in-healthy-climbers
#18
COMPARATIVE STUDY
Maude Pagé, Claude Sauvé, Karim Serri, Pierre Pagé, Yalin Yin, Erick Schampaert
BACKGROUND: Data regarding the effect of high altitude on heart function are sparse and conflicting. We aimed to assess the right and left ventricular responses to altitude-induced hypoxia and the occurrence of subclinical pulmonary edema. METHODS: Echocardiography was performed according to protocol on 14 subjects participating in an expedition in Nepal, at 3 altitude levels: Montreal (30 m), Namche Bazaar (3450 m), and Chukkung (4730 m). Systematic lung ultrasound was performed to detect ultrasound lung comets...
October 2013: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/20562696/frequent-subclinical-high-altitude-pulmonary-edema-detected-by-chest-sonography-as-ultrasound-lung-comets-in-recreational-climbers
#19
Lorenza Pratali, Marco Cavana, Rosa Sicari, Eugenio Picano
OBJECTIVE: The ultrasound lung comets detected by chest sonography are a simple, noninvasive, semiquantitative sign of increased extravascular lung water. The aim of this study was to evaluate, by chest sonography, the incidence of interstitial pulmonary edema in recreational high-altitude climbers. DESIGN: Observational study. SUBJECTS: Eighteen healthy subjects (mean age 45 +/- 10 yrs, ten males) participating in a high-altitude trek in Nepal...
September 2010: Critical Care Medicine
https://www.readbyqxmd.com/read/23453728/using-ultrasound-lung-comets-in-the-diagnosis-of-high-altitude-pulmonary-edema-fact-or-fiction
#20
REVIEW
Yashvi Wimalasena, Jeremy Windsor, Mark Edsell
High altitude pulmonary edema is a life-threatening condition that remains a concern for climbers and clinicians alike. Within the last decade, studies have shown ultrasonography to be valuable in the accurate diagnosis of a variety of lung pathologies, including cardiogenic pulmonary edema, pleural effusion, pneumothorax, and lung consolidation. Recently, studies conducted in remote areas have demonstrated that ultrasound lung comets can be used as a measure of subacute pulmonary edema and high altitude pulmonary edema in climbers ascending to altitude...
June 2013: Wilderness & Environmental Medicine
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