Journal
PHYSIOLOGICAL REPORTS
Volume 9, Issue 7, Pages -Publisher
WILEY
DOI: 10.14814/phy2.14809
Keywords
altitude; altitude sickness; exercise; hypoxia
Categories
Funding
- Linde Gas Therapeutics
- Eli Lilly
- London Clinic
- Smiths Medical
- Deltex Medical
- Rolex Foundation
- Atlantic Customer Solutions
- Association of Anaesthetists of Great Britain and Ireland
- United Kingdom Intensive Care Foundation
- Sir Halley Stewart Trust
- National Institute of Academic Anaesthesia
- Rhinology and Laryngology Research Fund
- Physiological Society
- Royal Free Hospital NHS Trust Charity
- Special Trustees of University College London Hospital NHS Foundation Trust
- Southampton University Hospital Charity
- UCL Institute of Sports Exercise and Health
- University of Southampton
- Duke University Medical School
- United Kingdom Department of Health's National Institute for Health Research Biomedical Research Centres
- University College London
- United Kingdom Department of Health's National Institute for Health Research Biomedical Research Units funding scheme
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During ascent to 5300 m, the overall occurrence of AMS was 73.5%, with 50.3% being moderate-severe. Participants who had not previously ascended >5000 m were more likely to develop moderate-severe AMS. Lower end-exercise SpO(2) and no previous exposure to altitude >5000 m were predictors of moderate-severe AMS development. The Xtreme Everest Step-Test offers a simple and reproducible field test to predict AMS, albeit with limited predictive precision.
Acute mountain sickness (AMS) occurs when there is failure of acclimatisation to high altitude. The aim of this study was to describe the relationship between physiological variables and the incidence of AMS during ascent to 5300 m. A total of 332 lowland-dwelling volunteers followed an identical ascent profile on staggered treks. Self-reported symptoms of AMS were recorded daily using the Lake Louise score (mild 3-4; moderate-severe >= 5), alongside measurements of physiological variables (heart rate, respiratory rate (RR), peripheral oxygen saturation (SpO(2)) and blood pressure) before and after a standardised Xtreme Everest Step-Test (XEST). The overall occurrence of AMS among participants was 73.5% (23.2% mild, 50.3% moderate-severe). There was no difference in gender, age, previous AMS, weight or body mass index between participants who developed AMS and those who did not. Participants who had not previously ascended >5000 m were more likely to get moderate-to-severe AMS. Participants who suffered moderate-to-severe AMS had a lower resting SpO(2) at 3500 m (88.5 vs. 89.6%, p = 0.02), while participants who suffered mild or moderate-to-severe AMS had a lower end-exercise SpO(2) at 3500 m (82.2 vs. 83.8%, p = 0.027; 81.5 vs. 83.8%, p < 0.001 respectively). Participants who experienced mild AMS had lower end-exercise RR at 3500 m (19.2 vs. 21.3, p = 0.017). In a multi-variable regression model, only lower end-exercise SpO(2) (OR 0.870, p < 0.001) and no previous exposure to altitude >5000 m (OR 2.740, p-value 0.003) predicted the development of moderate-to-severe AMS. The Xtreme Everest Step-Test offers a simple, reproducible field test to help predict AMS, albeit with relatively limited predictive precision.
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