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Physiological responses during ascent to high altitude and the incidence of acute mountain sickness

Physiological Reports2021Vol. 9(7), pp. e14809–e14809

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Alexandra Cobb, Denny Levett, Kay Mitchell, W Aveling, Daniel Hurlbut, Edward T. Gilbert-Kawai, P. J. Hennis, Monty Mythen, Michael P. W. Grocott, Daniel Martín, Caudwell Xtreme Everest, Xtreme Everest 2009, Xtreme Everest 2 investigators, Vineet Ahuja, Golnar Aref-Adib, Robert Burnham, Alexandra Chisholm, Kieran Clarke, David Coates, Matthew Coates, Derek G. Cook, Mark Cox, S Dhillon, C Dougall, Pat Doyle, Pamela W. Duncan, Mark Edsell, Laura Edwards, Lauren Evans, Peter Gardiner, Michael P. W. Grocott, P Gunning, Nicholas Hart, Jane Harrington, John Julian Harvey, C Holloway, Diantha B. Howard, David Hurlbut, Chris Imray, Can İnce, Jildou van der Kaaij, Maryam Khosravi, Nicky Kolfschoten, D Levett, H Luery, Andrew M. Luks, Daniel Martín, Roger McMorrow, Paula Meale, Kay Mitchell, Hugh Montgomery, Gareth J. Morgan, J Morgan, Andrew J. Murray, M Mythen, Stanton Newman, Michael O’Dwyer, James W. Pate, Timothy Plant, Matiram Pun, Paul Richards, Alan Richardson, George W. Rodway, John B. Simpson, Catherine Stroud, M Stroud, J Stygal, Barbara Symons, Piotr Szawarski, A Van Tulleken, Chris van Tulleken, André Vercueil, Liesl Wandrag, Mark H. Wilson, Jeremy S. Windsor, B Basnyat, Caroline S. Clarke, Thomas F. Hornbein, James S. Milledge, James A. West, Sabu Abraham, Tom Adams, W Anseeuw, Rónan Astin, B Basnyat, Oliver Burdall, Janet T. Carroll, Alistair R.M. Cobb, Jonny Coppel, Orestes Couppis, J. H. Court, Andrew F. Cumpstey, Thomas Davies, S Dhillon, Norman G. Diamond, C Dougall, T Geliot, Edward T. Gilbert-Kawai, Grace Gilbert-Kawai, Erich Gnaiger, Michael P. W. Grocott, C Haldane, P. J. Hennis, James A. Horscroft, Diantha B. Howard, Sandy Jack, Blair Jarvis, William N. Jenner, Gareth Jones, Jildou van der Kaaij, Johnny Kenth, Aleksandra Kotwica, Rajendra Kumar BC, J. Hubert Lacey, Verena Laner, D Levett, Daniel Martín, Paula Meale, K Mitchell, Zeyn Mahomed, J Moonie, Andrew J. Murray, M Mythen, P Mythen, Karel O’Brien, I Ruggles‐Brice, Karen Salmon, Adam Sheperdigian, Tom Smedley, Barbara Symons, Christopher Tomlinson, André Vercueil, Liesl Wandrag, Sue Ward, Anne Wight, Caroline R.M. Wilkinson, Stephen Wythe, Martin Feelisch, Edward T. Gilbert-Kawai, Michael P. W. Grocott, Mark A. Hanson, D Levett, Daniel Martín, K Mitchell, Hugh Montgomery, Richard E. Moon, Andrew J. Murray, M Mythen, Mark Peters

Abstract

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 (SpO₂ ) 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 SpO₂ 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 SpO₂ at 3500 m (82.2 vs. 83.8%, p = 0.027; 81.5 vs. 83.8%, p 2 (OR 0.870, p 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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Abstract

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