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

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

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 < 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 SpO2 (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.

altitude, altitude sickness, exercise, hypoxia
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Caudwell Xtreme Everest, Xtreme Everest 2009, Xtreme Everest 2 investigators (2021) Physiological responses during ascent to high altitude and the incidence of acute mountain sickness. Physiological Reports, 9 (7), [e14809]. (doi:10.14814/phy2.14809).

Record type: Article

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 < 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 SpO2 (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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Accepted/In Press date: 2 April 2021
Published date: 27 April 2021
Keywords: altitude, altitude sickness, exercise, hypoxia

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Local EPrints ID: 449554
URI: http://eprints.soton.ac.uk/id/eprint/449554
PURE UUID: 0508a2eb-e4c5-4992-b795-12783f324043
ORCID for K. Mitchell: ORCID iD orcid.org/0000-0001-6393-8475
ORCID for M. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for M. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for K. Mitchell: ORCID iD orcid.org/0000-0001-6393-8475
ORCID for J. West: ORCID iD orcid.org/0000-0002-5709-6790
ORCID for A. Cumpstey: ORCID iD orcid.org/0000-0001-6257-207X
ORCID for M. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for K. Mitchell: ORCID iD orcid.org/0000-0001-6393-8475
ORCID for M. Feelisch: ORCID iD orcid.org/0000-0003-2320-1158
ORCID for M. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for M. Hanson: ORCID iD orcid.org/0000-0002-6907-613X
ORCID for K. Mitchell: ORCID iD orcid.org/0000-0001-6393-8475

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Date deposited: 07 Jun 2021 16:32
Last modified: 26 Nov 2021 03:20

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Contributors

Author: Denny Z.H. Levett
Author: K. Mitchell ORCID iD
Author: M. Grocott ORCID iD
Author: D. Cook
Author: M. Cox
Author: L. Edwards
Author: L. Evans
Author: M. Grocott ORCID iD
Author: J. Harrington
Author: J. Harvey
Author: C. Holloway
Author: Denny Z.H. Levett
Author: D. Martin
Author: K. Mitchell ORCID iD
Author: G. Morgan
Author: J. Morgan
Author: A. Murray
Author: S. Newman
Author: T. Plant
Author: P. Richards
Author: A. Richardson
Author: J. Simpson
Author: M. Wilson
Author: J. Windsor
Author: C. Clarke
Author: J. Milledge
Author: J. West ORCID iD
Author: J. Carroll
Author: J. Court
Author: A. Cumpstey ORCID iD
Author: T. Davies
Author: M. Grocott ORCID iD
Author: S. Jack
Author: B. Jarvis
Author: G. Jones
Author: J. Lacey
Author: Denny Z.H. Levett
Author: D. Martin
Author: K. Mitchell ORCID iD
Author: A. Murray
Author: K. Salmon
Author: S. Ward
Author: C. Wilkinson
Author: M. Feelisch ORCID iD
Author: M. Grocott ORCID iD
Author: M. Hanson ORCID iD
Author: Denny Z.H. Levett
Author: D. Martin
Author: K. Mitchell ORCID iD
Author: R. Moon
Author: A. Murray
Corporate Author: Caudwell Xtreme Everest, Xtreme Everest 2009, Xtreme Everest 2 investigators

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