Acute Mountain Sickness in Tourists with Children at Lake Chungará (4400m) in Northern Chile

Moraga, Fernando A.; Osorio, Jorge; Vargas, Manuel

doi:10.1580/1080-6032(2002)013[0031:amsitw]2.0.co;2

Cited by 42 publications

(44 citation statements)

References 10 publications

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“…For comparisons, all six children aged 6 months to 4 yrs and five out of 10 children aged 13-18 yrs had significant symptoms of AMS (defined by o3 points in the Lake Louise questionnaire) after one night at 3,500 m (very young children were evaluated with a modified questionnaire) [16]. Since no statistical correlation was found among AMS scores and measures of periodic breathing in the current study, an interaction between periodic breathing and severity of AMS symptoms seems unlikely or weak.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, ventilatory instability and periodic breathing have been shown to depend on the proximity of the eupnoeic carbon dioxide tension (PCO 2 ) to the apnoeic and hypopnoeic threshold PCO 2 , as well as on the ventilatory sensitivity to CO 2 below eupnoea [14]. These factors may differ between children and adults and may affect ventilation, oxygenation and thereby well-being and performance at high altitude [15][16][17]. As respiratory adaptation to acute altitude exposure has not been studied in detail in children, the current authors performed unobtrusive breathing pattern recordings by calibrated respiratory inductive plethysmography and actimetry in pre-pubertal children and their fathers.…”

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confidence: 99%

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Children at high altitude have less nocturnal periodic breathing than adults

Kohler¹,

Kriemler²,

Wilhelm³

et al. 2008

Eur Respir J

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Although children commonly travel to high altitudes, their respiratory adaptation to hypoxia remains elusive. Therefore, in the present study respiratory inductive plethysmography, pulse oximetry (Sp,O 2 ) and end-tidal CO 2 tension (PET,CO 2 ) were recorded in 20 pre-pubertal children (aged 9-12 yrs) and their fathers during 1 night in Zurich (490 m) and 2 nights at the Swiss Jungfrau-Joch research station (3,450 m) following ascent by train within ,3 h.In children, mean¡SD nocturnal Sp,O 2 fell from 98¡1% at 490 m to 85¡4 and 86¡4% at 3,450 m (nights 1 and 2, respectively); PET,CO 2 decreased significantly from 37¡6 to 32¡3 and 33¡4 mmHg (3,450 versus 490 m). In adults, changes in nocturnal Sp,O 2 and PET,CO 2 at 3,450 m were similar to those in children.Children spent less time in periodic breathing at 3,450 m during night 1 and 2 (8¡11 and 9¡13%, respectively) than adults (34¡24 and 22¡17%, respectively), and their apnoea threshold for CO 2 was lower compared with adults (27¡2 and 30¡2 mmHg, respectively, both nights). Sp,O 2 , PET,CO 2 and time in periodic breathing at altitude were not correlated between children and their fathers.In conclusion, children revealed a similarly reduced nocturnal O 2 saturation and associated hyperventilation at high altitude as adults but their breathing pattern was more stable, possibly related to a lower apnoea threshold for CO 2 .

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Children at high altitude have less nocturnal periodic breathing than adults

Kohler¹,

Kriemler²,

Wilhelm³

et al. 2008

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Since different ascent speed, latitudes, and different diagnostic criteria were used, this is neither surprising nor contradictory (Schneider et al, 2002), but still might represent differences in individual susceptibility in different populations. Previous studies included much smaller numbers of children (Moraga et al, 2002;Moraga et al, 2008;Pradhan et al, 2009) compromising generalizability. As previously shown, there was no significant difference in AMS prevalence between females and males (Hackett et al, 1976;Maggiorini et al, 1990).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Kriemler

Bürgi

Wick

et al. 2014

High Altitude Medicine & Biology

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AIM: To investigate symptoms, prevalence and associated factors of acute mountain sickness (AMS) in families upon a fast ascent to 3450 m. Methods: 87 children, 70 adolescents, and 155 parents (n=312) were assessed for AMS 8-10 and 20-24 hours after fast passive ascent by the Lake Louise Score (LLS). Pain sensitivity and oxygen saturation (SO2) were measured and familial clustering was assessed. RESULTS: AMS prevalence was significantly lower in children (21%) compared to adolescents (34%) and adults (39%) on day 1 (p<0.05), but not on day 2 (18% vs. 19% and 25%). Cumulative prevalence of AMS was 30, 37, and 45% in children, adolescents, and adults, respectively (p<0.001). Familial clustering of AMS was consistent and explained 25%-50% of variability in AMS. Pain sensitivity significantly increased from low to high altitude and was higher at low altitude in those with compared to those without AMS. SO2 at high altitude was not related to the presence of AMS. CONCLUSIONS: After fast ascent to 3500 m, AMS prevalence was lower in children than in adolescents and adults on day 1, but not on day 2. Thus, children may travel at least as safely to an altitude of 3500 m as adolescents and adults, even if risk factors (pain sensitivity and heredity) are present. Methods: 87 children, 70 adolescents, and 155 parents (n = 312) were assessed for AMS 8-10 and 20-24 hours after fast passive ascent by the Lake Louise Score (LLS). Pain sensitivity and oxygen saturation (SO 2 ) were measured and familial clustering was assessed.Results: AMS prevalence was significantly lower in children (21%) compared to adolescents (34%) and adults (39%) on day 1 ( p < 0.05), but not on day 2 (18% vs. 19% and 25%). Cumulative prevalence of AMS was 30, 37, and 45% in children, adolescents, and adults, respectively ( p < 0.001). Familial clustering of AMS was consistent and explained 25%-50% of variability in AMS. Pain sensitivity significantly increased from low to high altitude and was higher at low altitude in those with compared to those without AMS. SO 2 at high altitude was not related to the presence of AMS. Conclusions: After fast ascent to 3500 m, AMS prevalence was lower in children than in adolescents and adults on day 1, but not on day 2. Thus, children may travel at least as safely to an altitude of 3500 m as adolescents and adults, even if risk factors (pain sensitivity and heredity) are present.

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“…2 More recently, age also has been proposed as a risk factor. 3 It has been suggested that the incidence and severity of AMS may be inversely related to climbers' age; brain swelling may be better tolerated by elderly individuals because of the smaller brain/cranial vault volume ratio. 4 • 5 There are few clinical data to substantiate this speculation, 6 however, and there is no information from a controlled study on the prevalence and time course of AMS in adolescents after rapid ascent by mechanical transportation to altitudes of ~3 500 m, at which major tourist destinations are located throughout the world.…”

Section: Absth/kfmentioning

confidence: 99%

Prevalence and Time Course of Acute Mountain Sickness in Older Children and Adolescents After Rapid Ascent to 3450 Meters

et al. 2009

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Grâce au développement de moyens de transport modernes, de plus en plus d'enfants et d'adolescents se rendent en haute altitude dans le cadre de leurs loisirs. Le mal aigu des montagnes est une complication fréquente des séjours en haute altitude. Ses symptômes en sont des maux de tête, une fatigue, des troubles du sommeil, des nausées et des vertiges. La vitesse d'ascension, l'altitude maximale atteinte, une susceptibilité individuelle ainsi qu'une acclimatation antérieure à l'altitude sont tous des facteurs influant sur le risque de développer un mal aigu des montagnes et sur sa sévérité.Bien que très fréquente chez l'adulte, nous ne possédions, au moment d'entreprendre l'étude faisant l'objet de cette thèse, que peu de données solides concernant la prévalence de cette affection chez l'enfant ainsi que sur son évolution au cours du temps.Cette étude a pour but de mesurer la prévalence du mal aigu des montagnes, et son évolution au cours du temps au sein d'un groupe d'enfants et d'adolescents dans des conditions contrôlées. C'est à dire en éliminant l'influence de facteurs confondants tels que l'importance de l'exercice physique fourni ou une différence dans la vitesse d'ascension.Pour ce faire nous avons évalué la présence de mal aigu des montagnes dans un groupe de 48 garçons et de filles âgés de 11 à 17 ans en bonne santé habituelle, n'ayant jamais séjourné en haute altitude au préalable. Afin d'évaluer la présence ou non de mal aigu des montagnes nous avons utilisé une version française du « Lake Louise Score ».Les mesures furent effectuées 6,24 et 48 heures après l'arrivée à la station de recherche de la Jungfraujoch située à 3'450m. L'ascension a consisté en un trajet de train durant 2h30.Nos observations montrent que la prévalence du mal aigu des montagnes durant les 3 premiers jours ne dépasse jamais les 25%. Elle est similaire pour les deux sexes et diminue au cours du séjour.(17% après 24 heures, 8% après 48 heures) Aucun sujet n'a dû être évacué à une altitude inférieure. Cinq sujets ont eu besoin de recourir à un traitement symptomatique et y ont bien répondu Les résultats de cette étude démontrent que dans le groupe d'âge étudié, après une ascension rapide en haute altitude, la prévalence du mal aigu des montagnes est relativement faible, ses manifestations cliniques sont bénignes et, lorsqu' elles sont présentes, se résolvent rapidement. Ces observations suggèrent que pour la majorité des enfants et des adolescents en bonne santé et non habitués à l'altitude, un séjour en haute altitude 'ne présente pas de risque et une prophylaxie pharmacologique du mal aigu des montagnes n'est pas nécessaire. ARTICLE

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Acute Mountain Sickness in Tourists with Children at Lake Chungará (4400m) in Northern Chile

Cited by 42 publications

References 10 publications

Children at high altitude have less nocturnal periodic breathing than adults

Children at high altitude have less nocturnal periodic breathing than adults

Prevalence of Acute Mountain Sickness at 3500 m Within and Between Families: A Prospective Cohort Study

Prevalence and Time Course of Acute Mountain Sickness in Older Children and Adolescents After Rapid Ascent to 3450 Meters

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