Children at High Altitude: An International Consensus Statement by an Ad Hoc Committee of the International Society for Mountain Medicine, March 12, 2001

Pollard, Andrew J.; Niermeyer, Susan; Barry, Peter; Bärtsch, Peter; Berghold, Franz; Bishop, Rachel A.; Clarke, Charles; Dhillon, Sundeep; Dietz, Thomas E.; Durmowicz, Anthony G.; Durrer, Bruno; Eldridge, Marlowe W.; Hackett, Peter H.; Jean, Dominique; Kriemler, Susi; Litch, James A.; Murdoch, David R.; Nickol, Annabel H.; Richalet, Jean‐Paul; Roach, Robert C.; Shlim, David R.; Wiget, Urs; Yaron, Michael; Zubieta-Castillo, Gustavo; Zubieta-Calleja, Gustavo

doi:10.1089/15270290152608561

Cited by 109 publications

(116 citation statements)

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“…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. Therefore, we performed serial assessments of AMS in 48 healthy nonacclimatized children and adolescents with no previous high-altitude experience who rapidly ascended from 568 m to 3450 m by train and then spent 48 hours at that altitude.…”

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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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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“…any families with children travel to high mountain areas for leisure activities, to pursue a parental occupation and for other reasons [1]. However, little is known about children's respiratory adaptation to hypobaric hypoxia and their tolerance of high altitude.…”

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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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“…The limited data available indicate that acute mountain sickness (AMS) is equally prevalent in adults and children [1]. However, the prevalence of high-altitude pulmonary oedema (HAPE) may differ between adults and children, despite some contradictory evidence [1]. Children residing at high altitude are more likely to develop HAPE [2,3] when returning to high altitude after a lowland stay.…”

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Higher pulmonary artery pressure in children than in adults upon fast ascent to high altitude

Kriemler¹,

Jansen²,

Linka³

et al. 2008

Eur Respir J

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The response of pulmonary artery pressure to high altitude has not been studied in children. It is also not known whether the individual response is hereditary. Therefore, the response of pulmonary artery pressure to high altitude was measured in pre-pubertal children in comparison to that in their biological fathers.Echocardiography was performed at 450 m and over 3 days at 3,450 m. Systolic pulmonary artery pressure was estimated from the pressure gradient of tricuspid regurgitation.The increase in pulmonary artery pressure in children was greater than that in adults at day 1 of high altitude (15.5¡9.1 versus 7.9¡6.4 mmHg), but returned to adult levels on day 2. The increase in pulmonary artery pressure from low to high altitude of each child correlated with that in the father.Pre-pubertal children transiently develop greater pulmonary hypertension than their fathers when exposed to high altitude. The individual response of pulmonary pressure to high altitude seems to be at least partly hereditary.

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Children at High Altitude: An International Consensus Statement by an Ad Hoc Committee of the International Society for Mountain Medicine, March 12, 2001

Cited by 109 publications

References 34 publications

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

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

Children at high altitude have less nocturnal periodic breathing than adults

Higher pulmonary artery pressure in children than in adults upon fast ascent to high altitude

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