Interventions for treating acute high altitude illness

Abstract

Background Acute high altitude illness is defined as a group of cerebral and pulmonary syndromes that can occur during travel to high altitudes. It is more common above 2500 metres, but can be seen at lower elevations, especially in susceptible people. Acute high altitude illness includes a wide spectrum of syndromes defined under the terms 'acute mountain sickness' (AMS), 'high altitude cerebral oedema' and 'high altitude pulmonary oedema'. There are several interventions available to treat this condition, both pharmacological and nonpharmacological; however, there is a great uncertainty regarding their benefits and harms. Objectives To assess the clinical effectiveness, and safety of interventions (non-pharmacological and pharmacological), as monotherapy or in any combination, for treating acute high altitude illness. Search methods We searched CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science, CINAHL, Wanfang database and the World Health Organization International Clinical Trials Registry Platform for ongoing studies on 10 August 2017. We did not apply any language restriction. Selection criteria We included randomized controlled trials evaluating the effects of pharmacological and non-pharmacological interventions for individuals suffering from acute high altitude illness: acute mountain sickness, high altitude pulmonary oedema or high altitude cerebral oedema. Data collection and analysis Two review authors independently assessed the eligibility of study reports, the risk of bias for each and performed the data extraction. We resolved disagreements through discussion with a third author. We assessed the quality of evidence with GRADE.

Hæðarveiki og tengdir sjúkdómar

“…Þaer takmörkuðu rannsóknir sem þó hafa verið gerðar benda engu að síður til virkni lyfjanna. 64 Asetasólamíð er best að gefa sem fyrst eftir að einkenni koma fram en til vara dexametasón sem er kröftugra lyf og má gefa í töfluformi, í vöðva eða í aeð. Asetasólamíð er áhrifaríkast fyrir þá sem eru með vaega háfjallaveiki.…”

Side effects of acetazolamide: a systematic review and meta-analysis assessing overall risk and dose dependence

“…Acetazolamide (AZM) is a carbonic anhydrase (CA) inhibitor that has been used since the 1950s for various medical conditions. [1][2][3][4][5][6][7] For example, it is highly efficacious in treating glaucoma, 8 9 preventing [10][11][12] -and possibly treating 13 acute mountain sickness (AMS); however, side effects are common with some studies reporting an incidence of 80%-100% 2 14 (especially paraesthesias, dysgeusia, polyuria and fatigue), which limits patients' tolerance and compliance. 2 15 It has been postulated that some of the side effects may be related to the amount of metabolic acidosis caused by AZM 16 (via renal bicarbonate wasting which reaches steady state within 1-2 days 17 18 ) and plasma drug levels that are affected by weight and renal function.…”

Study on the Oxygen Enrichment Effect of Individual Oxygen-Supply Device in a Tunnel of Plateau Mine

“…Pavlicek [ 11 ] discovered that cognitive flexibility and affective functions remained unchanged under the condition of functional impairment of the vasomotor center due to central hypoxia. In addition, some scholars have proven from various physiological indicators of the human body that medical treatment [ 12 , 13 ] and oxygen-supply [ 14 , 15 ] can effectively alleviate the impact of hypoxia on human health. However, the use of medical treatment is limited, and it is not suitable for people who work in the plateau area for a long time.…”