Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT)

Gertsch, Jeffrey H.; Basnyat, Buddha; Johnson, Eric W.; Onopa, Janet; Holck, Peter

doi:10.1136/bmj.38043.501690.7c

Cited by 139 publications

(102 citation statements)

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“…In addition, after 24 h, 78% of the obese males had AMS scores of o4 while only 40% of the nonobese males had scores at or above this level. This 78% incidence of AMS in the obese population far exceeds that for healthy individuals travelling to high altitudes [40,199,200].…”

Section: Obesity Hypoventilationmentioning

confidence: 99%

Travel to high altitude with pre-existing lung disease

Luks

Swenson²

2007

Eur Respir J

107

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The pathophysiology of high-altitude illnesses has been well studied in normal individuals, but little is known about the risks of high-altitude travel in patients with pre-existing lung disease. Although it would seem self-evident that any patient with lung disease might not do well at high altitude, the type and severity of disease will determine the likelihood of difficulty in a high-altitude environment. The present review examines whether these individuals are at risk of developing one of the main forms of acute or chronic high-altitude illness and whether the underlying lung disease itself will get worse at high elevations. Several groups of pulmonary disorders are considered, including obstructive, restrictive, vascular, control of ventilation, pleural and neuromuscular diseases. Attempts will be made to classify the risks faced by each of these groups at high altitude and to provide recommendations regarding evaluation prior to high-altitude travel, advice for or against taking such excursions, and effective prophylactic measures.

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Section: Obesity Hypoventilationmentioning

confidence: 99%

Travel to high altitude with pre-existing lung disease

Luks

Swenson²

2007

Eur Respir J

107

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“…However, the PHAIT trial (prevention of high altitude illness trial) showed that it does not seem to be efficacious for preventing AMS compared to results from acetazolamide. 56 Aspirin, at a dose of 325 mg three times daily, seems to reduce the incidence of headache associated with physical exertion at high altitude. 57 Different recommendations on preventive measures for HAH, are listed in Table 5 according to level of evidence.…”

Section: Acute Mountain Sicknessmentioning

confidence: 99%

High-altitude headache and acute mountain sickness

Carod-Artal

2014

Neurología (English Edition)

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Introduction: Headache is the most common complication associated with exposure to high altitude, and can appear as an isolated high-altitude headache (HAH) or in conjunction with acute mountain sickness (AMS). The purpose of this article is to review several aspects related to diagnosis and treatment of HAH.Development: HAH occurs in 80% of all individuals at altitudes higher than 3000 m. The second edition of ICHD-II includes HAH in the chapter entitled ''Headaches attributed to disorder of homeostasis''. Hypoxia elicits a neurohumoral and haemodynamic response that may provoke increased capillary pressure and oedema. Hypoxia-induced cerebral vasodilation is a probable cause of HAH. The main symptom of AMS is headache, frequently accompanied by sleep disorders, fatigue, dizziness and instability, nausea and anorexia. Some degree of individual susceptibility and considerable inter-individual variability seem to be present in AMS. Highaltitude cerebral oedema is the most severe form of AMS, and may occur above 2500 m. Brain MRI studies have found variable degrees of oedema in subcortical white matter and the splenium of the corpus callosum. HAH can be treated with paracetamol or ibuprofen. Pharmacological treatment of AMS is intended to increase ventilatory drive with drugs such as acetazolamide, and reduce inflammation and cytokine release by means of steroids.Conclusions: Symptom escalation seems to be present along the continuum containing HAH, AMS, and high-altitude cerebral oedema. Cefalea de elevada altitud y mal de altura ResumenIntroducción: La cefalea es la complicación más frecuente de la exposición a la altitud y puede aparecer de forma aislada o bien asociada al mal de altura (MA). El objetivo de este artículo es revisar los aspectos relacionados con el diagnóstico y tratamiento de la cefalea de elevada altitud (CEA). Edema cerebral de altitud; Mal de alturaDesarrollo: El 80% de las personas presentan CEA por encima de los 3.000 m de altitud. La segunda versión de la Internacional Classification of Headache Disorders (ICHD-II) incluye la CEA en el capítulo «Cefalea atribuida a trastornos de la homeostasia». La hipoxia desencadena una respuesta neurohumoral y hemodinámica que provoca un aumento de la presión capilar y edema. La vasodilatación cerebral inducida por hipoxia es una causa probable de CEA. El síntoma cardinal del MA es la cefalea, que se suele asociar con trastornos del sueño, fatiga, mareo e inestabilidad, náuseas y anorexia. Parece existir una cierta susceptibilidad así como una gran variación interindividual. La forma más grave es el edema cerebral de altitud y puede suceder por encima de los 2.500 m. Estudios de resonancia de encéfalo han mostrado la presencia de edema en sustancia blanca y esplenio del cuerpo calloso. La CEA puede tratarse con paracetamol e ibuprofeno. El tratamiento farmacológico del MA tiene la finalidad de incrementar la respuesta ventilatoria, mediante fármacos como la acetazolamida, y reducir los procesos inflamatorios y de liberación de citocinas, mediante el emp...

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“…The dose can be divided and climbers can take 125 mg twice a day [20]. The clinical trials demonstrate that the dose of 500 mg/day is effective to prevent AMS [20,21]. By inhibiting carbonate anhidrosis in kidneys, acetazolamide induces metabolic acidification, which results in quicker reactions of chemoreceptors to hypoxia associated with high altitudes.…”

Section: Pharmacological Prophylacticsmentioning

confidence: 99%

Acute mountain sickness

Borowska¹,

Harasim²,

Damme-Ostapowicz³

2014

apgr

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SummaryEach year millions of people travel to high altitude regions, i.e. 2500 metres above sea level to explore beautiful places or to realise to accomplish their mountaineering passions. Such high altitudes can induce health-related problems, called acute mountain sickness (AMS). The severity of the disease varies with altitude. The most common symptoms are headaches, weakness, and lack of appetite, which affect individuals living in lowland regions, who are not adjusted to the different mountain environment. The development of AMS can be simply prevented by gradual ascent. Moreover, there are pharmaceutical agents, which help to alleviate the symptoms.

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Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT)

Abstract: Objective To evaluate the efficacy of ginkgo biloba, acetazolamide, and their combination as prophylaxis against acute mountain sickness.

Cited by 139 publications

References 9 publications

Travel to high altitude with pre-existing lung disease

Travel to high altitude with pre-existing lung disease

High-altitude headache and acute mountain sickness

Acute mountain sickness

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