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The impact of sleeping in an elevated upper body position during acclimatization to high altitude on acute mountain sickness and pulmonary artery systolic pressure

100%

Graß M., Apel C., Bertsch D., Cerfontaine C., van der Giet M., van der Giet S., Haunolder M., Hundt N., Jäger J., Kühn C., Museol S., Timmermann L., Wernitz K., Gieseler U., Morrison A., Schöffl V., Küpper T.

Health Promotion & Physical Activity

2023

vol. 25

issue 4

1-8

Background: The effect of sleeping positions during acclimatization to high altitude on Acute Mountain Sickness (AMS) and High Altitude Pulmonary Edema (HAPE) is unknown. We tested whether sleeping with the upper body raised by 5° reduces prevalence and severity of symptoms of AMS as well as of elevated pulmonary artery systolic pressure (PASP) values as a risk factor of HAPE. Methods: Randomly assigning trekking tourist volunteers n = 44 (25 m, 19 f; mean age 42.9 yr) sleeping at 4280 m or 5170 m to the experimental group (upper body elevated by 5°), or to the control group. After exclusion of other reasons for AMS-like symptoms those assumed to be related to AMS were rated by Lake Louise Score questionnaire in the evening and the following morning of the study. Transthoracic echocardiography was performed on both occasions to estimate PASP. Results: In the study group, symptoms of AMS were significantly reduced in younger subjects (p = 0.021), prevalence of AMS was reduced in women (p = 0.156), and PASP values were significantly reduced in older subjects and men (p = 0.032; p = 0.031 respectively). Conclusion: Results suggest that sleeping with the upper body in elevated position during a high altitude ascent may benefit those suffering from AMS or at risk of HAPE due to elevated PASP values.

Risk Management and First Aid Knowledge of Trekkers in Nepal

63%

Lechner K., Scharfenberg C., Hettlich E. M., Giet S., Morrison A., Schöffl V., Küpper T.

Health Promotion & Physical Activity

2020

vol. 13

issue 4

21-24

Background: Trekking in Nepal is popular and generally safe. However preventable trekking injuries and deaths are often the result of poor risk managementand lack of skills – i.e. acute mountain sickness (AMS) and specific First Aid (FA). Shlim and Gallie’s reviews in 1992 and 2004 of trekking deaths here found a fivefold higher risk for fatal outcomes in organized trekking tours (OT) compared to independently organised trekkers (IT), including preventable deaths (i.e. AMS). Our survey sought to identify the AMS, FA and risk management knowledge/skills of OT and IT whilst trekking in Nepal. Methods: Based on previous pilot studies at the Khumbu region in Nepal, and on risk management information provided by leading German trekking operators, a survey was conducted using two questionnaires: one each for OT and IT.The study site was Manang (3,500m) in Annapurna region, Nepal. All trekkers passing through this site who volunteered their participation were included. For evaluation descriptive statistical methods and non-parametric tests were used. Results: 442 questionnaires were completed (155 OT; 287 IT). Mean agewas 36.4 +/– 12.0y and 61% were male. Mountaineering experience was low and FA training was scarce in both groups. IT (92.7%) followed acclimatization recommendations and 59.2% carried AMS medication, compared respectively to OT at 63.2% and 25.2%. Only 27.1% of OT had repatriation plans for a medical emergency. Conclusions: Most of OT and IT were inexperienced in mountaineering and in mountain emergencies. The preparedness of OT overall was inadequate and over-reliant on the organisers whose skills may also be inadequate when responding to an emergency. Responsible trekking should require that more than one person in a group have adequate, up-to-date riskassessment/management and FA skills specific to the trek, and in particular an understanding of altitude profile, AMS, and individual abilities.

Portable hyperbaric chambers for the treatment of altitude disease

51%

Küpper T., Gieseler U., Milledge J., Morrison A., Schöffl V.

Health Promotion & Physical Activity

2022

vol. 20

issue 3

36-40

Portable hyperbaric chambers are a therapeutic option for altitude disease in the mountains. By an increase of the oxygen partial pressure the patient’s symptoms ameliorate significantly. Portable hyperbaric chambers may be used as ‘stand alone therapy’ as well as in combination with other therapeutic options. Here we present the recommendation how to use the device and how to avoid problems. The recommendation has been agreed by all members of the medical commission of the world umbrella organization Union Internationale des Associations d’Alpinisme (UIAA MedCom).

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3 Health Promotion & Physical Activity

1 2024

1 2022

1 2020

3 Küpper T.

3 Morrison A.

3 Schöffl V.

2 Gieseler U.

1 Apel C.

1 Bertsch D.

1 Cerfontaine C.

1 Giet S.

1 Graß M.

1 Haunolder M.

1 Hettlich E. M.

1 Hundt N.

1 Jäger J.

1 Kühn C.

1 Lechner K.

1 Milledge J.

1 Museol S.

1 Scharfenberg C.

1 Timmermann L.

1 Wernitz K.

1 van der Giet M.

1 van der Giet S.

Search results

The impact of sleeping in an elevated upper body position during acclimatization to high altitude on acute mountain sickness and pulmonary artery systolic pressure

Risk Management and First Aid Knowledge of Trekkers in Nepal

Portable hyperbaric chambers for the treatment of altitude disease