Materiały źródłowe

• #1 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Theres only one way to cure altitude sickness outright: descend to a lower altitude. […] Several treatments can help altitude sickness when its not as severe. Some of these are also helpful when an immediate descent isnt possible. Treatment approaches include: […] Stop and acclimate. Stopping and resting is a good idea at the first signs of altitude sickness. […] Descend. If symptoms are more severe (such as additional dizziness, fatigue or nausea) or get worse, descending is a top priority. Most experts recommend descending until the symptoms get better. This usually involves a decrease of at least 984 feet (300 meters) and as much as 3,281 feet (1,000 meters). […] Supplemental oxygen. Breathing higher concentrations of oxygen can help offset some of the symptoms of altitude sickness.

• #2 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/high-altitude-travel-and-altitude-illness.html

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Travelers can optimize acclimatization by adjusting their itineraries to avoid going „too high too fast.” […] Acclimatization improves sleep, increases comfort and sense of well-being, and improves submaximal endurance; maximal exercise performance at high altitude will always be reduced compared to that at low altitude. […] Acetazolamide speeds acclimatization and resolves AMS but is more commonly used and better validated for use as prophylaxis. […] Dexamethasone is more effective than acetazolamide at rapidly relieving the symptoms of moderate to severe AMS. […] AMS improves rapidly with a descent of 300 m (1,000 ft) or more, especially if exertion is minimal.

• #2 Altitude Sickness Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/altitude-sickness/

  If you are going on a high-altitude trek, learn about altitude sickness, its symptoms, and how to treat it. […] The best treatment for altitude sickness is to go to a lower altitude. But if you have mild symptoms, you may be able to stay at that altitude and let your body get used to it. […] If you stay at a high altitude, rest. You can explore the area, but take it easy. Limit any walking or activity. Drink plenty of water, but do not drink alcohol. Do not go to a higher altitude until your symptoms go away. This may take from 12 hours to 3 or 4 days. […] For the headache, you can take an over-the-counter medicine, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). […] A doctor can give you acetazolamide (Diamox). This speeds up how fast your body gets used to the higher altitude. Nifedipine (Procardia) and dexamethasone are also used for altitude sickness. You may also be able to use oxygen or a specially designed pressure chamber to treat altitude sickness.

• #3 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html

  Altitude illness affects 25 to 85 percent of travelers to high altitudes, depending on their rate of ascent, home altitude, individual susceptibility, and other risk factors. […] Slow ascent is the most important measure to prevent the onset of altitude illness. If this is not possible, or if symptoms occur despite slow ascent, acetazolamide or dexamethasone may be used for prophylaxis or treatment of acute mountain sickness. […] Medical management is prudent in these patients. […] Recommendations for reducing the risk of altitude illness are listed in Table 1. Slow ascent is the most effective method to prevent altitude illness. […] Medications for prevention and treatment of acute mountain sickness and high-altitude cerebral edema include acetazolamide and dexamethasone. […] Dexamethasone is also effective for prophylaxis and treatment of acute mountain sickness as a second-line agent, but it does not assist in acclimatization and therefore may lead to rebound acute mountain sickness when it is discontinued.

• #3 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/high-altitude-travel-and-altitude-illness.html

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Travelers can optimize acclimatization by adjusting their itineraries to avoid going „too high too fast.” […] Acclimatization improves sleep, increases comfort and sense of well-being, and improves submaximal endurance; maximal exercise performance at high altitude will always be reduced compared to that at low altitude. […] Acetazolamide speeds acclimatization and resolves AMS but is more commonly used and better validated for use as prophylaxis. […] Dexamethasone is more effective than acetazolamide at rapidly relieving the symptoms of moderate to severe AMS. […] AMS improves rapidly with a descent of 300 m (1,000 ft) or more, especially if exertion is minimal.

• #4 Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness Medical Society | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p505.html

  Gradually increasing sleeping altitude is the best way to prevent altitude illness. Staged ascent and preacclimatization to hypoxia also reduce risk. […] Acetazolamide and dexamethasone can be used to prevent acute mountain sickness and high altitude cerebral edema, but only acetazolamide aids in acclimatization. […] The most important treatment for altitude illness is descent of 1,000 to 3,300 ft, with supplemental oxygen if available. […] Descent is indicated in patients with severe AMS, AMS that does not resolve with other treatments, or HACE. Unless terrain, weather, or injuries make descent impossible, patients should descend until symptoms resolve (typically a descent of 1,000 to 3,300 ft [300 to 1,000 m]). If descent is not practical or cannot be done expeditiously, supplemental oxygen or a portable hyperbaric chamber is a suitable alternative. Supplemental oxygen should be given at flow rates sufficient to relieve symptoms and increase oxygen saturation to more than 90%. If available, a portable hyperbaric chamber can be used for patients with severe AMS or HACE.

• #5 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/high-altitude-travel-and-altitude-illness.html

  In populated areas with access to medical care, HACE can be treated with supplemental oxygen and dexamethasone. […] In most circumstances, descent is urgent and mandatory for HAPE. […] The main point of instructing travelers about altitude illness is not to eliminate the possibility of mild illness but to prevent severe illness, need for evacuation, or death. […] Acetazolamide is effective for periodic breathing, and since it raises nocturnal SpO2, it can help with other aspects of altered sleep. […] Recommendations for use and dosages of medications to prevent and treat altitude illness are listed in Table 3.5.2.

• #6 EMS High-Altitude Field Prophylaxis And Treatment – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560677/

  The Wilderness Medical Society (WMS) publishes regularly updated evidence-based guidelines for treatment. […] The recommended method for the prevention of high-altitude illness is to allow the body time to acclimatize via gradual ascent. […] Acetazolamide is the only medication proven to speed acclimatization. […] Dexamethasone is the medication of choice for the treatment of both AMS and HACE. […] Immediate evacuation to a lower altitude is the definitive treatment for both Severe AMS and HACE. […] If available, supplemental oxygen should be administered with oxygen saturation of above 90% as a goal for both severe AMS and HACE. […] Portable chambers are indicated for the treatment of HAPE as a temporary measure when evacuation is delayed. […] Nifedipine should only be used as a treatment option when evacuation becomes delayed or unavailable.

• #7 Treatment of Acute Mountain Sickness and High Altitude Pulmonary Oedema

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4923381/

  Management of AMS follows three axioms: a) further ascent should be avoided until the symptoms have resolved, b) patients with no response to medical treatment should descend to a lower altitude and c) if and when HACO is suspected, patients should urgently descend to a lower altitude. […] Descent and supplementary oxygen are the treatments of choice and for severe illness, the combination provides optimal therapy. Remarkably, a descent of only 500 to 1000 m usually leads to resolution of acute mountain sickness while high-altitude cerebral oedema may require further descent. […] Medical therapy becomes crucial when descent is not immediately possible. Treatment is summarized in Table 1. Various drugs have been tried for high altitude illnesses with variable effect (Table 2). A small, placebo-controlled study showed that the administration of acetazolamide reduced the severity of symptoms. Dexamethasone is as effective as acetazolamide and starts acting within 12 hours while acetazolamide takes around 24 hours. Other drugs which have been used are ibuprofen and sumatriptan. For high altitude related insomnia acetazolamide is effective. Newer non-benzodiazepine sedatives like zolpidem, which do not depress ventilation are also effective.

• #8 Altitude Sickness Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/altitude-sickness/

  Go to a lower altitude if your symptoms are moderate to severe, they get worse, or medicine or oxygen treatment does not help. Go down at least 1500 ft (450 m). Go to a lower altitude as fast as you can or get emergency help if someone with you has severe symptoms such as being confused or not being able to walk straight. Go with the person. Never let someone with severe altitude sickness go down alone. […] You may be able to prevent altitude sickness by taking your time when you go to high altitudes and using medicine in advance. […] You may consider taking medicines such as ibuprofen, acetazolamide (Diamox) or dexamethasone before traveling to high altitudes. These medicines may prevent or lessen symptoms. Talk to your doctor about this.

• #9 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  How quickly you feel better depends strongly on the severity of your altitude sickness and the treatments you receive. Descending to a lower altitude is the fastest way to feel better, and most people feel progressively better as they descend. […] People who choose to stop and acclimate may have symptoms that last several hours or up to a day. Minor symptoms usually stop within a day or two as your body gets used to the altitude. […] Preventive medications. Medications like acetazolamide or nifedipine can prevent altitude sickness and treat it. Phosphodiesterase (PDE) inhibitors like sildenafil and tadalafil can also serve as preventive medications.

• #10 Altitude Sickness: Symptoms, Treatment & Medication, Prevention

  https://www.webmd.com/a-to-z-guides/altitude-sickness

  If you get a headache and at least one other symptom linked to altitude sickness within a day or two of changing your elevation, you might have altitude sickness. For mild symptoms, you can try staying at your current altitude to see if your body adjusts. Rest, keep warm, and have plenty of liquids. Dont go any higher until your symptoms are completely gone. […] If your symptoms are severe, or if mild symptoms dont go away in a couple of days or get worse, get to a lower elevation as quickly as possible. Dont exert yourself. Get medical help. […] To treat HACE, you might need a steroid called dexamethasone. If you have HAPE, you will need supplemental oxygen and may need medications, as well as moving to a lower altitude.

• #11 Altitude sickness

  https://www.nhs.uk/conditions/altitude-sickness/

  Altitude sickness usually gets better without treatment if you rest. […] You may be given medicine to help ease symptoms. […] If your symptoms are more serious, you may be given: steroid medicine, medicine to lower your blood pressure, oxygen through a mask. […] Rarely, you may need to be treated with oxygen in a special air-tight chamber (hyperbaric chamber) to increase the level of oxygen in your blood.

• #12 Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care

  https://www.mdpi.com/2077-0383/11/14/3937

  Appropriate therapy depends on disease severity, available treatment options, proximity to medical care facilities, and the altitude where symptoms occurred. Most patients benefit from descent and treatment with hyperbaric or oxygen therapy, all leading to increased PiO2, which immediately increases arterial oxygenation, protecting the brain, and reducing pulmonary arterial pressure, heart effort, respiratory rate, and dyspnea.

• #12 Pathophysiology and Therapy of High-Altitude Sickness: Practical Approach in Emergency and Critical Care

  https://www.mdpi.com/2077-0383/11/14/3937

  High altitude can be a hostile environment and a paradigm of how environmental factors can determine illness when human biological adaptability is exceeded. This paper aims to provide a comprehensive review of high-altitude sickness, including its epidemiology, pathophysiology, and treatments. […] Early recognition of clinical symptoms is important for the establishment of the correct therapy. […] The treatment of the mild-moderate form of AMS (rest, NSAIDs, antiemetics) is different from that of the severe form and of HACE (imperative descent, hyperbaric caisson, oxygen, steroids). Hyperventilation can momentarily improve symptoms. In severe cases, therapy should aim to reduce intracerebral volume and intracranial pressure (ICP). This can be achieved by (1) administering oxygen therapy with increased inspired oxygen fraction; (2) bringing the patient to a lower altitude; (3) using a hyperbaric chamber, which immediately decreases cerebral blood flow (CBF) and, thus, ICP; and (4) using drugs to halt cerebral edema formation.

• #13 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness

  Medications. Certain medications, especially acetazolamide, dexamethasone or nifedipine, can treat altitude sickness and delay more severe symptoms or complications. Dexamethasone and nifedipine are generally reserved for moderate or worse altitude sickness. […] Hyperbaric therapy. This is similar to treating a scuba diver with decompression sickness (better known as the bends). At high altitudes, hyperbaric therapy is possible with portable hyperbaric bags (sometimes known as Gamow bags after their inventor, Igor Gamow). These can delay the worsening of symptoms until its possible to evacuate a person to a lower altitude. […] Complications can vary depending on the treatment you receive, especially medications. Your healthcare provider is the best person to tell you what complications you might experience or should watch for.

• #14 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  Healthcare professionals should provide international travelers visiting high altitudes with guidance on gradual acclimatization and medications to prevent altitude illness. […] Travelers can optimize acclimatization by adjusting their itineraries to avoid going „too high too fast.” […] Acetazolamide speeds acclimatization and resolves AMS but is more commonly used and better validated for use as prophylaxis. […] Dexamethasone is more effective than acetazolamide at rapidly relieving the symptoms of moderate to severe AMS. […] AMS improves rapidly with a descent of 300 m (1,000 ft) or more, especially if exertion is minimal. […] In populated areas with access to medical care, HACE can be treated with supplemental oxygen and dexamethasone. […] In most circumstances, descent is urgent and mandatory.

• #15 Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness Medical Society | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0415/p505.html

  Although acetazolamide facilitates acclimatization and can treat mild AMS, it is not recommended for treatment of moderate to severe AMS or HACE. Dexamethasone is a more reliable treatment for moderate to severe AMS or HACE. The recommended dosage of dexamethasone for AMS treatment is 4 mg every six hours in adults, or 0.15 mg per kg (maximum: 4 mg) every six hours in children. The recommended regimen for adults with HACE is an initial 8-mg dose given orally, intravenously, or intramuscularly, then 4 mg every six hours until symptoms resolve. Acetazolamide can be used as an adjunct to dexamethasone for AMS or HACE treatment. The recommended dosage is 250 mg every 12 hours in adults or 2.5 mg per kg (maximum: 250 mg) every 12 hours in children. Further ascent should not be attempted after dexamethasone is given.

• #16 The Pharmacist’s Role in the Treatment and Prevention of Acute Mountain Sickness

  https://www.uspharmacist.com/article/the-pharmacists-role-in-the-treatment-and-prevention-of-acute-mountain-sickness

  In moderate-to-severe risk situations, acetazolamide is the preferred agent, with recommended dosing of 125 to 250 mg orally two to three times daily, preferably initiated 24 to 48 hours before ascent and continued for the first day or two at high altitude. […] For patients who are intolerant or allergic to acetazolamide, dexamethasone 8 mg daily in divided doses may be considered. […] Several studies have focused on the utility of analgesics in AMS. Prophylaxis with aspirin has shown a significant reduction in the development of AMS-associated headache at a dosage of 320 mg orally taken at 4-hour intervals, starting 1 to 2 hours prior to arrival at final altitude, for a total of three doses. […] Ginkgo biloba is an herbal product that may be effective for prophylaxis of AMS. […] Antioxidant vitamin supplements may also be helpful in preventing AMS; however, supporting data were found only in a single clinical trial.

• #17 Patient education: High-altitude illness (including mountain sickness) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/high-altitude-illness-including-mountain-sickness-beyond-the-basics/print

  Dexamethasone — Dexamethasone is a steroid that also treats and prevents AMS, but is usually reserved for treatment. You can take dexamethasone with acetazolamide, if needed. Dexamethasone increases blood sugar levels in people with diabetes. […] HACE treatment — HACE is a medical emergency, and you should immediately descend to a lower altitude. Waiting to descend can be disastrous; symptoms can worsen quickly, and you may not be able to walk. Delaying descent increases the risk of life-threatening complications or even death. […] HAPE treatment — HAPE is a medical emergency. You should seek medical care or descend as soon as possible if you develop symptoms. Waiting to descend can be disastrous; symptoms can worsen quickly, and you may not be able to walk. Waiting also increases the risk of developing life-threatening complications or even death.

• #18 High-Altitude Travel and Altitude Illness | Yellow Book | CDC

  https://wwwnc.cdc.gov/travel/yellowbook/2024/environmental-hazards-risks/high-elevation-travel-and-altitude-illness

  The main point of instructing travelers about altitude illness is not to eliminate the possibility of mild illness but to prevent severe illness, need for evacuation, or death. […] Acetazolamide is effective for periodic breathing, and since it raises nocturnal SpO2, it can help with other aspects of altered sleep. […] Recommendations for use and dosages of medications to prevent and treat altitude illness are listed in Table 3.5.2.

• #19 Travelling safely to places at high altitude – Understanding and preventing altitude illness

  https://www.racgp.org.au/afp/2017/june/travelling-safely-to-places-at-high-altitude-under

  Acetazolamide and other medications used to prevent altitude illness are discussed in detail, including the finding that inhaled budesonide may prevent altitude illness. […] The management of altitude illness is not covered, as treatment is usually provided by expedition doctors or clinics at high altitude. […] Medications are a useful adjunct to prevent altitude illness in travellers who are not able to follow the recommendations for prevention, or who may have had altitude illness before. […] Acetazolamide, commonly prescribed off-label in Australia to prevent AMS, is the only drug currently shown to facilitate acclimatisation. […] Multiple trials have shown dexamethasone to be of benefit in preventing AMS. […] A more recent trial found that a study group using budesonide 200 g inhaled twice a day had an AMS incidence of 24%, which was significantly different from the placebo group in which the incidence was 60%.

• #20 Travelling safely to places at high altitude – Understanding and preventing altitude illness

  https://www.racgp.org.au/afp/2017/june/travelling-safely-to-places-at-high-altitude-under

  Nifedipine 60 mg was shown to prevent HAPE, but not decrease AMS, and is currently the primary agent used for prevention and treatment for HAPE. […] Some have suggested coca tea, offered at hotels in Cusco, as a prevention against AMS; however, there are currently no systematic studies to support these claims.

• #21 5 Medications that Help Acclimatization & Combat Altitude Sickness | Ultimate Kilimanjaro

  https://www.ultimatekilimanjaro.com/5-prescription-medicines-for-acclimatization-altitude-sickness/

  Additionally, Viagra can improve oxygen delivery to muscles, improving physical endurance. Researchers found that Viagra significantly improved the cardiovascular and exercise performance measures of the participants, improving their output up to 45 percent. […] The recommended dose of sildenafil is 50 milligrams every eight hours. […] 5. Nifedipine (Adalat, Procardia) […] Nifedipine is similar to Viagra, but is a less potent drug that also lowers pulmonary artery pressure. The dihydropyridine calcium channel blocker is most commonly used for the treatment of high blood pressure. Nifedipine opens the pulmonary artery, which reduces chest tightness and makes breathing easier. […] The recommended dose is 20mg slow-release capsule every 8 hours or 30mg slow-release every 12 hours.

• #22 Treatment of Acute Mountain Sickness and High Altitude Pulmonary Oedema

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4923381/

  Increasing alveolar and arterial oxygenation is the highest priority. It is mainly achieved by supplemental oxygen and descent. Patients with severe pulmonary oedema must be immediately moved to a lower altitude. […] Medication like nifedipine has been tried only when supplemental oxygen is unavailable or descent is impossible. In clinical studies, although nifedipine reduced pulmonary-artery pressure by approximately 30 percent, it barely increased the partial pressure of arterial oxygen. Inhaled beta-agonists have also been used in the prevention as well as treatment of high-altitude pulmonary oedema, as they appreciably increase the clearance of fluid from the alveolar space and might also lower pulmonary artery pressure. […] After an episode of high altitude pulmonary oedema, a person should avoid high altitude areas. In armed forces after an episode of HAPO, a person is not posted to high altitude areas again. […] New developments like portable hyperbaric chamber and inhaled nitric oxide have shown promise in various trials.

• #23

  https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx

  Descent remains the single best treatment for HAPE. Individuals should try to descend at least 1000 m or until symptoms resolve. […] When available, supplemental oxygen sufficient to achieve an SpO2 90% or relieve symptoms should be used while waiting to initiate descent, when descent is infeasible and during descent in severely ill patients. […] Nifedipine should be used for HAPE treatment when descent is impossible or delayed and reliable access to supplemental oxygen or portable hyperbaric therapy is unavailable. […] For HAPE patients with neurologic dysfunction that does not resolve rapidly with administration of supplemental oxygen and improvement in the patients oxygen saturation, dexamethasone should be added to the treatment regimen at the doses described for HACE.

• #23

  https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx

  Travel to elevations above 2500 m is associated with risk of developing one or more forms of acute altitude illness: acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). […] To provide guidance to clinicians and disseminate knowledge about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for prevention, diagnosis, and treatment of acute altitude illness. Preventive and therapeutic modalities are presented, and recommendations made for each form of acute altitude illness. […] Suggested Approach: Care should be taken to exclude disorders whose symptoms and signs resemble those seen with AMS and HACE, such as cerebrovascular accident, carbon monoxide poisoning, hypoglycemia, hyponatremia, infection, or traumatic brain injury.

• #24 High-altitude Illness | Doctor

  https://patient.info/doctor/high-altitude-illness

  Hyperbaric therapy (in portable hyperbaric chambers such as the Gamow Bag) can improve symptoms sufficiently to aid actual descent – eg, bring an individual out of a coma or improve ataxia; it can be life-saving when descent is not possible and oxygen is unavailable. […] If symptoms persist after descent, treatment with oxygen and dexamethasone should be continued. […] HAPE […] Descent with supplementary oxygen if available; descent of even a few hundred metres may be enough. […] Nifedipine (30 mg bd of a slow-release product) can relieve symptoms and aid descent; or can be used in situations where descent is not possible. […] Phosphodiesterase inhibitors (sildenafil and tadalafil) have been used with success. There are no systematic reviews of their use for this indication. […] Hyperbaric therapy can be useful to aid descent or in situations where descent is impossible or oxygen is unavailable.

• #25 Altitude Sickness: Signs, Symptoms, Treatment, Medications, Death, Prevention

  https://www.emedicinehealth.com/mountain_sickness/article_em.htm

  What Is the Medical Treatment for Altitude Sickness Treatment? […] Descending to lower altitudes (about 1640-3280 feet or 500-1000 meters lower altitude than the altitude the person was at when symptoms developed) or delaying further ascent are treatments for altitude mountain sickness until symptoms are gone. […] A Gamow bag may be used if descent is not feasible (see previous sections for details). […] Oxygen (2-4 liters per minute) will improve the oxygen saturation of the blood. […] Aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) may be taken for headaches (do not give aspirin to children). […] For nausea, the doctor may prescribe prochlorperazine (Compazine), an antinausea medication that also enhances the body’s ability to increase the breathing rate in response to low-oxygen environments. Other antiemetics have been used (for example, ondansetron (Zofran).

• #26 Altitude sickness – Wikipedia

  https://en.wikipedia.org/wiki/Altitude_sickness

  Altitude sickness typically occurs only above 2,500 metres (8,000 ft), though some people are affected at lower altitudes. […] Generally, descent and sufficient fluid intake can treat symptoms. […] The only definite and reliable treatment for severe AMS, HACE, and HAPE is to descend immediately until symptoms resolve. […] For more serious cases of AMS, or where rapid descent is impractical, a Gamow bag, a portable plastic hyperbaric chamber inflated with a foot pump, can be used to reduce the effective altitude by as much as 1,500 m (5,000 ft). […] Acetazolamide 250 mg twice daily dosing assists in AMS treatment by quickening altitude acclimatization. […] Two studies in 2012 showed that ibuprofen 600 milligrams three times daily was effective at decreasing the severity and incidence of AMS; it was not clear if HAPE or HACE was affected. […] Paracetamol (acetaminophen) has also shown to be as good as ibuprofen for altitude sickness when tested on climbers ascending Everest.

• #27 5 Medications that Help Acclimatization & Combat Altitude Sickness | Ultimate Kilimanjaro

  https://www.ultimatekilimanjaro.com/5-prescription-medicines-for-acclimatization-altitude-sickness/

  Dexamethasone is not routinely recommended as a prophylactic agent for AMS or High Altitude Pulmonary Edema (HAPE), but it may reduce the risk of HAPE and AMS in susceptible persons. […] The recommended dosage is 4 mg, 6 hours apart. People usually experience an improvement in symptoms within approximately 6 hours. […] 4. Sildenafil (Viagra) […] Being at high altitude causes blood vessels to constrict, known as pulmonary vasoconstriction. This increases the demand on the heart which can lead to heart failure. It also increases pulmonary artery pressures, which can also cause blood vessels in the lungs to leak fluid a potentially fatal condition known as high-altitude pulmonary edema (HAPE). […] Viagra acts as a vasodilator. It relaxes blood vessels, allowing more blood to flow freely through vessels. This counteracts the constriction caused by high altitude and thus reduces the pressure on the heart and lungs. In medical terms, it reduces pulmonary artery pressure and the formation of pulmonary edema fluid, thus reducing the risk of heart failure and HAPE.

• #28 Altitude Sickness: Signs, Symptoms, Treatment, Medications, Death, Prevention

  https://www.emedicinehealth.com/mountain_sickness/article_em.htm

  Sleeping pills for insomnia should not be taken. They are potentially dangerous because they can slow breathing. However, some doctors still may prescribe them under certain circumstances. […] Acetazolamide (Diamox) may be prescribed to hasten acclimatization. […] High-altitude pulmonary edema responds best when the person descends from their current altitude. […] The only definitive treatment for high-altitude cerebral edema is descent from the person’s current altitude. […] Dexamethasone (Decadron), a steroid, may be beneficial. […] Oxygen may be helpful. […] A Gamow bag may buy time until descent is possible.

• #29 High-Altitude Pulmonary Edema (HAPE) Treatment & Management: Approach Considerations, Medical Care, Prevention

  https://emedicine.medscape.com/article/300716-treatment

  A randomized, double-blinded, placebo-controlled study showed that adults with previous HAPE who received prophylactic tadalafil (10 mg) or dexamethasone (8 mg) had significantly less HAPE compared with those who received placebo twice daily. […] The conclusion was that both dexamethasone and tadalafil decrease systolic pulmonary artery pressure and may reduce the incidence of HAPE in adults with a history of HAPE. Dexamethasone prophylaxis may also reduce the incidence of acute mountain sickness in these adults. […] Portable hyperbaric chambers (Gamow, CERTEC) are in wide use by trekkers. A physiologic (simulated) descent of approximately 2000 m may be achieved in a few minutes. […] Finally, the use of an expiratory positive airway pressure mask improves oxygenation and may be useful as a temporizing measure. […] Admission to a hospital is warranted for significant arterial desaturation and clinical deterioration despite outpatient management of HAPE.

• #29 High-Altitude Pulmonary Edema (HAPE) Treatment & Management: Approach Considerations, Medical Care, Prevention

  https://emedicine.medscape.com/article/300716-treatment

  Educate travelers with the following three Centers for Disease Control and Prevention (CDC) principles to prevent death or serious consequences from altitude illness: Know the early symptoms of altitude illness, and be willing to acknowledge when they are present. Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor they seem. Descend if the symptoms become worse while resting at the same altitude. […] Supplemental oxygen and descent are the definitive therapy for all forms of altitude illness; however, descent may not always be possible due to climate, environmental, or logistic issues. […] The treatment of high-altitude pulmonary edema (HAPE) includes rest, administration of oxygen (first line), and descent to a lower altitude (first line if oxygen is unavailable). If diagnosed early, recovery is rapid with a descent of only 500-1000 m. A portable hyperbaric chamber or supplemental oxygen administration immediately increases oxygen saturation and reduces pulmonary artery pressure, heart rate, respiratory rate, and symptoms. In situations where descent is difficult, these treatments can be lifesaving.

• #30 Altitude sickness | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/altitude-sickness

  First aid options include descending immediately, medications and the use of oxygen administered from a portable container. […] In severe cases of altitude sickness, descend immediately. Aim for a descent of around 500 m to 1,000 m. […] Administer oxygen from a portable oxygen cylinder. […] Hyperbaric oxygen therapy uses specially designed chambers or rooms that can withstand high pressures. Air at sea level contains 21 per cent oxygen, while hyperbaric oxygen therapy can deliver up to 100 per cent pure oxygen. This form of therapy floods the body with oxygen and relieves the symptoms of altitude sickness. A portable oxygen cylinder enables oxygen to be administered via a facemask or hood. Never use oxygen therapy or altitude sickness medications to continue an ascent once symptoms have occurred. The result can be fatal.

• #31 Altitude Illness – Cerebral Syndromes Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/768478-treatment

  Importantly, in HACE cases, these chambers should only be used as a means of acute/temporizing care (eg, to improve a patient’s ability to more safely participate in their evacuation in technical terrain). They should never be considered as a replacement for actual descent. […] Coca leaf tea is widely recommended in South America, on the Internet, and in the popular press as a cure for altitude illness; however, no studies support this claim. […] Dexamethasone should be continued in symptomatic patients with HACE. […] Hospitalization is usually indicated for patients with HACE, depending on severity. Patients with focal neurologic deficits or persistent mental status changes should be admitted. After descent, care is supportive. […] Residual headache or nausea in patients with AMS should be treated symptomatically. Continue dexamethasone for 1-2 days after descent in patients with uncomplicated HACE or until the mental status clears in patients with severe HACE who require hospitalization.

• #31 Altitude Illness – Cerebral Syndromes Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/768478-treatment

  Management of AMS follows 3 axioms: (1) no further ascent until symptoms resolve, (2) descend to a lower altitude if no improvement occurs with medical therapy, and (3) at the first sign of HACE, descend immediately. Predicting the eventual severity from the initial clinical presentation is not possible, and patients must be watched closely for progression of illness. […] Descent to an altitude below that where symptoms started is always effective treatment but may not be practical or possible given the topography, weather, the patient’s ultimate trekking or climbing goals, or group resources. Accordingly, a descent of 500-1,000 m is usually sufficient. […] Acetazolamide accelerates acclimatization and thus quickens resolution of the illness, but this may still require 12-24 hours; it is of limited value in HACE because of its relatively slow action. Acetazolamide can be taken episodically without fear of rebound symptoms when it is discontinued. Dexamethasone swiftly reverses symptoms (2-4 h) but does not improve acclimatization. It is the drug of choice for treating HACE and should be given early. Both agents may be used to treat AMS if the victim does not descend. Oxygen is extremely effective, but availability is often limited.

• #32 Untitled Document

  http://rnceus.com/altitude/TX.html

  As with most things, the best treatment for high altitude sickness is prevention. […] The treatment of choice is to descend to a lower altitude or, if the symptoms are mild, at least to stay at the same altitude until the symptoms subside. […] In addition to acclimation and descent there are medications and treatments that can be used to prevent or treat symptoms at a mountain camp or on the trail. […] Medications are the most important treatment for AMS. […] Several portable hyperbaric chambers are now available for treatment of severe forms of altitude sickness. […] The portable hyperbaric chamber (Gamow, Certec, PAC) is often simply referred to as the Gamow bag, named after its inventor, Dr. Igor Gamow. […] These portable chambers have saved many lives. […] Relief usually occurs within minutes, but there may be rebound effects if treatments are too short. […] Typical total treatment times are as follow: 2-4 hours for HAPE, 4-6 hours for HACE. […] Several portable hyperbaric chambers are available to treat high altitude sickness.

• #33 High-altitude Illness | Doctor

  https://patient.info/doctor/high-altitude-illness

  Symptom control […] Analgesics and antiemetics. […] Ibuprofen, which is more effective than aspirin for relieving high-altitude headache. […] Mild AMS […] Rest and avoiding further ascent until symptoms improve. […] Moderate to severe cases of AMS […] Descent is required if symptoms are not improving or are getting worse with rest at the same altitude. […] Supplementary oxygen therapy. […] Acetazolamide (250 mg bd) and/or dexamethasone (8 mg stat then 4 mg qds), especially if descent is not possible. (Acetazolamide is more effective for prophylaxis than for treatment – dexamethasone may be the effective option when it comes to treatment.) […] HACE […] Descent with supplementary oxygen. Descent should be immediate, even at night if possible, as it may be life-saving. […] Dexamethasone to relieve symptoms and aid descent, or in situations where descent is not possible.

• #34 Altitude Sickness | Risk, Prevention and Treatment

  https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/altitude-sickness

  As soon as the first symptoms of altitude sickness develop, the most important treatment is stop the ascent and rest. […] If the symptoms are severe, do not improve, or are getting worse, then descent to a lower altitude is essential. […] The most important treatment if starting to develop symptoms of mild AMS is to stop the ascent and to rest at the same altitude. For most people, symptoms will improve within 24-48 hours with no specific treatment. Acclimatisation usually occurs after 1 to 3 days at a given altitude. […] Medicines are sometimes prescribed to help with AMS. The most common is a medicine called acetazolamide. Acetazolamide can be used for the prevention as well as treatment of AMS. […] If symptoms are severe, do not improve after 24 hours, or are getting worse, it is essential to descend to a lower altitude.

• #35 Altitude Sickness: Symptoms, causes and treatment

  https://www.medicalnewstoday.com/articles/179819

  People with very mild symptoms may continue ascending but should go at a much slower pace. […] Those with more severe symptoms should rest, consume plenty of fluids, and avoid anything that may affect blood oxygen levels, such as smoking. […] There are a number of potential treatments that may remedy altitude sickness. These include: […] Descending: Moving to a lower altitude is usually the best action to take if a person develops symptoms of altitude sickness. Once acclimatized they may be able to ascend once more. […] Pure oxygen: Giving pure oxygen can help a person with severe breathing problems caused by altitude sickness. Physicians at mountain resorts commonly provide this treatment. […] A Gamow bag: This portable, plastic hyperbaric chamber can be inflated with a foot pump and is used when a rapid descent is not possible.

• #36 Altitude Sickness | Risk, Prevention and Treatment

  https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/altitude-sickness

  Treatment with oxygen (if possible) and the steroid medicine dexamethasone can help to relieve symptoms and can mean that getting someone down to a lower altitude becomes easier. […] Again, someone with HAPE needs to descend to a lower altitude immediately. Even a descent of a few hundred metres can make a difference but ideally descent should be to the point where symptoms are better.

• #37 Altitude Sickness – Harvard Health

  https://www.health.harvard.edu/a_to_z/altitude-sickness-a-to-z

  If a descent must be delayed you can treat high-altitude cerebral edema with supplemental oxygen and the drugs acetazolamide and dexamethasone, which help decrease brain swelling. If one is available, this condition is also helped by time spent in a portable hyperbaric (pressure) chamber, which simulates descent to a lower altitude, during the time that supervision and transportation arrangements are being made for descent to lower altitude. […] Treatment for high-altitude pulmonary edema is similar, but may also include oral nifedipine, furosemide and/or an inhaled bronchodilator.

• #38 High-altitude Illness | Doctor

  https://patient.info/doctor/high-altitude-illness

  If there are persistent symptoms after descent then the patient may require continued treatment with oxygen and nifedipine. […] Prevention of high-altitude illness […] Prevention of altitude-related illness by slow ascent is the best approach but this is not always practical. […] General advice […] Gradual ascent allowing time for acclimatisation. A typical rate of ascent would be 500 metres (1,600 feet) per day with a rest day for every 1000 m (3,300 feet) ascent. Avoid going directly (eg, flying or driving) from low altitude to more than 2750 m (9,000 feet) if possible. […] Keep warm and well hydrated. […] Avoid alcohol, particularly in the first 48 hours. […] Mild exercise only for the first 48 hours. […] Visitors to altitude can monitor themselves for AMS using the Lake Louise AMS score.

• #39

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abn0652

  Altitude sickness can range from mild to life-threatening. With good planning, such as ascending slowly or taking certain medicines, it is often preventable. […] You may be able to prevent altitude sickness by taking your time when you go to high altitudes and using medicine in advance. […] You may consider taking medicines such as ibuprofen, acetazolamide, or dexamethasone before travelling to high altitudes. These medicines may prevent or lessen symptoms. Talk to your doctor about this. […] Go to a lower altitude. This is the best treatment for altitude sickness. […] Your doctor may recommend dexamethasone to treat altitude sickness. Take it as directed. […] If available, you may also be able to use oxygen or a specially designed pressure chamber to treat altitude sickness.

• #40 High-altitude Illness | Doctor

  https://patient.info/doctor/high-altitude-illness

  Anyone who develops symptoms should not ascend further until the symptoms have settled. If they are getting worse then immediate descent is recommended. […] Medication […] Prophylactic treatment with acetazolamide has been shown to be effective in reducing the symptoms of AMS. A systematic review in the BMJ showed that the lowest effective dose was 250 mg daily (usually given as 125 mg bd) and the number needed to treat to prevent AMS was six. […] The most common adverse effect of acetazolamide is paraesthesia; at this lower dose it is more likely to be tolerated. […] Dexamethasone has evidence of benefit and the recommended adult doses are 2 mg every six hours or 4 mg every twelve hours. It should not be used for more than ten days to avoid adrenal suppression. […] There is no robust evidence that ginkgo biloba extract is effective in preventing AMS.

• #41 Altitude Illness – Cerebral Syndromes Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/768478-treatment

  Acetazolamide effectively prevents AMS; it accelerates acclimatization by inducing a bicarbonate diuresis, stimulating ventilation, and improving sleep-breathing patterns. It does not mask symptoms of AMS. Acetazolamide prophylaxis is indicated for persons with an unavoidable rapid ascent, such as flying in to a high city (eg, Lhasa, Tibet; La Paz, Bolivia), or with a history of recurrent AMS. […] Dexamethasone also effectively prevents AMS but does not improve acclimatization. Because of the concern of rebound symptoms and the adverse effect profile, this medication cannot be routinely recommended for prophylaxis. […] Ibuprofen may be taken prophylactically to reduce the likelihood of AMS. Taking 600 mg 3 times per day has been shown to decrease AMS symptoms.

• #42 High-altitude Illness | Doctor

  https://patient.info/doctor/high-altitude-illness

  Ibuprofen has been studied and found in some trials to be effective in preventing AMS at a dose of 600 mg tds compared to placebo. It has not yet been compared to acetazolamide. […] Nifedipine can be used prophylactically (30 mg bd of a slow-release preparation) for individuals with high risk or a previous history of HAPE. […] Tadalafil has been studied as a possible preventative treatment for HAPE in high-risk individuals but further studies are needed before it can be recommended.

• #43 Diamox: Travel Clinic: Health Answers: Student Health Center: Indiana University Bloomington

  https://healthcenter.indiana.edu/health-answers/travel/diamox.html

  Diamox (Acetazolamide) is used for the prevention or lessening of symptoms related to mountain sickness in climbers attempting rapid ascent and in those experiencing mountain sickness despite gradual ascent. […] If gradual ascent and/or Diamox is used, this does not eliminate the need to descend if severe forms of high altitude sickness, HAPE or HACE should occur. […] Discuss the use of Diamox with your doctor if you have glaucoma or diabetes. […] This medicine is also used as a diuretic and will increase the amount of urine produced. […] If you experience these symptoms, contact a doctor and discontinue the medicine. […] Take one 125 mg tablet twice a day. Begin this medicine 24 hours before arriving at high altitude and continue for 48 hours while at high altitude. You may continue taking Diamox up to 48 hours longer if your symptoms indicate the need for additional pills.

• #44 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html

  Treatment of high-altitude cerebral edema starts with immediate descent, if possible. […] If descent is not possible (e.g., because of weather conditions), supplemental oxygen should be administered, and the patient should be placed in a portable hyperbaric oxygen chamber until descent is possible. […] When descent is not possible, limited evidence suggests that treatment with acetazolamide, bed rest, nifedipine, supplemental oxygen, salmeterol, or phosphodiesterase-5 inhibitors may improve oxygen saturation and pulmonary edema. […] High-altitude pulmonary edema is the leading cause of death from altitude illness, but it is avoidable with careful ascent and reversible with early recognition and treatment.

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