Choroba wysokościowa
Zapobieganie i profilaktyka

Choroba wysokościowa (AMS) występuje u osób szybko przemieszczających się na wysokości powyżej 2500 m n.p.m., gdzie obniżone ciśnienie parcjalne tlenu prowadzi do objawów klinicznych. Podstawą profilaktyki jest stopniowa aklimatyzacja, zgodna z zaleceniami Wilderness Medical Society: unikanie wznoszenia się na wysokość snu powyżej 2750 m w ciągu jednego dnia, tempo wznoszenia nie przekraczające 500 m/dobę powyżej 3000 m, wprowadzenie dodatkowej nocy aklimatyzacyjnej na każde 1000 m przyrostu wysokości oraz dni odpoczynku co 3-4 dni. Zaleca się także spędzenie 2-3 nocy na wysokości 2450-2750 m przed dalszym wznoszeniem. Zasada „climb high, sleep low” jest kluczowa dla poprawy adaptacji. Farmakologicznie, acetazolamid (125-250 mg p.o. 2x/dobę, rozpoczynając 24-48 h przed wejściem na wysokość) jest lekiem pierwszego wyboru, przyspieszającym aklimatyzację poprzez indukcję kwasicy metabolicznej i stymulację ośrodka oddechowego. Deksametazon stosuje się jako alternatywę u pacjentów z przeciwwskazaniami do acetazolamidu, jednak nie wspomaga aklimatyzacji i maskuje objawy AMS.

  1. Choroba wysokościowa – Zapobieganie (Profilaktyka)
    1. Stopniowa aklimatyzacja – złoty standard profilaktyki
    2. Zasada „Wspinaj się wysoko, śpij nisko”
    3. Farmakologiczna profilaktyka choroby wysokościowej
    4. Dodatkowe strategie profilaktyczne
    5. Wskazówki dla szczególnych grup pacjentów
    6. Praktyczne zalecenia profilaktyczne
  2. Wskazania do profilaktyki farmakologicznej
  3. Najnowsze kierunki badań
  4. Podsumowanie
    1. Kolejne rozdziały

Choroba wysokościowa – Zapobieganie (Profilaktyka)

Choroba wysokościowa (AMS – Acute Mountain Sickness) to zespół objawów występujących u osób, które szybko przemieszczają się na duże wysokości, najczęściej powyżej 2500 m n.p.m., gdzie ciśnienie parcjalne tlenu jest niższe. Zapobieganie tej chorobie jest zdecydowanie lepszym podejściem niż jej leczenie, szczególnie biorąc pod uwagę, że może ona prowadzić do poważnych powikłań w postaci wysokościowego obrzęku mózgu (HACE) lub wysokościowego obrzęku płuc (HAPE), które stanowią zagrożenie życia.12

Stopniowa aklimatyzacja – złoty standard profilaktyki

Najskuteczniejszą metodą zapobiegania chorobie wysokościowej jest stopniowe zwiększanie wysokości, na której przebywa pacjent, co pozwala organizmowi na fizjologiczną adaptację do zmniejszonego ciśnienia parcjalnego tlenu.12 Towarzystwo Medycyny Górskiej (Wilderness Medical Society) zaleca przestrzeganie następujących zasad aklimatyzacyjnych:

  • Unikanie bezpośredniego wznoszenia się na wysokość snu przekraczającą 2750 m (9000 stóp) w ciągu jednego dnia1
  • Wznoszenie się z prędkością nie większą niż 500 m (1650 stóp) na dobę po przekroczeniu wysokości 3000 m (9800 stóp)12
  • Wprowadzenie dodatkowej nocy aklimatyzacyjnej na każde 1000 m (3300 stóp) przyrostu wysokości snu12
  • Powyżej 3000 m należy włączyć dzień odpoczynku (bez zwiększania wysokości snu) co 3-4 dni12

Zaleca się również, aby przed podróżą na duże wysokości spędzić 2-3 noce na pośredniej wysokości około 2450-2750 m (8000-9000 stóp), co znacząco zmniejsza ryzyko wystąpienia ostrej choroby wysokościowej.1

Zasada „Wspinaj się wysoko, śpij nisko”

Istotną strategią w profilaktyce choroby wysokościowej jest zasada „climb high, sleep low” (wspinaj się wysoko, śpij nisko). Polega ona na tym, że w ciągu dnia można osiągać większe wysokości, natomiast na noc należy zejść na niższą wysokość, co wspomaga proces aklimatyzacji.12

Zasada ta jest szczególnie istotna przy wznoszeniu się na wysokości powyżej 10000 stóp (3000 m), gdzie organizm adaptuje się do znacznie zmniejszonej ilości tlenu. Nawet różnica kilkuset metrów wysokości podczas snu może znacząco wpłynąć na komfort i bezpieczeństwo.1

Farmakologiczna profilaktyka choroby wysokościowej

W sytuacjach, gdy stopniowe wznoszenie nie jest możliwe lub gdy istnieje umiarkowane do wysokiego ryzyko wystąpienia choroby wysokościowej, zaleca się rozważenie profilaktyki farmakologicznej. Należy jednak podkreślić, że farmakoterapia nie zastępuje właściwej aklimatyzacji, a jedynie stanowi jej uzupełnienie.12

Acetazolamid (Diamox)

Acetazolamid jest lekiem pierwszego wyboru w profilaktyce AMS. Jest to inhibitor anhydrazy węglanowej, który przyspiesza proces aklimatyzacji poprzez zwiększenie częstości oddechów i poprawę utlenowania krwi.12 Lek działa poprzez:

  • Wywoływanie diurezy wodorowęglanowej w nerkach i kwasicy metabolicznej
  • Stymulację ośrodka oddechowego, co zwiększa wentylację płuc
  • Przyspieszenie naturalnych procesów adaptacyjnych organizmu do warunków wysokogórskich12

Zalecane dawkowanie acetazolamidu w profilaktyce AMS to 125-250 mg doustnie 2 razy dziennie, rozpoczynając 24-48 godzin przed wejściem na wysokość i kontynuując przez pierwsze 1-2 dni po osiągnięciu najwyższego punktu lub do zakończenia wznoszenia.12 Badania systematyczne wykazały, że dawka 250 mg dziennie jest najniższą skuteczną dawką w profilaktyce AMS.1

U dzieci, w sytuacjach gdy profilaktyka farmakologiczna jest konieczna, dawka acetazolamidu wynosi 2,5 mg/kg masy ciała dwa razy dziennie (maksymalnie 125 mg/dawkę).1

Deksametazon

Deksametazon może być stosowany jako alternatywa dla acetazolamidu u dorosłych pacjentów z umiarkowanym lub wysokim ryzykiem AMS, szczególnie u osób nietolerujących acetazolamidu lub z alergią na sulfonamidy.12

Istotną różnicą między deksametazonem a acetazolamidem jest to, że deksametazon nie wspomaga aklimatyzacji, a jedynie maskuje objawy AMS poprzez zmniejszenie stanu zapalnego. Po odstawieniu leku może dojść do nawrotu objawów (rebound AMS).12

Ze względu na potencjalne działania niepożądane przy dłuższym stosowaniu (supresja nadnerczy, efekty glikokortykosteroidowe), deksametazon nie jest zalecany w rutynowej profilaktyce AMS, a raczej w sytuacjach wyjątkowych.1

Profilaktyka wysokościowego obrzęku płuc (HAPE)

Farmakologiczna profilaktyka HAPE powinna być rozważana jedynie u osób z udokumentowaną historią HAPE, szczególnie nawracającym.12 Lekami stosowanymi w profilaktyce HAPE są:

  • Nifedypina o przedłużonym uwalnianiu – 30 mg co 12 godzin, rozpoczynając dzień przed wejściem na wysokość i kontynuując przez 4-7 dni po osiągnięciu docelowej wysokości lub do rozpoczęcia zejścia. Jest to lek pierwszego wyboru w profilaktyce HAPE.12
  • Inhibitory fosfodiesterazy-5 (tadalafil, sildenafil) – mogą być stosowane u osób nietolerujących nifedypiny. Leki te wybiórczo obniżają ciśnienie w tętnicy płucnej.12

Dodatkowe strategie profilaktyczne

Oprócz stopniowej aklimatyzacji i potencjalnej farmakoterapii, istnieje kilka dodatkowych strategii, które mogą zmniejszyć ryzyko wystąpienia choroby wysokościowej:

Prawidłowe nawodnienie

Utrzymanie odpowiedniego nawodnienia jest kluczowe w profilaktyce choroby wysokościowej. Na dużych wysokościach występuje zwiększona utrata płynów przez drogi oddechowe i skórę, co może prowadzić do odwodnienia.1 Zaleca się wypijanie minimum 4-5 litrów płynów dziennie podczas pobytu na dużej wysokości.12

Odpowiednia dieta

Dieta bogata w węglowodany (ponad 70% kalorii z węglowodanów) jest zalecana podczas pobytu na dużej wysokości. Węglowodany wymagają mniej tlenu do metabolizmu w porównaniu z tłuszczami i białkami, co jest korzystne w warunkach hipoksji.12

Unikanie substancji depresyjnych

Należy unikać spożywania alkoholu, tytoniu i leków działających depresyjnie na ośrodkowy układ nerwowy (np. leków nasennych, opioidów) przez pierwsze 48 godzin po przybyciu na dużą wysokość, gdyż mogą one zaburzać oddychanie i pogarszać objawy choroby wysokościowej.12

Ograniczenie wysiłku fizycznego

W pierwszych 24-48 godzinach po przybyciu na dużą wysokość zaleca się ograniczenie intensywnego wysiłku fizycznego, co pozwala organizmowi stopniowo adaptować się do nowych warunków.12

Monitorowanie stanu zdrowia

Bardzo ważne jest rozpoznawanie wczesnych objawów choroby wysokościowej i odpowiednie reagowanie. W przypadku wystąpienia objawów należy powstrzymać się od dalszego wznoszenia, dopóki objawy nie ustąpią. Jeśli objawy się nasilają, konieczne jest zejście na niższą wysokość.12

Wskazówki dla szczególnych grup pacjentów

Osoby z historią wcześniejszej choroby wysokościowej są szczególnie narażone na jej nawrót i powinny rozważyć profilaktyczne stosowanie acetazolamidu przed podróżą na dużą wysokość.12

Pacjenci z chorobami przewlekłymi, szczególnie chorobami układu oddechowego i krążenia, powinni skonsultować się z lekarzem przed podróżą na dużą wysokość, aby ocenić ryzyko i omówić strategię profilaktyczną.12

U dzieci zapobieganie chorobie wysokościowej opiera się głównie na stopniowej aklimatyzacji, a farmakoterapia powinna być stosowana tylko w wyjątkowych przypadkach i pod ścisłym nadzorem lekarza.1

Praktyczne zalecenia profilaktyczne

Poniżej przedstawiono praktyczne zalecenia profilaktyczne dla osób planujących pobyt na dużej wysokości:

  1. Zaplanuj stopniowe wznoszenie się, szczególnie powyżej 3000 m (nie więcej niż 500 m przyrostu wysokości snu na dobę).
  2. Uwzględnij w planie podróży dni odpoczynku na aklimatyzację (co 3-4 dni lub po każdym przyroście wysokości o 1000 m).
  3. Stosuj zasadę „wspinaj się wysoko, śpij nisko”.
  4. Rozważ profilaktyczne przyjmowanie acetazolamidu (125-250 mg 2 razy dziennie), jeśli należysz do grupy umiarkowanego lub wysokiego ryzyka.
  5. Pij minimum 4-5 litrów płynów dziennie.
  6. Stosuj dietę bogatą w węglowodany.
  7. Unikaj alkoholu, tytoniu i leków działających depresyjnie na OUN przez pierwsze 48 godzin.
  8. Ogranicz intensywny wysiłek fizyczny przez pierwsze 1-2 dni.
  9. Monitoruj swój stan zdrowia i reaguj na pierwsze objawy choroby wysokościowej.123

Wskazania do profilaktyki farmakologicznej

Profilaktyka farmakologiczna choroby wysokościowej powinna być rozważona w następujących sytuacjach:12

  • Historia wcześniejszej choroby wysokościowej
  • Szybkie wznoszenie się (np. lot bezpośrednio na dużą wysokość)
  • Przekroczenie wysokości 3500 m (11500 stóp) w mniej niż 2 dni
  • Wznoszenie się i nocowanie na wysokości większej niż 500 m dziennie powyżej 3000 m
  • Znane indywidualne predyspozycje do choroby wysokościowej
  • Historia HAPE lub HACE (obowiązkowa konsultacja z lekarzem)

Ostateczna decyzja o zastosowaniu profilaktyki farmakologicznej powinna być podjęta przez lekarza po indywidualnej ocenie ryzyka i korzyści.1

Najnowsze kierunki badań

Obecnie prowadzone są badania nad nowymi metodami zapobiegania chorobie wysokościowej, w tym:

  • Systemy monitorowania parametrów fizjologicznych w czasie rzeczywistym, które mogą przewidywać wystąpienie choroby wysokościowej na 4-8 godzin przed pojawieniem się objawów12
  • Namioty hipoksyczne i inne metody preaklimatyzacji, które mogą przygotować organizm do pobytu na dużej wysokości12
  • Nowe biomarkery w krwi lub moczu, które mogłyby pomóc w identyfikacji osób predysponowanych do choroby wysokościowej jeszcze przed ekspozycją na warunki wysokogórskie1

Te innowacyjne podejścia mogą w przyszłości zrewolucjonizować profilaktykę choroby wysokościowej i uczynić podróże wysokogórskie jeszcze bezpieczniejszymi.1

Podsumowanie

Zapobieganie chorobie wysokościowej opiera się przede wszystkim na stopniowej aklimatyzacji, która pozwala organizmowi dostosować się do zmniejszonej ilości tlenu na dużych wysokościach. W przypadku osób z umiarkowanym lub wysokim ryzykiem wystąpienia choroby wysokościowej, profilaktyka farmakologiczna z zastosowaniem acetazolamidu lub, w wyjątkowych przypadkach, deksametazonu może stanowić cenne uzupełnienie. Dodatkowe strategie, takie jak odpowiednie nawodnienie, dieta bogata w węglowodany i ograniczenie wysiłku fizycznego w początkowym okresie, również odgrywają istotną rolę w profilaktyce.123

Kluczowe znaczenie ma również znajomość wczesnych objawów choroby wysokościowej i odpowiednie reagowanie na nie, w tym bezwzględne przestrzeganie zasady, aby nie wznoszić się wyżej w przypadku wystąpienia objawów i zejść na niższą wysokość, jeśli objawy się nasilają.1

Właściwe przygotowanie i przestrzeganie zasad profilaktyki pozwala zmniejszyć ryzyko wystąpienia choroby wysokościowej i cieszyć się bezpiecznym pobytem na dużych wysokościach.1

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 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. […] Controlling the rate of ascent specifically, gradually increasing sleeping altitude over several days is recommended to prevent AMS and HACE. When feasible, staged ascent and preacclimatization should be considered. […] Acetazolamide aids in acclimatization and should be strongly considered for high-altitude travelers at moderate to high risk of AMS. […] Dexamethasone can prevent AMS and HACE in adults at moderate to high risk, although it does not help with acclimatization. […] Pharmacologic prophylaxis should be considered only for people with a history of HAPE, especially recurrent episodes. The preferred medication is extended-release nifedipine, 30 mg every 12 hours starting the day before ascent and continuing for four to seven days after reaching target elevation or until descent.
  • #1 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.” […] Gradually ascending to altitude or staging the ascent provides crucial time for the body to adjust. […] Acclimatizing for a minimum of 2 to 3 nights at around 2,450 to approximately 2,750 m (8,000-9,000 ft) before proceeding to a higher altitude is markedly protective against acute mountain sickness (AMS). […] The Wilderness Medical Society recommends avoiding ascent to a sleeping altitude of 2,750 m (9,000 ft) in a single day; ascending at a rate of no greater than 500 m (1,650 ft) per night in sleeping altitude once above 3,000 m (9,800 ft); and allowing an extra night to acclimatize for every 1,000 m (3,300 ft) of sleeping altitude gain.
  • #1 Altitude and Travel – Fit for Travel
    https://www.fitfortravel.nhs.uk/advice/general-travel-health-advice/altitude-and-travel
    At altitude the air pressure is lower and this means there is less oxygen available to your body when you breath. […] The best way to prevent AMS is to give your body enough time to acclimatise to being at a higher altitude. […] You can do this by not travelling too quickly to altitudes above 2,500m. […] The major cause of AMS is going too high too quickly. […] The Wilderness Medical Society recommend that once you are at an altitude of 2,500m, you should: not sleep more than 500m higher than you slept the night before; have a rest day every 3 to 4 days. […] It is also important that you: make sure you drink enough water so you do not get dehydrated; avoid drinking alcohol; eat a light but high calorie diet. […] Acetazolamide (Diamox) is a medicine that is sometimes taken to prevent AMS. […] Acetazolamide does not replace the need to acclimatise through a gradual assent. […] You should speak with a travel health professional who will be able to advise further on using Diamox.
  • #1 Altitude Sickness: What It Is, Symptoms, Treatment & Prevention
    https://my.clevelandclinic.org/health/diseases/15111-altitude-sickness
    Altitude sickness is very preventable, and there are a few key ways you can prevent it. They are: […] Limit how fast you ascend. Altitude sickness is more likely when you ascend too far and too fast. A slower ascent is ideal for preventing altitude sickness. At 8,202 feet (2,500 meters), the recommendation is ascending no more than 984 feet (300 meters) to 1,640 feet (500 meters) per day. […] Take rest days to acclimate. At 8,202 feet (2,500 meters), experts recommend a day of initial rest to acclimate. If you continue ascending, rest every third day. Above 14,000 feet (4,267 meters), a two-day rest per 1,000 feet is recommended. […] Sleep at a lower altitude if possible. If you can, ascend during the day and return to a lower altitude to sleep. That can make altitude sickness less severe and make it easier to acclimate. […] 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.
  • #1 How to Prevent & Treat Altitude Sickness | REI Expert AdviceREI Co-op, Go to REI.com Home PageCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon
    https://www.rei.com/learn/expert-advice/altitude-sickness.html
    Not surprisingly, managing altitude and ascent is key to avoiding altitude sickness. If you do this effectively, your body can adjust its physiology to run on rarefied air. […] Acclimatization: It’s remarkable how well we can adapt to altitude, if we give our body time to do so. Your heart rate and breathing will speed up, and your blood will develop higher-than-normal amounts of red blood cells. The rest of your cells slowly change too, so that they use oxygen more efficiently. […] If you give yourself at least two days to reach an 8,000- to 10,000-foot elevation, and then limit daily ascents to 1,000 feet, your body will have a better chance to adapt. Note, too, that it’s your sleeping altitude that’s key: You can climb higher in a given day as long as you come back down to a snoozing elevation that’s within this limit. […] Everyone adapts at a different rate: You might be able to acclimatize more quickly than the above rule of thumb, or less quickly. Age, gender, race—even your level of fitness—don’t correlate conclusively with faster or slower adaptation rates. Take your time and listen to your body.
  • #1 The Pharmacist’s Role in the Treatment and Prevention of Acute Mountain Sickness
    https://www-staging.uspharmacist.com/article/the-pharmacists-role-in-the-treatment-and-prevention-of-acute-mountain-sickness
    Pharmacists may be faced with questions regarding strategies to prevent AMS. Current guidelines provide recommendations based on patient risk factors including a prior history of AMS, rate of ascent, and maximum altitudes for climbing and sleeping. Low-risk patients should rely solely on nonpharmacologic strategies to prevent AMS, whereas patients with a moderate-to-severe risk may benefit from both behavioral approaches and pharmacologic prophylaxis. […] […] Gradual ascent is considered the most effective approach to prevent the development of AMS. Prior to ascending to higher elevations, it is recommended that patients sleep at an altitude of 1,500 to 2,500 m to help with acclimatization. Those traveling above 2,500 m should ascend at no more than 300 to 600 m/day above the sleeping altitude of the previous night. Adding a rest day after every 600 to 1,200 m of ascent will also assist the acclimatization process. When gradual ascent is not possible, individuals may ascend faster than the recommended rate if they return to lower elevations for sleep (climb high, sleep low). Other nonpharmacologic strategies include maintaining adequate hydration, limiting activity for the first few days at higher elevations, and avoiding alcohol and other depressants. […]
  • #1 The Pharmacist’s Role in the Treatment and Prevention of Acute Mountain Sickness
    https://www-staging.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. Although drug prophylaxis should be avoided in children, there are cases when it may be necessary. The pediatric dosage of acetazolamide is 2.5 mg/kg per dose twice daily (125 mg/dose maximum). For patients who are intolerant or allergic to acetazolamide, dexamethasone 8 mg daily in divided doses may be considered. Duration should be limited in order to prevent glucocorticoid toxicity and/or adrenal suppression. Dexamethasone should not be used for prevention in the pediatric population. […] Although the combination of acetazolamide and dexamethasone was found to be more effective than either given alone, use of the combination should be reserved for when more severe symptoms of AMS are likely.
  • #1 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
    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. Although the exact mechanism remains unclear, it inhibits carbonic anhydrase, an enzyme found in many tissues. Acetazolamide decreases the resorption of bicarbonate in the proximal renal tubule and binds carbon dioxide in the peripheral tissues, resulting in metabolic acidosis. By reducing the metabolic alkalosis of hypocapnia, which normally inhibits the central respiratory drive, hyperventilation can continue for longer. Acetazolamide also acts as a mild diuretic, decreasing oedema.
  • #1 Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis | The BMJ
    https://www.bmj.com/content/345/bmj.e6779
    This systematic review and meta-analysis summarises the current evidence on the efficacy of acetazolamide 250 mg, 500 mg, and 750 mg daily in the prevention of acute mountain sickness. […] Acetazolamide 250 mg was the lowest effective dose for which there was evidence for this indication. […] This systematic review found that acetazolamide 250 mg and 500 mg daily are also effective in preventing acute mountain sickness. […] Acetazolamide 250 mg daily was the lowest dose with evidence on effectiveness in preventing acute mountain sickness.
  • #1 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html
    Avoid flying or driving to high altitudes unless necessary. Hiking is best because it allows for acclimatization. […] The most accepted method of preventing acute mountain sickness and high-altitude cerebral edema is to ascend slowly. […] Acetazolamide, a carbonic anhydrase inhibitor, may be used as prophylaxis; it should be started at least one day before climbing and continued until acclimatization at the highest sleeping elevation. […] 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. […] 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.
  • #1 Altitude Illness: Risk Factors, Prevention, Presentation, and Treatment | AAFP
    https://www.aafp.org/pubs/afp/issues/2010/1101/p1103.html
    Small randomized trials have shown that when started one day before ascent, prophylactic dexamethasone, nifedipine (Procardia), salmeterol (Serevent), and phosphodiesterase-5 inhibitors (tadalafil [Cialis], sildenafil [Viagra]) reduce the incidence of high-altitude pulmonary edema in persons with a history of the condition.
  • #1 Altitude Sickness Prevention: Top Tips
    https://www.healthline.com/health/altitude-sickess-prevention
    Altitude sickness describes several symptoms that happen to your body when you’re exposed to a higher elevation within a short period of time. […] Here are some things you can do to prevent yourself from getting altitude sickness. […] Your body needs about two to three days of slowly going higher in order to adjust to the changes. Avoid flying or driving directly to high altitudes. Instead, go up higher each day, stop to rest, and continue the next day. If you have to fly or drive, pick a lower altitude to stay at for 24 hours before going all the way up. […] Staying hydrated is also important in preventing altitude sickness. Drink water regularly during your climb. […] Usually medication isn’t given ahead of time unless flying or driving to high altitude is unavoidable. There’s some evidence that taking acetazolamide (the former brand name of Diamox) two days before a trip and during your trip can help prevent altitude sickness.
  • #1 Altitude sickness | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/healthyliving/altitude-sickness
    The best way to prevent altitude sickness is to ascend slowly. Once you are more than 3,000 m above sea level, only advance 300 m or less per day. Be sure to take an extra day of rest and acclimatisation for every subsequent 1,000 m. Other suggestions for preventing altitude sickness include: […] Considerable evidence exists for the effectiveness of acetazolamide as a preventative. It is particularly useful if you are flying into a location at altitude and will not have time to adjust. Salmeterol inhalers and even Viagra-like drugs have been used to prevent fluid building up in the lungs. […] Remember that medications such as nifedipine and dexamethasone are best used as a treatment for mild altitude sickness, not as a prevention measure. These medications could mask the early warning signs.
  • #1 OA Guide to High Altitude: Acclimatization and Illnesses
    http://www.princeton.edu/~rcurtis/altitude.html
    Eat a high carbohydrate diet (more than 70% of your calories from carbohydrates) while at altitude. […] The acclimatization process is inhibited by dehydration, over-exertion, and alcohol and other depressant drugs. […] Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms caused by poor oxygenation. […] Dexamethasone (a steroid) is a prescription drug that decreases brain and other swelling reversing the effects of AMS.
  • #1 Altitude sickness
    https://www.nhs.uk/conditions/altitude-sickness/
    There are some things you can do to help reduce your risk of getting altitude sickness. […] travel or climb to a high altitude slowly to give your body time to get used to lower oxygen levels […] spend a few days at an altitude below 2,500 metres before going any higher […] have a rest day at the same altitude every 3 to 4 days (if you’re at an altitude of 3,000 metres or more) […] drink enough water so you do not get dehydrated […] speak to a GP or travel clinic if you’ve had altitude sickness before or if you’re travelling to a high altitude quickly they may prescribe medicine to help prevent altitude sickness […] try not to travel from an altitude that’s less than 1,200 metres to an altitude that’s more than 3,500 metres in 1 day […] try not to fly directly to a place with a high altitude if this is not possible, rest for 1 day before going any higher […] try not to sleep more than 500 metres higher than you slept the night before (if you’re at an altitude of 3,000 metres or more) […] do not drink alcohol while travelling or climbing.
  • #1 Altitude Sickness: Symptoms, Treatment & Medication, Prevention
    https://www.webmd.com/a-to-z-guides/altitude-sickness
    If you walk, hike, or climb over 10,000 feet, only go up an additional 1,000 feet per day. For every 3,000 feet you climb, rest at least a day at that height. […] Climb high and sleep low: If you have to climb over 1,000 feet in a day, make sure you come back down to a lower altitude to sleep. […] Drink 3-4 quarts of water every day, and make sure about 70% of your calories are coming from carbs. […] Don’t use tobacco, alcohol, or medications such as sleeping pills, especially for the first 48 hours. Caffeine is OK if you normally drink it. […] Don’t vigorously exercise for the first 48 hours. […] Know how to identify the first signs of altitude sickness. Move to a lower elevation right away if you start to have these symptoms.
  • #1 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
    Acetazolamide prophylaxis would be beneficial; consider its use. […] Strongly encourage acetazolamide prophylaxis, and have the traveler carry dexamethasone for emergency use. […] 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. […] Travelers can adhere to 3 rules to help prevent death or serious consequences from altitude illness: Know the early symptoms of altitude illness and be willing to acknowledge when symptoms are present; Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor the symptoms seem; Descend if the symptoms become worse despite rest or treatment at the same elevation.
  • #1 Acute mountain sickness: MedlinePlus Medical EncyclopediaLock
    https://medlineplus.gov/ency/article/000133.htm
    Keys to preventing acute mountain sickness include: […] Climb the mountain gradually. Gradual ascent is the most important factor in preventing acute mountain sickness. […] Stop for a day or two of rest for every 2000 feet (600 meters) of climb above 8000 feet (2400 meters). […] Sleep at a lower altitude when possible. […] Make sure that you have the ability to rapidly descend if needed. […] Learn how to recognize early symptoms of mountain sickness. […] If you are traveling above 9840 feet (3000 meters), you should carry enough oxygen for several days. […] If you plan on climbing quickly, or climbing to a high altitude, ask your provider about medicines that may help prevent acute mountain sickness, such as acetazolamide or dexamethasone. […] If you are at risk for a low red blood cell count (anemia), ask your provider if your planned trip is safe. Also ask if an iron supplement is right for you. Anemia lowers the amount of oxygen in your blood. This makes you more likely to have mountain sickness. […] While climbing: […] Do not drink alcohol […] Drink plenty of fluids […] Eat regular meals that are high in carbohydrates […] You should avoid high altitudes if you have heart or lung disease.
  • #1 High-altitude sickness prevention medication | TravelClinicNY
    https://www.travelclinicny.com/altitude-illness-prevention-medications.html
    Recommended by the CDC before going to high-altitude areas. […] Diamox (acetazolamide) is the medication of choice for most travelers. […] Ascending gradually to a high altitude is the best way to prevent high-altitude illness. But sometimes medication is necessary as a form of prevention. […] Medication is advised for those with a history of high-altitude sickness, ascending to (and sleeping at) more than 500 meters (1,640 feet) a day above 3,000 meters (9,800 feet), ascending to 3,500 meters (11,500 feet) in less than two days, or having a medical condition that predisposes to high-altitude sickness. […] Acetazolamide (Diamox) 125 mg twice a day is the most commonly used medication for prevention. […] Dexamethasone 4 mg every 12 hours is not commonly used for prevention purposes. […] No other proven ways of preventing high-altitude illness. […] Gradual ascent is one of the surest and safest methods of preventing high-altitude illness.
  • #1 A next-generation acute mountain sickness prevention tool that aims to help Soldiers and Civilians | Article | The United States Army
    https://www.army.mil/article/279896/a_next_generation_acute_mountain_sickness_prevention_tool_that_aims_to_help_soldiers_and_civilians
    AMS monitor 1 / 2 Show Caption + Hide Caption A wearable wrist monitor is provided to Soldiers that tracks the amount of oxygen in the bodys bloodstream and links this health information to the patented AMS_alert algorithm, which predicts an individuals likelihood of experiencing AMS four to eight hours before symptoms. […] The U.S. Army Research Institute of Environmental Medicine and the University of New Mexico are creating a predictive tool to transform the way altitude-related health illnesses are managed and prevented during military operational exercises. […] The current tool is a wearable wrist monitor that tracks the amount of oxygen in the bodys bloodstream and links this health information to the patented AMS_alert algorithm, which predicts an individuals likelihood of experiencing AMS four to eight hours before symptoms.
  • #1 We’re sorry, your browser does not support some of the features on this website.
    https://iantaylortrekking.com/blog/altitude-sickness-practice-guidelines-and-recommendations/
    Acetazolamide should be strongly considered in travelers at moderate or high risk of AMS with ascent to high altitude. […] Dexamethasone can be used as an alternative to acetazolamide for adult travelers at moderate or high risk of AMS. […] When feasible, staged ascent and preacclimatization can be considered as a means for AMS prevention. […] Hypoxic tents can be used for facilitating acclimatization and preventing AMS, provided sufficiently long exposures can be undertaken regularly over an appropriate number of weeks and other factors, such as sleep quality, are not compromised. […] Prophylactic medications are not necessary in low-risk situations but should be considered in addition to gradual ascent for use in moderate- to high-risk situations. […] Acetazolamide is the preferred medication; dexamethasone may be used as an alternative in individuals with a history of intolerance of or allergic reaction to acetazolamide.
  • #1 A next-generation acute mountain sickness prevention tool that aims to help Soldiers and Civilians | Article | The United States Army
    https://www.army.mil/article/279896/a_next_generation_acute_mountain_sickness_prevention_tool_that_aims_to_help_soldiers_and_civilians
    With this algorithm, leaders can see who may be at high risk early in the altitude exposure and possibly prevent injuries and casualties that could occur later in the exposure. […] Hypoxia monitoring can help detect future altitude sickness and therefore allow early intervention so that Soldiers can complete a successful mission. […] The goal is to have a smart phone application that houses the algorithm to provide a green, yellow and red alert to leaders and Commanders in the field on the health status of their Soldiers, Beidleman said. […] One goal of this research is to replace the Environmental Symptoms Questionnaire with a diagnostic blood or urine test, given that Soldiers typically underreport their symptoms. […] Another mission in this research is to collect these biomarkers at sea level, prior to deployment, to assess whether an individual has a high likelihood of getting sick at altitude.
  • #1 A next-generation acute mountain sickness prevention tool that aims to help Soldiers and Civilians | Article | The United States Army
    https://www.army.mil/article/279896/a_next_generation_acute_mountain_sickness_prevention_tool_that_aims_to_help_soldiers_and_civilians
    In addition to using this tool to predict AMS, it could potentially be used to mitigate life-threatening events such as high-altitude pulmonary edema fluid in lungs and cerebral edema fluid in brain that can develop at high altitude by providing alerts prior to such events from occurring. […] This research has become one of USARIEMs biggest multi-divisional and collaborative studies. […] Acute mountain sickness can be a debilitating condition. With this tool, Warfighters will be able to make better informed decisions before the onset of more severe symptoms, said Steven Landspurg, ORISE fellow at USARIEM. […] The research team aims transition to the U.S. Army Medical Materiel Development Activity for launch of the app by early fall of 2025. Beidleman says that this tool can go beyond military purposes and expand to civilian use.
  • #1 Altitude Sickness – Symptoms, Prevention, and Treatment
    https://camotrek.com/blogs/news/altitude-sickness/
    This post is dedicated to a condition known as altitude sickness, its signs and symptoms, means of prevention as well as proper treatment. […] The best way to deal with altitude sickness is prevention done through acclimatization to high elevations. After 3000m, try to stick to a controlled, gradual ascent of no more than 500m in vertical elevation gain in sleeping altitude per day followed by a day of no gain in sleeping elevation every three to four days. […] Other measures for prevention of AMS include proper hydration, high-carbohydrate diet, and reduction in energy expenditure to a moderate level until you’re acclimated. […] Prevention via staged and gradual ascent is recommended. […] As with all kinds of altitude sickness, prevention through gradual ascent and appropriate acclimatization is key.
  • #2 Acute Mountain Sickness – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430716/
    At higher altitudes, the decreased partial pressure of oxygen can cause several pathological presentations, including high altitude pulmonary edema, high altitude cerebral edema, and the more mild, but much more common acute mountain sickness (also referred to as altitude illness or altitude sickness). […] In contrast, acute mountain sickness can be prevented or managed with oral medication, and does not typically require prompt descent or oxygen supplementation. This activity reviews the evaluation and management of patients with acute mountain sickness and provides recommendations to preventing the condition. […] Describe how to prevent altitude sickness by modifying the rate of ascent. […] Describe how to use acetazolamide for both prophylaxis and treatment of acute mountain 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.” […] Gradually ascending to altitude or staging the ascent provides crucial time for the body to adjust. […] Acclimatizing for a minimum of 2 to 3 nights at around 2,450 to approximately 2,750 m (8,000-9,000 ft) before proceeding to a higher altitude is markedly protective against acute mountain sickness (AMS). […] The Wilderness Medical Society recommends avoiding ascent to a sleeping altitude of 2,750 m (9,000 ft) in a single day; ascending at a rate of no greater than 500 m (1,650 ft) per night in sleeping altitude once above 3,000 m (9,800 ft); and allowing an extra night to acclimatize for every 1,000 m (3,300 ft) of sleeping altitude gain.
  • #2 EMS High-Altitude Field Prophylaxis And Treatment – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK560677/
    The recommended method for the prevention of high-altitude illness is to allow the body time to acclimatize via gradual ascent. The WMS recommends one day of travel for every 1,500 ft ascent above 10,000 ft above sea level and a day of rest every 3 to 4 days. […] Acetazolamide is the only medication proven to speed acclimatization. It induces metabolic acidosis by bicarbonate diuresis. This acidosis triggers compensatory hyperventilation helping acclimatization. […] The recommended method for the prevention of high-altitude illness is to allow the body time to acclimatize via gradual ascent. The WMS recommends one day of travel for every 1,500 ft gained above 10,000 ft and a day of rest every 3 or 4 days. […] Preventative treatment using nifedipine is reserved for individuals with a history of HAPE. It helps by decreasing pulmonary hypertension. Dosing begins one day before ascent and is discontinued after four days at the highest point of ascent or beginning of the descent.
  • #2
    https://wms.org/magazine/magazine/1252/2019altitude-cpg/default.aspx
    If travelers are unable to ascend gradually due to various logistical factors, pharmacologic prophylaxis can be considered. […] Prophylactic medications are generally not necessary in low risk situations but should be considered in addition to gradual ascent for use in moderate to high-risk situations (Table 1). […] With travel above 3000 m/9800 ft, individuals should not increase the sleeping elevation by more than 500 m/1600 ft per day and should include a rest day (i.e. no ascent to higher sleeping elevation) every 3-4 days. […] Gradual Ascent: Controlling the rate of ascent, in terms of the number of meters/feet gained per day, is a highly effective means of preventing acute altitude illness. […] Acetazolamide has an established role in prevention of AMS. […] Dexamethasone does not facilitate acclimatization like acetazolamide, but it has an established benefit in AMS prevention.
  • #2 Altitude Sickness: What Every Traveler Needs to Know
    https://www.worldnomads.com/travel-wiser/wellness/how-to-deal-with-altitude-sickness
    Sleep at a lower altitude if possible. Do day trips to higher altitudes and return to lower elevations to sleep. If on a trek, subscribe to the „climb high, sleep low” adage, where you continue to gain elevation during the day but find lower elevations to spend the night. […] Avoid alcohol and sedatives. These can mask symptoms of AMS and should be avoided in the first few days at altitude. […] Stay hydrated. Drink plenty of fluids to aid acclimatization. […] Mild exercise, such as short walk, on the day of arrival can help with acclimatization but avoid heavy exercise. […] Overall, many travelers spend time at high altitude every day, and return without problems. Be vigilant about the symptoms of altitude sickness in yourself and others around you and understand that any illness or headache at altitude should be treated as altitude sickness until proven otherwise.
  • #2 WMS Prevention and Treatment of Acute Altitude Illness Guideline Summary
    https://www.guidelinecentral.com/guideline/40619/
    Gradual ascent, defined as a slow increase in sleeping elevation, is recommended for AMS and HACE prevention. A specific approach is described further later in the text. […] Acetazolamide should be strongly considered in travelers at moderate or high risk of AMS with ascent to high altitude. […] Acetazolamide can be used in children for prevention of AMS. […] Dexamethasone can be used as an alternative to acetazolamide for adult travelers at moderate or high risk of AMS. […] When feasible, staged ascent and preacclimatization can be considered as a means for AMS prevention. […] Hypoxic tents can be used for facilitating acclimatization and preventing AMS, provided sufficiently long exposures can be undertaken regularly over an appropriate number of weeks and other factors, such as sleep quality, are not compromised.
  • #2 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
    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. Although the exact mechanism remains unclear, it inhibits carbonic anhydrase, an enzyme found in many tissues. Acetazolamide decreases the resorption of bicarbonate in the proximal renal tubule and binds carbon dioxide in the peripheral tissues, resulting in metabolic acidosis. By reducing the metabolic alkalosis of hypocapnia, which normally inhibits the central respiratory drive, hyperventilation can continue for longer. Acetazolamide also acts as a mild diuretic, decreasing oedema.
  • #2
    https://journals.lww.com/acsm-csmr/fulltext/2013/03000/acute_mountain_sickness_prophylaxis__a.15.aspx
    Acute mountain sickness (AMS) is the most common form of altitude illness affecting athletes and adventurists who work or play at elevations greater than 10,000 ft above mean sea level. […] In our experience, prophylaxis with the recommended doses of acetazolamide resulted in fewer AMS symptoms and seemed to confer a higher likelihood of successfully summiting each peak. We conclude that acetazolamide is an acceptable choice for AMS prevention along with a slow, controlled ascent and proper fitness, nutrition, clothing, and gear. […] Prophylaxis needs to be effective, reliable, and readily available with a low adverse effect profile. Current prophylactic options include acetazolamide or a regimented ascent-rest cycle in lieu of pharmaceutical agents. […] The USASOC prophylaxis protocol for rapid ascent to a working environment higher than 10,000-ft mean sea level calls for acetazolamide 125 mg by mouth every 12 h starting as soon as practical, but not more than 5 d prior to ascent. […] We conclude that acetazolamide is an important adjunct to AMS prevention along with a slow, controlled ascent, proper nutrition, clothing, and gear. Frequent rest breaks, a high-calorie diet, and vigilant hydration appear to provide additional protection against AMS.
  • #2 Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis | The BMJ
    https://www.bmj.com/content/345/bmj.e6779
    This systematic review and meta-analysis summarises the current evidence on the efficacy of acetazolamide 250 mg, 500 mg, and 750 mg daily in the prevention of acute mountain sickness. […] Acetazolamide 250 mg was the lowest effective dose for which there was evidence for this indication. […] This systematic review found that acetazolamide 250 mg and 500 mg daily are also effective in preventing acute mountain sickness. […] Acetazolamide 250 mg daily was the lowest dose with evidence on effectiveness in preventing acute mountain sickness.
  • #2 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
    Multiple trials have shown dexamethasone to be of benefit in preventing AMS. However, unlike acetazolamide, it only masks the symptoms of AMS by reducing inflammation, has significant side effects and, if stopped early, may lead to rebound AMS. The key role of dexamethasone is in the treatment of altitude illness, with prevention being reserved for those who cannot tolerate acetazolamide. […] 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. Nifedipine works by inhibiting the hypoxic pulmonary vasoconstriction, thus preventing or relieving pulmonary oedema.
  • #2
    https://wms.org/magazine/magazine/1252/2019altitude-cpg/default.aspx
    A gradual ascent profile is the primary method for preventing HAPE; the recommendations provided above for AMS and HACE prevention also apply to HAPE prevention. […] Pharmacologic prophylaxis should only be considered for individuals with a prior history of HAPE, especially multiple episodes; nifedipine is the preferred drug in such situations (Table 2). […] There is a clear relationship between rate of ascent and disease incidence. Gradual ascent is recommended to prevent HAPE.
  • #2 Altitude Sickness Prevention 如何預防高山症 | 衛教單張 – China Medical University Hospital
    https://www.cmuh.cmu.edu.tw/HealthEdus/Detail_EN?no=7177
    Prophylactic medication for mountain sickness […] Acetazolamide is a diuretic that prevents acute mountain sickness and accelerates the body’s adaptation to high altitude environments. The dosage, ranging from 125mg to 250mg, is taken 2 to 3 times a day, starting from the day before departure to the highlands. After arriving at high altitudes, take it for 2 days before discontinuance. […] Dexamethasone can prevent acute mountain sickness and HACE, but there is no evidence that it can accelerate the body’s adaptation to high altitude environment. […] Calcium channel blocker Nifedipine is a calcium channel blocker, which can prevent and treat HAPE. The usual dose is 20 to 30 mg for the long-acting effect, taken every 12 hours. Sildenafil citrate (Viagra) can also selectively reduce pulmonary arterial pressure and has small effect on blood pressure, which proves to be effective in the prevention and treatment of HAPE. The dose is 50mg taken 1-3 times a day.
  • #2 How to Prevent Altitude Sickness for Trekkers | Switchback Travel
    https://www.switchbacktravel.com/nepal/altitude-sickness
    Drink 5 Liters of Water Per Day. Quite simply, drink a minimum of five liters of water per day, no matter what. […] Avoid Dramatic Gains in Elevation. Treks at altitude should avoid big single-day gains in elevation (more than 1,500 vertical feet). […] Climb High, Sleep Low. You will acclimatize better if you expose yourself to higher altitudes but return to a lower altitude to sleep. […] Eat, Eat, Eat. Your body is doing more work than usual so make sure to stay nourished and full of carbohydrates. […] Listen to Your Body. By following the above rules, you will greatly increase your odds of staying healthy throughout your trek, but everybody reacts differently to altitude so pay close attention to how you feel. […] Diamox (Acetazolamide) is a respiratory stimulant that helps the body metabolize more oxygen, especially at night, thereby accelerating the process of acclimatization. Diamox can be used as a prophylactic, particularly by those making unavoidably large ascents.
  • #2 Altitude Sickness: Symptoms, Treatment & Medication, Prevention
    https://www.webmd.com/a-to-z-guides/altitude-sickness
    If you walk, hike, or climb over 10,000 feet, only go up an additional 1,000 feet per day. For every 3,000 feet you climb, rest at least a day at that height. […] Climb high and sleep low: If you have to climb over 1,000 feet in a day, make sure you come back down to a lower altitude to sleep. […] Drink 3-4 quarts of water every day, and make sure about 70% of your calories are coming from carbs. […] Don’t use tobacco, alcohol, or medications such as sleeping pills, especially for the first 48 hours. Caffeine is OK if you normally drink it. […] Don’t vigorously exercise for the first 48 hours. […] Know how to identify the first signs of altitude sickness. Move to a lower elevation right away if you start to have these symptoms.
  • #2 Altitude Sickness: Prevention & Symptoms | CommonSpirit Health
    https://www.mountain.commonspirit.org/care-and-health/high-altitude-health
    If at all possible, it is suggested you spend an extra day or two at an elevation of 5,000-7,000 feet before attempting activities at higher elevations. This adjustment period will give your body a chance to adapt to the change in altitude gradually. […] To avoid or lessen your symptoms of altitude sickness, try to avoid alcohol, sleeping pills, caffeine and narcotic pain medicine during your first days at higher elevations. Alcohol and drugs can escalate symptoms of altitude sickness. Drink plenty of fluids and try to acclimate to the altitude. […] Note: Vigorous physical exercise can increase your risk of developing altitude sickness.
  • #2 Altitude Sickness | Risk, Prevention and Treatment
    https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/altitude-sickness
    There are recommended rates of ascent to altitude to help with acclimatisation: If possible, spend at least one night at an 'intermediate’ elevation below 3000 metres. Above 3000 metres, increase the sleeping altitude by only 300-500 metres per day. Above 3000 metres, take a rest day for every 1000 metres of elevation gained (ie spend a second night at the same altitude). If possible, don’t fly or drive directly to high altitude. […] People going directly to high altitude by car or plane should not over-exert themselves or move higher for the first 24 hours. […] It is advisable to take special care if having previously had acute mountain sickness (AMS). […] If symptoms of AMS develop, further ascent needs to be delayed. […] If symptoms become worse, descent as soon as possible is essential.
  • #2 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
    Ascending to or being at a new high altitude may cause high-altitude illness (HAI). HAI includes acute mountain sickness (AMS), high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). HAI is caused by lower oxygen levels in the air and thus the blood. Travel to high altitude may also exacerbate certain pre-existing medical conditions. While 8000 feet (2500 meters) is considered the usual threshold altitude for HAI, some persons are more sensitive to lower oxygen levels and may become ill at 5000 to 7000 feet (1500 to 2100 meters). […] It is generally possible to prevent HAI by ascending slowly and allowing your body to adjust gradually. Serious complications can be avoided by monitoring early signs and symptoms of high-altitude illness and responding promptly. […] If you will be sleeping at altitudes above 8000 feet (2400 m) and have concerns about developing altitude sickness due to previous episodes or other risk factors, you should schedule an appointment with a knowledgeable health care provider. During this visit, discuss your travel plans, the availability of medical care at your destination, and the potential need for medications to prevent and/or treat high-altitude illness.
  • #2 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
    Ascend slowly—Ascending slowly is the best way to avoid AMS. Experts recommend the following: […] Consider taking a preventive medicine—Preventive treatment with a medicine may be recommended if you have had high-altitude illness previously or if you must ascend quickly. […] Prevention typically involves a medication called acetazolamide (brand name: Diamox), which you begin taking the day before your ascent and continue for 48 hours or until you reach the highest point of your trip. Acetazolamide accelerates the acclimatization process. […] Dexamethasone is a steroid that may be recommended as preventive treatment if you are allergic to acetazolamide or do not tolerate it. […] HACE can be prevented with the measures discussed above. […] As with other high-altitude illnesses, the best way to prevent HAPE is to ascend slowly. This is especially true if you have a previous history of HAPE.
  • #2 A next-generation acute mountain sickness prevention tool that aims to help Soldiers and Civilians | Article | The United States Army
    https://www.army.mil/article/279896/a_next_generation_acute_mountain_sickness_prevention_tool_that_aims_to_help_soldiers_and_civilians
    With this algorithm, leaders can see who may be at high risk early in the altitude exposure and possibly prevent injuries and casualties that could occur later in the exposure. […] Hypoxia monitoring can help detect future altitude sickness and therefore allow early intervention so that Soldiers can complete a successful mission. […] The goal is to have a smart phone application that houses the algorithm to provide a green, yellow and red alert to leaders and Commanders in the field on the health status of their Soldiers, Beidleman said. […] One goal of this research is to replace the Environmental Symptoms Questionnaire with a diagnostic blood or urine test, given that Soldiers typically underreport their symptoms. […] Another mission in this research is to collect these biomarkers at sea level, prior to deployment, to assess whether an individual has a high likelihood of getting sick at altitude.
  • #2
    https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx
    If travelers are unable to ascend gradually due to various logistical factors, pharmacologic prophylaxis can be considered. Prophylactic medications are generally not necessary in low risk situations but should be considered in addition to gradual ascent for use in moderate to high risk situations. […] With travel above 3000 m, individuals should not increase the sleeping elevation by more than 500 m per day and should include a rest day (i.e. no ascent to higher sleeping elevation) every 3-4 days. […] Acetazolamide has an established role in prevention of AMS. […] Dexamethasone does not facilitate acclimatization like acetazolamide but has an established benefit in AMS prevention. […] The panel does not endorse a particular protocol for preacclimatization and staged ascent as a means of AMS prevention.
  • #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
    Acetazolamide prophylaxis would be beneficial; consider its use. […] Strongly encourage acetazolamide prophylaxis, and have the traveler carry dexamethasone for emergency use. […] 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. […] Travelers can adhere to 3 rules to help prevent death or serious consequences from altitude illness: Know the early symptoms of altitude illness and be willing to acknowledge when symptoms are present; Never ascend to sleep at a higher altitude when experiencing symptoms of altitude illness, no matter how minor the symptoms seem; Descend if the symptoms become worse despite rest or treatment at the same elevation.
  • #3 OA Guide to High Altitude: Acclimatization and Illnesses
    http://www.princeton.edu/~rcurtis/altitude.html
    Prevention of altitude illnesses falls into two categories, proper acclimatization and preventive medications. Below are a few basic guidelines for proper acclimatization. […] If possible, don’t fly or drive to high altitude. Start below 10,000 feet (3,048 meters) and walk up. […] If you do fly or drive, do not over-exert yourself or move higher for the first 24 hours. […] If you go above 10,000 feet (3,048 meters), only increase your altitude by 1,000 feet (305 meters) per day and for every 3,000 feet (915 meters) of elevation gained, take a rest day. […] „Climb High and sleep low.” This is the maxim used by climbers. You can climb more than 1,000 feet (305 meters) in a day as long as you come back down and sleep at a lower altitude. […] If you begin to show symptoms of moderate altitude illness, don’t go higher until symptoms decrease (quotDon’t go up until symptoms go down”).
  • #3
    https://wms.org/magazine/magazine/1463/2024-Altitude-Summary/default.aspx
    A gradual ascent profile is the primary method for preventing HAPE; the recommendations provided above for AMS and HACE prevention also apply to HAPE prevention. […] Pharmacologic prophylaxis should only be considered for individuals with a history of HAPE, especially multiple episodes. […] There is a clear relationship between rate of ascent and disease incidence. Gradual ascent is recommended to prevent HAPE.

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