Objective: Acute mountain sickness(AMS) is a common condition in individuals who ascend to altitudes over 2 500 m. There is no measurements that can reliably predict or diagnose this condition. We therefore determined...Objective: Acute mountain sickness(AMS) is a common condition in individuals who ascend to altitudes over 2 500 m. There is no measurements that can reliably predict or diagnose this condition. We therefore determined whether pulse oximetry data are associated with the development of AMS and can help diagnose AMS. Methods: We studied 58 young male undergraduates who traveled from Chongqing(300 m) to Lhasa(3 658 m) by train. We collected data on the ascent profiles and AMS symptoms based on the Lake Louise Score(LLS). The resting arterial oxygen saturation(R-Sp O2) and pulse rate were then measured using finger pulse oximetry. Results: In Golmud(2 800 m) and Tanggula(5 200 m), R-SpO_2 was significantly lower in the AMS group than in the group without AMS(P<0.05). However, upon arrival in Lhasa(3 658 m), the R-SpO_2 was higher in the AMS group than in the non-AMS group(P<0.05). In Tanggula, the change in the SpO_2(CR-SpO_2) in the AMS group was higher than that in the non-AMS group(P<0.05). But in Lhasa, the CR-SpO_2 in the AMS group was lower than that in the non-AMS group(P<0.05). We also monitored heart rate(HR) throughout the study. In Xining(2 200 m) and Golmud, the HRs in the AMS group were higher than those in the non-AMS group. However, the HRs in the AMS group were lower than those in the non-AMS group in Tanggula and Lhasa. Conclusion: Based on the results of this study, the R-SpO_2 graph was not consistent. We can thus conclude that the utility of SpO_2 remains limited in the diagnosis of AMS. The results suggest that using pulse oximetry to diagnose AMS is not valuable in people ascending to Lhasa on the Qinghai-Tibet train.展开更多
Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation...Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.展开更多
基金supported by the National Natural Science Foundation of China(81372125)
文摘Objective: Acute mountain sickness(AMS) is a common condition in individuals who ascend to altitudes over 2 500 m. There is no measurements that can reliably predict or diagnose this condition. We therefore determined whether pulse oximetry data are associated with the development of AMS and can help diagnose AMS. Methods: We studied 58 young male undergraduates who traveled from Chongqing(300 m) to Lhasa(3 658 m) by train. We collected data on the ascent profiles and AMS symptoms based on the Lake Louise Score(LLS). The resting arterial oxygen saturation(R-Sp O2) and pulse rate were then measured using finger pulse oximetry. Results: In Golmud(2 800 m) and Tanggula(5 200 m), R-SpO_2 was significantly lower in the AMS group than in the group without AMS(P<0.05). However, upon arrival in Lhasa(3 658 m), the R-SpO_2 was higher in the AMS group than in the non-AMS group(P<0.05). In Tanggula, the change in the SpO_2(CR-SpO_2) in the AMS group was higher than that in the non-AMS group(P<0.05). But in Lhasa, the CR-SpO_2 in the AMS group was lower than that in the non-AMS group(P<0.05). We also monitored heart rate(HR) throughout the study. In Xining(2 200 m) and Golmud, the HRs in the AMS group were higher than those in the non-AMS group. However, the HRs in the AMS group were lower than those in the non-AMS group in Tanggula and Lhasa. Conclusion: Based on the results of this study, the R-SpO_2 graph was not consistent. We can thus conclude that the utility of SpO_2 remains limited in the diagnosis of AMS. The results suggest that using pulse oximetry to diagnose AMS is not valuable in people ascending to Lhasa on the Qinghai-Tibet train.
基金funded by grants from the Special Health Research Project,the Ministry of Health of China (01002012)
文摘Background: So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness(AMS). The aim of this study was to determine the role of heart rate(HR) difference(ΔHR) and oxygen saturation(Sa O2) as objective risk factors in aiding the diagnosis of AMS.Methods: A total of 1,019 participants were assigned to either the acute exposure group(AEG): from 500 m to 3,700 m by flight within 2.5 hours(n=752); or the pre-acclimatization group(PAG): ascended to 4,400 m from 3,650 m within three hours by car after adapting 33 days at 3,650m(n=267). The questionnaires or measurements of resting Sa O2 and HR were completed between 18 and 24 hours before departure and after arrival.Results: Incidence of AMS was 61.3%(461) in AEG, with 46.1%(347) mild cases and 15.2%(114) severe cases. In PAG, the incidence was 38.9%(104), with 30.7%(82) mild cases and 8.2%(22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in Sa O2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure Sa O2 were significantly correlated with the Lake Louise Score(LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and Sa O2 <88% in AEG as well as ΔHR >15 and Sa O2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or Sa O2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.
