Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation—independent of absolute altitude?

• Published in: Sleep & breathing Vol. 20; no. 1; pp. 435 - 442
• Main Authors: Leichtfried, Veronika, Basic, Daniel, Burtscher, Martin, Matteucci Gothe, Raffaella, Siebert, Uwe, Schobersberger, Wolfgang
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2016; Springer Nature B.V
• Subjects: Acute Disease; Adult; Altitude; Altitude Sickness - blood; Altitude Sickness - diagnosis; Dentistry; Female; Humans; Illnesses; Internal Medicine; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Mountaineering; Mountains; Neurology; Original Article; Otorhinolaryngology; Oxygen; Oxygen - blood; Pediatrics; Pneumology/Respiratory System; Predictive Value of Tests; Risk Factors; Statistics as Topic; Field studies at high altitude; Acute mountain sickness; Pulse oximetry; Lake Louise Score; Adaptation
• ISSN: 1520-9512; 1522-1709; 1522-1709
• DOI: 10.1007/s11325-015-1195-x

Purpose Commercialization of trekking tourism enables untrained persons to participate in trekking tours. Because hypoxia is one of the main purported triggers for acute mountain sickness (AMS), pulse oximetry, which measures arterial oxygen saturation (SPO 2 ), is discussed to be a possible and useful tool for the diagnosis of AMS. The purpose of this study was to evaluate possible associations between SPO 2 values and the occurrence of AMS. Methods In 204 trekkers, SPO 2 values (pulse oximetry) were measured and the Lake Louise Self-assessment Score (LLS) was administered over the first 7 days of their trekking tours. Results During treks at altitudes of 2500–5500 m in Nepal, India, Africa, and South America, 100 participants suffered from mild AMS, 3 participants suffered from severe AMS, and 9 participants reported both mild and severe AMS. The lowest mean SPO 2 was 85.5 (95 % confidence interval (CI), 83.9–86.1 %) on day 5. SPO 2 and LLS exhibited a weak to moderate negative correlation for all days of the study ( ρ ranging from −0.142 to −0.370). Calculation of time-shifted associations of 24 and 48 h resulted in the disappearance of most associations. Susceptibility to headaches (odds ratio (OR) 2.9–7.2) and a history of AMS (OR 2.2–3.1) were determined to be potential risk factors for the development of AMS. Conclusion Since there is no strong altitude-independent association between AMS and SPO 2 during the first week of high-altitude adaptation, the implementation of pulse oximetry during trekking in order to detect and predict AMS remains questionable.