Prevention of Acute Mountain Sickness by Acetazolamide in Nepali Porters: A Double-Blind Controlled Trial

Hillenbrand, Peter; Pahari, Anil; Soon, Yuen; Subedi, Deepak; Bajracharya, Rajan; Gurung, Puncho; Lal, Barun K.; Marahatta, Ramesh; Pradhan, Santosh; Rai, Dilip; Sharma, Shailendra

doi:10.1580/1080-6032-17.2.87

Cited by 28 publications

(15 citation statements)

References 8 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is surprising, since a recent study of porters in the Khumbu found lowland porters to be at increased risk of AMS compared with highlanders (Hillenbrandt, 2006), and it might be expected that the same would be true of HAPE. All the high altitude residents in our series had previously traveled as high as or higher than the maximum altitudes attained during their HAPE episodes.…”

Section: Discussionmentioning

confidence: 94%

Treatment of High Altitude Pulmonary Edema at 4240 m in Nepal

Fagenholz

Gutman

Murray

et al. 2007

High Altitude Medicine & Biology

View full text Add to dashboard Cite

High altitude pulmonary edema (HAPE) is the leading cause of death from altitude illness and rapid descent is often considered a life-saving foundation of therapy. Nevertheless, in the remote settings where HAPE often occurs, immediate descent sometimes places the victim and rescuers at risk. We treated 11 patients (7 Nepalese, 4 foreigners) for HAPE at the Himalayan Rescue Association clinic in Pheriche, Nepal (4240 m), from March 3 to May 14, 2006. Ten were admitted and primarily treated there. Seven of these (6 Nepalese, 1 foreigner) had serious to severe HAPE (Hultgren grades 3 or 4). Bed rest, oxygen, nifedipine, and acetazolamide were used for all patients. Sildenafil and salmeterol were used in most, but not all patients. The duration of stay was 31 +/- 16 h (range 12 to 48 h). Oxygen saturation was improved at discharge (84% +/- 1.7%) compared with admission (59% +/- 11%), as was ultrasound comet-tail score (11 +/- 4 at discharge vs. 33 +/- 8.6 at admission), a measure of pulmonary edema for which admission and discharge values were obtained in 7 patients. We conclude it is possible to treat even serious HAPE at 4240 m and discuss the significance of the predominance of Nepali patients seen in this series.

show abstract

Section: Discussionmentioning

confidence: 94%

Treatment of High Altitude Pulmonary Edema at 4240 m in Nepal

Fagenholz

Gutman

Murray

et al. 2007

High Altitude Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…After two study authors independently assessed the full text articles we excluded from the review 10 of the studies4 21 32 33 34 35 36 37 38 39 included in the second of the published reviews31 (see supplementary table 1 for reasons for exclusion). Our inclusion criteria specified that trials were required to randomise participants to either acetazolamide or placebo.…”

Section: Discussionmentioning

confidence: 99%

“…This was not, however, a specific requirement of the second review, and one study32 was included where all participants were given acetazolamide for three days before being randomised to intervention or placebo groups. We excluded trials that were not blinded,4 used hypobaric chambers to simulate ascent to altitude,38 or included the indigenous population (owing to the likelihood of acclimatisation) 37. One study included in the systematic review and meta-analysis by Kayser et al31 was excluded from our review because the same participants took part in both the intervention and placebo groups during two different ascents, and these were then compared with each other 40.…”

Section: Discussionmentioning

confidence: 99%

Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis

Low

Avery

Gupta

et al. 2012

BMJ

View full text Add to dashboard Cite

Objectives To assess the efficacy of three different daily doses of acetazolamide in the prevention of acute mountain sickness and to determine the lowest effective dose.Design Systematic review and meta-analysis. Data sourcesMedline and Embase along with a hand search of selected bibliographies. No language restrictions were applied. Study selectionRandomised controlled trials assessing the use of acetazolamide at 250 mg, 500 mg, or 750 mg daily versus placebo in adults as a drug intervention for the prophylaxis of acute mountain sickness. Included studies were required to state the administered dose of acetazolamide and to randomise participants before ascent to either acetazolamide or placebo. Two reviewers independently carried out the selection process.Data extraction Two reviewers extracted data concerning study methods, pharmacological intervention with acetazolamide, method of assessment of acute mountain sickness, and event rates in both control and intervention groups, which were verified and analysed by the review team collaboratively.Data synthesis 11 studies (with 12 interventions arms) were included in the review. Acetazolamide at doses of 250 mg, 500 mg, and 750 mg were all effective in preventing acute mountain sickness above 3000 m, with a combined odds ratio of 0.36 (95% confidence interval 0.28 to 0.46). At a dose of 250 mg daily the number needed to treat for acetazolamide to prevent acute mountain sickness was 6 (95% confidence interval 5 to 11). Heterogeneity ranged from I 2 =0% (500 mg subgroup) to I 2 =44% (750 mg subgroup).Conclusions Acetazolamide in doses of 250 mg, 500 mg, and 750 mg daily are all more effective than placebo for preventing acute mountain sickness. Acetazolamide 250 mg daily is the lowest effective dose to prevent acute mountain sickness for which evidence is available.

show abstract

“…Subjects on prophylaxis received one 125 mg acetazolamide tablet to be taken twice a day (35) .The dosage schedule was decided after consulting previous studies (33,34,35,3,4,5,6,19) . Tablets were administered by an appointed person who ensured the timely intake of tablets.…”

Section: Acetazolamide Regimenmentioning

confidence: 99%

Pen Paper & A Pulse Oxymeter: Prospective Study of the Effect Acetazolamide Have in Quick Trans-Himalayan Acescent

Mbbs¹

2017

jmscr

View full text Add to dashboard Cite

Prevention of Acute Mountain Sickness by Acetazolamide in Nepali Porters: A Double-Blind Controlled Trial

Cited by 28 publications

References 8 publications

Treatment of High Altitude Pulmonary Edema at 4240 m in Nepal

Treatment of High Altitude Pulmonary Edema at 4240 m in Nepal

Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness: systematic review and meta-analysis

Pen Paper & A Pulse Oxymeter: Prospective Study of the Effect Acetazolamide Have in Quick Trans-Himalayan Acescent

Contact Info

Product

Resources

About