References

Basnyat B. Pro: pulse oximetry is useful in predicting acute mountain sickness. High Alt Med Biol. 2014; (4)440-441 https://doi.org/10.1089/ham.2014.1045

Branch MN, Pennypacker HS. Generality and generalization of research findings. APA handbook of behavior analysis. 2013; 1:151-175 https://doi.org/10.1037/13937-000

Burtscher M, Flatz M, Faulhaber M. Prediction of susceptibility to acute mountain sickness by SaO2 values during short-term exposure to hypoxia. High Alt Med Biol. 2004; 5:(3)335-340 https://doi.org/10.1089/ham.2004.5.335

Chen HC, Lin WL, Wu JY Change in oxygen saturation does not predict acute mountain sickness on Jade Mountain. Wilderness Environ Med. 2012; 23:(2)122-127 https://doi.org/10.1016/j.wem.2012.03.014

Coppel J, Hennis P, Gilbert-Kawai E, Grocott MP. The physiological effects of hypobaric hypoxia versus normobaric hypoxia: a systematic review of crossover trials. Extrem Physiol Med. 2015; 4:(1) https://doi.org/10.1186/s13728-014-0021-6

Faulhaber M, Wille M, Gatterer H, Heinrich D, Burtscher M. Resting arterial oxygen saturation and breathing frequency as predictors for acute mountain sickness development: a prospective cohort study. Sleep Breath. 2014; 18:(3)669-674 https://doi.org/10.1007/s11325-013-0932-2

Fink A. Evaluation fundamentals: insights into program effectiveness, quality, and value.Los Angeles (CA): University of California; 2014

Hackshaw A. Small studies: strengths and limitations. Eur Respir J. 2008; 32:(5)1141-1143 https://doi.org/10.1183/09031936.00136408

Haslam C, Jetten J, Alexander SH. The social cure: identity, health and well-being.London: Psychology Press; 2012

Heale R, Twycross A. Validity and reliability in quantitative studies. Evid Based Nurs. 2015; 18:(3)66-67 https://doi.org/10.1136/eb-2015-102129

Higgins JP, Tuttle T, Higgins JA. Altitude and the heart: is going high safe for your cardiac patient?. Am Heart J. 2010; 159:(1)25-32 https://doi.org/10.1016/j.ahj.2009.10.028

Imray C, Wright A, Subudhi A, Roach R. Acute mountain sickness: pathophysiology, prevention, and treatment. Prog Cardiovasc Dis. 2010; 52:(6)467-484 https://doi.org/10.1016/j.pcad.2010.02.003

High altitude cerebral edema (HACE). 2020. https//www.ncbi.nlm.nih.gov/books/NBK430916/ (accessed 12 August 2021)

Karinen HM, Peltonen JE, Kähönen M, Tikkanen HO. Prediction of acute mountain sickness by monitoring arterial oxygen saturation during ascent. High Alt Med Biol. 2010; 11:(4)325-332 https://doi.org/10.1089/ham.2009.1060

Kayser B, Dumont L, Lysakowski C, Combescure C, Haller G, Tramèr MR. Reappraisal of acetazolamide for the prevention of acute mountain sickness: a systematic review and meta-analysis. High Alt Med Biol. 2012; 13:(2)82-92 https://doi.org/10.1089/ham.2011.1084

Kite ME, Whitley BE. The external validity of research.New York (NY): Routledge; 2018

Leichtfried V, Basic D, Burtscher M, Gothe RM, Siebert U, Schobersberger W. Diagnosis and prediction of the occurrence of acute mountain sickness measuring oxygen saturation—independent of absolute altitude?. Sleep Breath. 2016; 20:(1)435-442 https://doi.org/10.1007/s11325-015-1195-x

LoBiondo-Wood G, Haber J. Chapter 15: Reliability and validity 289–309.St Louise (MO): Elsevier; 2014

Luks AM, Swenson ER. Pulse oximetry at high altitude. High Alt Med Biol. 2011; 12:(2)109-119 https://doi.org/10.1089/ham.2011.0013

Luks AM, Auerbach PS, Freer L Wilderness Medical Society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness Environ Med. 2019; 30:(4S)S3-S18 https://doi.org/10.1016/j.wem.2019.04.006

Millet GP, Faiss R, Pialoux V. Point: hypobaric hypoxia induces different physiological responses from normobaric hypoxia. J Appl Physiol (1985). 2012; 112:(10)1783-1744 https://doi.org/10.1152/japplphysiol.00067.2012

Milner QJW, Mathews GR. An assessment of the accuracy of pulse oximeters. Anaesthesia. 2012; 67:(4)396-401 https://doi.org/10.1111/j.1365-2044.2011.07021.x

Muza SR, Beidleman BA, Fulco CS. Altitude preexposure recommendations for inducing acclimatization. High Alt Med Biol. 2010; 11:(2)87-92 https://doi.org/10.1089/ham.2010.1006

Page MJ, McKenzie JE, Bossuyt PM The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372 https://doi.org/10.1136/bmj.n71

Parahoo K. Nursing research: principles, process and issues.London: Macmillan International Higher Education; 2014

Pedersen T, Nicholson A, Hovhannisyan K, Møller AM, Smith AF, Lewis SR. Pulse oximetry for perioperative monitoring. Cochrane Database Syst Rev. 2014; 2014:(3) https://doi.org/10.1002/14651858.CD002013.pub3

Roach RC, Hackett PH, Oelz O The 2018 Lake Louise acute mountain sickness score. High Alt Med Biol. 2018; 19:(1)4-6 https://doi.org/10.1089/ham.2017.0164

Ross EM, Matteucci MJ, Shepherd M, Barker M, Orr L. Measuring arterial oxygenation in a high altitude field environment: comparing portable pulse oximetry with blood gas analysis. Wilderness Environ Med. 2013; 24:(2)112-117 https://doi.org/10.1016/j.wem.2012.11.009

Shen G, Xie K, Yan Y The role of oxygen-increased respirator in humans ascending to high altitude. Biomed Eng Online. 2012; 11:(1)

Swenson ER, Bärtsch P. High altitude.New York (NY): Springer-Verlag; 2016

Tannheimer M, Lechner R. The correct measurement of oxygen saturation at high altitude. Sleep Breath. 2019; 23:(4)1101-1106 https://doi.org/10.1007/s11325-019-01784-9

Wagner DR, Teramoto M, Knott JR, Fry JP. Comparison of scoring systems for assessment of acute mountain sickness. High Alt Med Biol. 2012; 13:(4)245-251 https://doi.org/10.1089/ham.2012.1030

Pulse oximetry to predict the onset of acute mountain sickness: a literature review

02 September 2021
Volume 13 · Issue 9

Abstract

Acute mountain sickness (AMS) is a common illness affecting people ascending to high altitudes. AMS may progress rapidly, and can be fatal if symptoms are neglected, acclimatisation processes fail or if the ascent continues. For many patients with AMS or AMS symptoms, medical assistance is given by mountain rescue and allied health professionals. Currently, the prediction of AMS in the high-altitude environment relies upon recognising and tracking subjective symptoms. However, owing to psychophysical factors commonly associated with high-altitude travel, such as stress and fatigue, subjective symptom recall is innately at risk of bias. There is no objective method for predicting AMS. This scoping literature review analyses the accuracy of pulse oximetry as a tool for predicting the onset of AMS.

Travelling to high-altitude regions ≥2500 m above sea level requires physiological adaption and acclimatisation to a lower partial pressure of oxygen (Higgins et al, 2010; Shen et al, 2012). If adaption processes fail owing to rapid ascent or exceptional physiological characteristics (e.g. chronic obstructive pulmonary disease (COPD), heart failure), individuals are at risk of acute mountain sickness (AMS) and the development of high-mortality illnesses including high-altitude cerebral oedema and pulmonary oedema (Higgins et al, 2010; Imray et al, 2010; Jensen and Vincent, 2020).

Globally, AMS affects between 40% and 90% of unacclimatised individuals ascending over 500 m per day to altitudes between 4500 m and 6000 m (Muza et al, 2010; Kayser et al, 2012). AMS symptoms commonly include headache, loss of appetite, nausea, dizziness, insomnia and lassitude, and regularly present 4–12 hours after arrival at the high-altitude location (Luks et al, 2019; Swenson and Bärtsch, 2016). Importantly, AMS symptoms resolve with descent or supplementary oxygen (Higgins et al, 2010; Jensen and Vincent, 2018).

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