Skip to main content

2019 | OriginalPaper | Buchkapitel

45. Akute Höhenkrankheit

verfasst von : Dr. med. W. Schaffert

Erschienen in: Alpin- und Höhenmedizin

Verlag: Springer Berlin Heidelberg

Zusammenfassung

In diesem Kapitel über die akute Höhenkrankheit (AMS) soll versucht werden, praxisrelevante und allgemeinverständliche Handlungsempfehlungen zu vermitteln, die eine deutliche Risikoreduktion und einen beschwerdefreien Aufstieg in große und extreme Höhen erlauben. Gerade in unserer modernen Leistungsgesellschaft, in der offensichtlich der schnelle Erfolg allzu häufig unser Handeln bestimmt und umgekehrt Freizeit zum kostbaren Gut erklärt wird, geraten wir beim Höhenbergsteigen in einen nahezu unlösbaren Interessenkonflikt. Darüber soll in diesem Kapitel auch durchaus kontrovers berichtet werden.
Literatur
Zurück zum Zitat Ayus JC, Moritz ML (2008) Exercise-associated hyponatremia masqerading as acute mountain sickness: are we missing the diagnosis? Clin J Sport Med 18:383–386CrossRef Ayus JC, Moritz ML (2008) Exercise-associated hyponatremia masqerading as acute mountain sickness: are we missing the diagnosis? Clin J Sport Med 18:383–386CrossRef
Zurück zum Zitat Bailey DM, Bärtsch P, Knauth M, Baumartner RW (2009a) Emerging concepts in acute mountain sickness and high altitude cerebral edema: form the molecular to the morphological. Cell Mol Life Sci 66: 3583–3594CrossRef Bailey DM, Bärtsch P, Knauth M, Baumartner RW (2009a) Emerging concepts in acute mountain sickness and high altitude cerebral edema: form the molecular to the morphological. Cell Mol Life Sci 66: 3583–3594CrossRef
Zurück zum Zitat Bailey DM, Taudorf S, Berg RM et al (2009b) Increased cerebral output of free radicals during hypoxia: implications for acute mountain sickness? Am J Physiol Regul Integr Comp Physiol 297: R 1238–1292CrossRef Bailey DM, Taudorf S, Berg RM et al (2009b) Increased cerebral output of free radicals during hypoxia: implications for acute mountain sickness? Am J Physiol Regul Integr Comp Physiol 297: R 1238–1292CrossRef
Zurück zum Zitat Basnyat B, Lemaster J, Litch JA (1999) Everest or bust: a cross sectional, epidemiological study of acute mountain sickness at 4243 m in the Himalayas. Aviat Space Environ Med 70:867–873 Basnyat B, Lemaster J, Litch JA (1999) Everest or bust: a cross sectional, epidemiological study of acute mountain sickness at 4243 m in the Himalayas. Aviat Space Environ Med 70:867–873
Zurück zum Zitat Basnyat B, Gertsch JH, Holck PS et al (2006) Acetazolamide 125 mg BD is not significantly different from 375 mg BD in the pevention of acute mountain sickness: the prophylactic acetazolamide dosage comparison for efficacy trial. High Alt Med Biol 7:17–27 Basnyat B, Gertsch JH, Holck PS et al (2006) Acetazolamide 125 mg BD is not significantly different from 375 mg BD in the pevention of acute mountain sickness: the prophylactic acetazolamide dosage comparison for efficacy trial. High Alt Med Biol 7:17–27
Zurück zum Zitat Bloch KE, Turk AJ, Maggiorini M et al (2009) Effect of ascent protocol on acute mountain sickness and success at Muztagh Ata, 7546 m. High Alt Med Biol 10:25–32CrossRef Bloch KE, Turk AJ, Maggiorini M et al (2009) Effect of ascent protocol on acute mountain sickness and success at Muztagh Ata, 7546 m. High Alt Med Biol 10:25–32CrossRef
Zurück zum Zitat Davies AJ, Kalson NS, Stokes S et al (2009) Determinants of summiting success and acute mountain sickness on Mt Kilimajaro 5895 m. Wilderness Environ Med 20:311–317CrossRef Davies AJ, Kalson NS, Stokes S et al (2009) Determinants of summiting success and acute mountain sickness on Mt Kilimajaro 5895 m. Wilderness Environ Med 20:311–317CrossRef
Zurück zum Zitat De Acosta I (1590) Historia natural y moral de las Indias, Lib 3, Cap. 9. luan de Leon, Seville De Acosta I (1590) Historia natural y moral de las Indias, Lib 3, Cap. 9. luan de Leon, Seville
Zurück zum Zitat Dumont L, Mardirosoff C, Tramer MR (2000) Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review. BMJ 321:267–272CrossRef Dumont L, Mardirosoff C, Tramer MR (2000) Efficacy and harm of pharmacological prevention of acute mountain sickness: quantitative systematic review. BMJ 321:267–272CrossRef
Zurück zum Zitat Ellsworth AJ, Meyer EF, Larson EB (1991) Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier. West J Med 154:289–293 Ellsworth AJ, Meyer EF, Larson EB (1991) Acetazolamide or dexamethasone use versus placebo to prevent acute mountain sickness on Mount Rainier. West J Med 154:289–293
Zurück zum Zitat Ferrazzini G, Maggiorini M, Friemler S et al (1987) Successful treatment of acute mountain sickness with dexamethasone. BMJ 294:1380–1382CrossRef Ferrazzini G, Maggiorini M, Friemler S et al (1987) Successful treatment of acute mountain sickness with dexamethasone. BMJ 294:1380–1382CrossRef
Zurück zum Zitat Fitch RF (1964) Mountain sickness: a cerebral form. Ann Intern Med 60:871–876CrossRef Fitch RF (1964) Mountain sickness: a cerebral form. Ann Intern Med 60:871–876CrossRef
Zurück zum Zitat Hackett PH, Roach RC, Wood RA et al (1988) Dexamethasone for prevention and treatment of acute montain sickness. Aviat Space Environ Med 59: 950–954 Hackett PH, Roach RC, Wood RA et al (1988) Dexamethasone for prevention and treatment of acute montain sickness. Aviat Space Environ Med 59: 950–954
Zurück zum Zitat Hackett PH, Roach RC (2001) Current concepts: high-altitude illness. N Engl J Med 345:107–114CrossRef Hackett PH, Roach RC (2001) Current concepts: high-altitude illness. N Engl J Med 345:107–114CrossRef
Zurück zum Zitat Hackett PH, Rennie D (1979) Rales, peripheral edema, retinal hemorrhage and acute mountain sickness. Am J Med 67:214–218CrossRef Hackett PH, Rennie D (1979) Rales, peripheral edema, retinal hemorrhage and acute mountain sickness. Am J Med 67:214–218CrossRef
Zurück zum Zitat Houston, CS (1960) Acute pulmonary edema of high altitude. N Engl J Med 263:478–480CrossRef Houston, CS (1960) Acute pulmonary edema of high altitude. N Engl J Med 263:478–480CrossRef
Zurück zum Zitat Houston, CS, Dickinson J (1975) Cerebral form of high-altitude illness. Lancet 2:758–761CrossRef Houston, CS, Dickinson J (1975) Cerebral form of high-altitude illness. Lancet 2:758–761CrossRef
Zurück zum Zitat Hultgren H, Spickard W (1960) Medical experiences in Peru. Stanford Med Bull 18:97–98 Hultgren H, Spickard W (1960) Medical experiences in Peru. Stanford Med Bull 18:97–98
Zurück zum Zitat Kallenberg K, Bailey FM, Christ S et al (2007) Magnetic resonance imaging evidence of cytotoxic cerebral edema in acute mountain sickness. J Cereb Blood Flow Metab 27:1064–1071 Kallenberg K, Bailey FM, Christ S et al (2007) Magnetic resonance imaging evidence of cytotoxic cerebral edema in acute mountain sickness. J Cereb Blood Flow Metab 27:1064–1071
Zurück zum Zitat Kalson NS, Thompson J, Davie AJ et al (2009) The effect of angiotensin-converting enzyme genotype on acute mountain sickness and summit success in trekkers attempting the summit of Mt. Kilimanjaro 5895 m. Eur J Appl Physiol 105:373–379CrossRef Kalson NS, Thompson J, Davie AJ et al (2009) The effect of angiotensin-converting enzyme genotype on acute mountain sickness and summit success in trekkers attempting the summit of Mt. Kilimanjaro 5895 m. Eur J Appl Physiol 105:373–379CrossRef
Zurück zum Zitat Karinen H, Peltonen J, Tikkanen H (2008) Prevalence of acute mountain sickness among Finnish trekkers on Mount Kilimanjaro, Tanzania: an observational study. High Alt Med Biol 9:301–306CrossRef Karinen H, Peltonen J, Tikkanen H (2008) Prevalence of acute mountain sickness among Finnish trekkers on Mount Kilimanjaro, Tanzania: an observational study. High Alt Med Biol 9:301–306CrossRef
Zurück zum Zitat Kayser B, Dumont L, Lysakowski C et al (2012) Reappraisal of acetazolamide for the prevention of acute mountain sickness: a systematic review and meta-analysis. High Alt Med Biol 13:82–92CrossRef Kayser B, Dumont L, Lysakowski C et al (2012) Reappraisal of acetazolamide for the prevention of acute mountain sickness: a systematic review and meta-analysis. High Alt Med Biol 13:82–92CrossRef
Zurück zum Zitat Kim JW, Tchernyshyov I, Semenza GL et al (2006) HIF-1-mediated expression of pyruvate dehydrogenase kinase: a metabolic switch required for cellular adaptation to hypoxia. Cell Metab 3:177–185CrossRef Kim JW, Tchernyshyov I, Semenza GL et al (2006) HIF-1-mediated expression of pyruvate dehydrogenase kinase: a metabolic switch required for cellular adaptation to hypoxia. Cell Metab 3:177–185CrossRef
Zurück zum Zitat Levine BD, Yoshimura K, Kobayashi T et al (1989) Dexamethasone in the treatment of acute mountain sickness. N Engl J Med 321:1707–1713CrossRef Levine BD, Yoshimura K, Kobayashi T et al (1989) Dexamethasone in the treatment of acute mountain sickness. N Engl J Med 321:1707–1713CrossRef
Zurück zum Zitat Luks AM, Swenson ER (2008) Medication and dosage considerations in the prophylaxis and treatment of high-altitude illness. Chest 133:744–755CrossRef Luks AM, Swenson ER (2008) Medication and dosage considerations in the prophylaxis and treatment of high-altitude illness. Chest 133:744–755CrossRef
Zurück zum Zitat Luks AM, McIntosh SE, Grissom CK et al. (2010) Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med 21:146–155CrossRef Luks AM, McIntosh SE, Grissom CK et al. (2010) Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med 21:146–155CrossRef
Zurück zum Zitat Maggiorini M, Muller A, Hofstetter D et al (1998) Assessment of acute mountain sickness by different score protocols in the Swiss Alps. Aviat Space Environ Med 69:1186–1192 Maggiorini M, Muller A, Hofstetter D et al (1998) Assessment of acute mountain sickness by different score protocols in the Swiss Alps. Aviat Space Environ Med 69:1186–1192
Zurück zum Zitat Murdoch DR (1999) How fast is too fast? Attempts to define a recommended ascent rate to prevent acute mountain sickness. ISMM Newsletter 9:3–6 Murdoch DR (1999) How fast is too fast? Attempts to define a recommended ascent rate to prevent acute mountain sickness. ISMM Newsletter 9:3–6
Zurück zum Zitat Pesce C, Leal C, Pinto H et al (2005) Determinants of acute mountain sickness and success on Mount Aconcagua 6962 m. High Alt Med Biol 6:158–166CrossRef Pesce C, Leal C, Pinto H et al (2005) Determinants of acute mountain sickness and success on Mount Aconcagua 6962 m. High Alt Med Biol 6:158–166CrossRef
Zurück zum Zitat Ravenhill TH (1913) Some experience of mountain sickness in the Andes. J Trop Med Hyg 16:313–320 Ravenhill TH (1913) Some experience of mountain sickness in the Andes. J Trop Med Hyg 16:313–320
Zurück zum Zitat Richalet JP, Larmignat P, Poitrine E et al (2011) Physiological risk factors of severe high altitude illness: a prospective cohort study. Am J Respir Crit Care Med 185:192–198 Richalet JP, Larmignat P, Poitrine E et al (2011) Physiological risk factors of severe high altitude illness: a prospective cohort study. Am J Respir Crit Care Med 185:192–198
Zurück zum Zitat Richardson A, Wat P, Maxwell N (2009) Hydration and the physiological responses to acute normobaric hypoxia. Wilderness Environ Med 20:212–220CrossRef Richardson A, Wat P, Maxwell N (2009) Hydration and the physiological responses to acute normobaric hypoxia. Wilderness Environ Med 20:212–220CrossRef
Zurück zum Zitat Roach RC, Bärtsch P, Hackett PH, Oelz O (1993) The Lake Louise acute mountain sickness scoring system. In: Sutton JR, Houston CS, Coates G (Hrsg) Hypoxia and mountain medicine. Queen City Printers, Burlington, VT, S 272–274 Roach RC, Bärtsch P, Hackett PH, Oelz O (1993) The Lake Louise acute mountain sickness scoring system. In: Sutton JR, Houston CS, Coates G (Hrsg) Hypoxia and mountain medicine. Queen City Printers, Burlington, VT, S 272–274
Zurück zum Zitat Roach RC, Maes D, Sandoval D et al (2000) Exercise exacerbates acute mountain sickness at simulated high altitude. J Appl Physiol 88:581–585CrossRef Roach RC, Maes D, Sandoval D et al (2000) Exercise exacerbates acute mountain sickness at simulated high altitude. J Appl Physiol 88:581–585CrossRef
Zurück zum Zitat Schneider M, Bernasch D, Weymann J et al (2002) Acute mountain sickness: influence of susceptibility, preexposure, and ascent rate. Med Sci Sports Exerc 34:1886–1891CrossRef Schneider M, Bernasch D, Weymann J et al (2002) Acute mountain sickness: influence of susceptibility, preexposure, and ascent rate. Med Sci Sports Exerc 34:1886–1891CrossRef
Zurück zum Zitat Schoonmann GG, Sandor PS, Nirkko AC et al (2008) Hypoxia-induced acute mountain sickness is associated with intracellular cerebral edema: a 3 T magnetic resonance imaging study. J Cereb Blood Flow Metab 28:198–206CrossRef Schoonmann GG, Sandor PS, Nirkko AC et al (2008) Hypoxia-induced acute mountain sickness is associated with intracellular cerebral edema: a 3 T magnetic resonance imaging study. J Cereb Blood Flow Metab 28:198–206CrossRef
Zurück zum Zitat Silber E, Sonnenberg P, Collier DJ et al (2003) Clinical features of headache at altitude: a prospective study. Neurology 60:1167–1171CrossRef Silber E, Sonnenberg P, Collier DJ et al (2003) Clinical features of headache at altitude: a prospective study. Neurology 60:1167–1171CrossRef
Zurück zum Zitat Swenson ER, Teppema LJ (2007) Prevention of acute mountain sickness by acetazolamide: as yet an unfinished sotroy. J Appl Physiol 102:1305–1307CrossRef Swenson ER, Teppema LJ (2007) Prevention of acute mountain sickness by acetazolamide: as yet an unfinished sotroy. J Appl Physiol 102:1305–1307CrossRef
Zurück zum Zitat Van Osta A, Moraine JJ, Melot C et al (2005) Effects of high altitude exposure on cerebral hemodynamics in normal subjects. Stroke 36:557–560CrossRef Van Osta A, Moraine JJ, Melot C et al (2005) Effects of high altitude exposure on cerebral hemodynamics in normal subjects. Stroke 36:557–560CrossRef
Zurück zum Zitat Wang P, Koehle MS, Rupert JL (2010) No association between alleles of the bradykinin receptor-B2 gene and acute mountain sickness. Exp Biol Med 235: 737–740CrossRef Wang P, Koehle MS, Rupert JL (2010) No association between alleles of the bradykinin receptor-B2 gene and acute mountain sickness. Exp Biol Med 235: 737–740CrossRef
Zurück zum Zitat West JB, Lahiri S, Gill MB et al (1962) Arterial oxygen saturation during exercise at high altitude. J Appl Physiol 17:617–621CrossRef West JB, Lahiri S, Gill MB et al (1962) Arterial oxygen saturation during exercise at high altitude. J Appl Physiol 17:617–621CrossRef
Zurück zum Zitat West JB (1996) T.H. Ravenhill and his contributions to mountain sickness. J Appl Physiol 80:715–724CrossRef West JB (1996) T.H. Ravenhill and his contributions to mountain sickness. J Appl Physiol 80:715–724CrossRef
Zurück zum Zitat West JB (1998) High life: a history of high-altitude physiology and medicine. Oxford University Press, New York West JB (1998) High life: a history of high-altitude physiology and medicine. Oxford University Press, New York
Zurück zum Zitat West JB (2004) The physiologic basis of high-altitude disease. Ann Intern Med 141:789–800CrossRef West JB (2004) The physiologic basis of high-altitude disease. Ann Intern Med 141:789–800CrossRef
Zurück zum Zitat West JB (2011) Con: Headache should not be a required symptom for the diagnosis of acute mountain sickness. High Alt Med Biol 12:23–25; discussion 27CrossRef West JB (2011) Con: Headache should not be a required symptom for the diagnosis of acute mountain sickness. High Alt Med Biol 12:23–25; discussion 27CrossRef
Zurück zum Zitat Wilson DF, Roy A, Lahiri S (2005) Immediate and long-term responses of the carotid body to high altitude. High Alt Med Biol 6:97–111CrossRef Wilson DF, Roy A, Lahiri S (2005) Immediate and long-term responses of the carotid body to high altitude. High Alt Med Biol 6:97–111CrossRef
Zurück zum Zitat Wu TY, Ding SQ, Liu JL et al (2009) Reduced incidence and severity of acute mountain sickness in Qinghai-Tibet railroad construction workers after repeated 7-month exposures despite 5-month low altitude periods. High Alt Med Biol 10:221–232 Wu TY, Ding SQ, Liu JL et al (2009) Reduced incidence and severity of acute mountain sickness in Qinghai-Tibet railroad construction workers after repeated 7-month exposures despite 5-month low altitude periods. High Alt Med Biol 10:221–232
Zurück zum Zitat Wu TY, Ding SQ, Zhang SL et al (2010) Altitude illness in Qinghai-Tibet railroad passengers. High Alt Med Biol 11:189–198CrossRef Wu TY, Ding SQ, Zhang SL et al (2010) Altitude illness in Qinghai-Tibet railroad passengers. High Alt Med Biol 11:189–198CrossRef
Metadaten
Titel
Akute Höhenkrankheit
verfasst von
Dr. med. W. Schaffert
Copyright-Jahr
2019
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-56396-0_45

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.