Acetazolamide in the Treatment of Acute Mountain Sickness: Clinical Efficacy and Effect on Gas Exchange
- 15 March 1992
- journal article
- clinical trial
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 116 (6) , 461-465
- https://doi.org/10.7326/0003-4819-116-6-461
Abstract
To determine the efficacy of acetazolamide in the treatment of patients with acute mountain sickness and the effect of the drug on pulmonary gas exchange in acute mountain sickness. A randomized, double-blind, placebo-controlled trial. The Denali Medical Research Project high-altitude research station (4200 m) on Mt. McKinley, Alaska. Twelve climbers attempting an ascent of Mt. McKinley (summit, 6150 m) who presented to the medical research station with acute mountain sickness. Climbers were randomly assigned to receive acetazolamide, 250 mg orally, or placebo at 0 (baseline) and 8 hours after inclusion in the study. An assessment of acute mountain sickness using a symptom score and pulmonary gas exchange measurements was done at baseline and at 24 hours. After 24 hours, five of six climbers treated with acetazolamide were healthy, whereas all climbers who received placebo still had acute mountain sickness (P = 0.015). Arterial blood gas specimens were obtained from three of the six acetazolamide recipients and all of the placebo recipients. The alveolar to arterial oxygen pressure difference (PAO2-PaO2 difference) decreased slightly over 24 hours in the acetazolamide group (-0.8 +/- 1.2 mm Hg) but increased in the placebo group (+3.3 +/- 2.3 mm Hg) (P = 0.024). Acetazolamide improved PaO2 over 24 hours (+2.9 +/- 0.8 mm Hg) when compared with placebo (-1.3 +/- 2.8 mm Hg) (P = 0.045). In established cases of acute mountain sickness, treatment with acetazolamide relieves symptoms, improves arterial oxygenation, and prevents further impairment of pulmonary gas exchange.Keywords
This publication has 13 references indexed in Scilit:
- Renal carbonic anhydrase inhibition reduces high altitude sleep periodic breathingRespiration Physiology, 1991
- Dexamethasone in the Treatment of Acute Mountain SicknessNew England Journal of Medicine, 1989
- DISSOCIATION OF RENAL AND RESPIRATORY EFFECTS OF ACETAZOLAMIDE IN THE CRITICALLY ILLBritish Journal of Anaesthesia, 1986
- Prevention of Acute Mountain Sickness by DexamethasoneNew England Journal of Medicine, 1984
- Acute Mountain SicknessSeminars in Respiratory and Critical Care Medicine, 1983
- Acute Mountain Sickness and AcetazolamideJAMA, 1982
- Rales, peripheral edema, retinal hemorrhage and acute mountain sicknessThe American Journal of Medicine, 1979
- The Relationship between Acute Mountain Sickness and Pulmonary Ventilation at 2,835 Meters (9,300 ft)Chest, 1979
- THE INCIDENCE, IMPORTANCE, AND PROPHYLAXIS OF ACUTE MOUNTAIN SICKNESSThe Lancet, 1976
- Acute Mountain SicknessNew England Journal of Medicine, 1969