High-altitude medicine

ZONE OF KNOWLEDGE

Asthma at high altitudes requires special attention and appropriate medical preparation. Bronchial hypersensitivity at altitude can be triggered by various factors that need to be known and managed.

TRIGGERS OF BRONCHIAL HYPERREACTIVITY

The most important factors include:

➤ Cold – increased breathing of cold air can trigger an asthma attack.

➤ Physical exertion – affects 60–80% of asthmatics; excessive effort should be avoided.

➤ Hypoxia – reduced oxygen content in the air can intensify asthma symptoms.

➤ Decreased humidity – drying of the mucous membranes of the airways causes hyperreactivity.

➤ Reduced air density – affects ease of breathing and may increase bronchial sensitivity.

Bronchospasm at altitude increases hypoxia, which may contribute to the onset of acute mountain sickness (AMS) and high altitude pulmonary edema (HAPE).

ASTHMA AT DIFFERENT ALTITUDES

Up to 2000 m above sea level. – fewer allergens and thinner air make breathing easier, and the risk of infection is lower.

Above 2500 m above sea level. – the air is colder and drier, which increases the risk of exacerbating asthma symptoms.

3500–5000 m above sea level. – the risk of an asthma attack decreases due to the beneficial effects of acclimatization. Higher levels of steroid hormones and lower amounts of allergens alleviate bronchial hypersensitivity. Scientific hypotheses suggest that hypoxia increases sympathetic nervous system activity, which reduces lung response to cold air.

RECOMMENDATIONS FOR ASTHMATICS

➤ Use walks, BUFF-type headbands, and dedicated breathing masks to protect airways from cold air and wind.

➤ Exercise should be moderate, so as not to induce hyperventilation.

➤ Avoid passive altitude gain (cable cars), as acute hypoxia can increase bronchial hypersensitivity.

➤ Protect yourself from upper respiratory infections.

➤ Monitor airway status using PEF (Peak Expiratory Flow).

PREPARATION BEFORE DEPARTURE

➤ If asthma is not stabilized, a trip to the mountains is not advisable.

➤ Those most at risk are asthmatics who need to use inhalers more than 3 times a week and those planning significant exertion at altitude.

➤ Check the validity of vaccinations, including against influenza.

➤ Bring spare inhalers, walks, and steroid medications.

➤ Learn the triggers that cause you shortness of breath and avoid them during your trip.

➤ Gradually increase endurance, starting from light exertion at a low altitude.

ASTHMA AT HIGH ALTITUDE

➤ Always carry all inhalers with you.

➤ Prevent problems – do not overexert yourself, use medications, and if necessary – descend to a lower altitude.

➤ Avoid anti-inflammatory medications, such as aspirin and ibuprofen, which may exacerbate bronchial reactions.

BIBLIOGRAPHY:

• Travel at high altitude – www.medex.org.uk

• Journal of Travel Medicine 2010; Volume 17 (Issue 1): 48–62; K. Mieske et al.; Journeys to High Altitude—Risks and Recommendations for Travelers with Preexisting Medical Conditions

• High Altitude Medicine & Biology 2009, Volume 10, Number 2: 117–121; A. Cogo, G. Fiorenzano; Bronchial Asthma: Advice for Patients Traveling to High Altitude

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DO YOU WANT TO KNOW MORE?

If you want to better prepare health-wise for trekking or high-altitude expeditions, you can find the extended version of the guide in the ebook “High Altitude Medicine in Practice – A Guide for Trekking and Expeditions” >>

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You can also learn practical knowledge about emergency procedures in the mountains in the online training “High Altitude First Aid” >> - designed for those planning trips to high altitudes.

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The detailed contents of the expedition first aid kit and precise instructions for preparing an expedition kit and personal rescue set can be found in the ebook “Expedition First Aid Kit – A Complete Medical Guide” >>

ARE YOU PLANNING A TREKOR A HIGH-ALTITUDE EXPEDITION?

If you want to check if your health condition allows you to safely participate in trekking or high-altitude expeditions, it is advisable to use a medical consultation >> or a telemedicine expedition package >>

This way, you can assess health risks in advance, prepare properly for the trip, and enhance safety while at altitude.

The company was established in 2004. The goal of MedEverest is education in the field of mountain medicine and the dangers of high altitudes. I deal with all medical aspects of staying at high altitude. I organize medical support for trekking and high-altitude expeditions.

Specialist Medical Practice Medeverest Robert Szymczak based in Gdańsk (80-360), at ul. Bolesława Krzywoustego 19F, NIP: 5841943576, REGON: 220148318.

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