Prediction of the susceptibility to AMS in simulated altitude.

UNLABELLED: Acute mountain sickness (AMS) develops when rapidly ascending to high altitudes. However, some mountaineers will suffer from AMS even at 2,000 m and others not until 5,000 m. The awareness of the individual susceptibility for AMS would be helpful for preventive strategies. Thus, the main purpose of this paper is the comparison of existing studies dealing with the prediction of AMS susceptibility and to draw conclusions on presently most valuable tests. DATA SOURCE: A PubMed search has been performed, and preliminary observations from our laboratory have been included. The cautious conclusion derived from the reviewed 16 studies is that values of arterial oxygen saturation (SaO(2)), determined 20-30 min after exposure to simulated hypoxia equivalent to 2,300-4,200 m, seem to be the most useful predictors of AMS susceptibility (>80% correct prediction). Because the sympathetic activation during acute exposure to hypoxia may well contribute to the AMS development, parameters like heart rate variability or blood lactate could even enhance this predictability. The ventilatory response to hypoxia is easily trainable by pre-exposures to hypoxia but considers only part of the complex acclimatization process.