BACKGROUND: Little has so far been published on the detection of subjects having acute mauntain sickness (AMS) during high-altitide-trekking. This study was performed to find a practical way or instrument to measure mountaineers at high altitudes who are susceptible of having AMS. METHODS: In 1996 we assesed 6 Trekking-Groups in the Himalaya with a general questionaire and a AMS-score almost similar to the Lake Louise Consensus-Score. One of those Grousps (N=7) was measured three times a day during their 25 days of Trekking using Pulseoximeters, Capnometers, expiratory peak flow- meters and blood pressure watches in altitudes between 2600 and 6100m. RESULTS: Two cases of severe AMS have occured during the Trekking, one of them in the measured Group. The questionaire showed that the subjective AMS- score is a very useful instrument for the Detection of early onset AMS. The measurements of O2-Saturation, ETCO2 and Pulsrate in a subject with severe AMS, who showed the symptoms of a beginning high altitude cerebral edema(HACE), compared with a symptom-free subject showed clear differences during the whole trip. It also showed the value of pulse oximeters in the early detection of AMS. There is a significant korrelation between oxygen-saturation (SaO2, p=0,003), pulse rate (P,p=0,000), peak flow (PEF, p=0,006) and respiratory- rate(AF, p=o,001) and the AMS-score. CONCLUSION: Early detection of AMS is possible only with documentation and evaluation of subjective Symptoms like in the AMS-Score. A very useful method, wich should be possible in every Trekking,to confirm the diagnosis of AMS ore at least a beginning severe AMS like HAPE is to measure the oxygen saturation and the pulse rate with an Oximeter. Peakflowmeters and Capnometers are less useful.
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