Acute mountain sickness symptom severity at the South Pole: The influence of self-selected prophylaxis with acetazolamide

Michael F. Harrison, Paul J. Anderson, Jacob B. Johnson, Maile Richert, Andrew D. Miller, Bruce David Johnson

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Abstract

Introduction Acetazolamide, a carbonic anhydrase inhibitor, remains the only FDA approved pharmaceutical prophylaxis for acute mountain sickness (AMS) though its effectiveness after rapid transport in real world conditions is less clear. Methods Over 2 years, 248 healthy adults traveled by airplane from sea level (SL) to the South Pole (ALT, ~3200m) and 226 participants provided Lake Louise Symptom Scores (LLSS) on a daily basis for 1 week; vital signs, blood samples, and urine samples were collected at SL and at ALT. Acetazolamide was available to any participant desiring prophylaxis. Comparisons were made between the acetazolamide with AMS (ACZ/AMS) (n = 42), acetazolamide without AMS (ACZ/No AMS)(n = 49), no acetazolamide with AMS (No ACZ/AMS) (n = 56), and the no acetazolamide without AMS (No ACZ/No AMS) (n = 79) groups. Statistical analysis included Chisquared and one-way ANOVA with Bonferroni post-hoc tests. Significance was p2Sat) at ALT. No significant differences were found in serum electrolyte concentrations or PFT results. Discussion Acetazolamide during rapid ascent provided no apparent protection from AMS based on LLSS. However, it is unclear if this lack of effect was directly associated with the drug or if perhaps there was some selection bias with individuals taking ACZ more likely to have symptoms or if there may have been more of perceptual phenomenon related to a constellation of side effects.

Original languageEnglish (US)
Article numbere0148206
JournalPLoS One
Volume11
Issue number2
DOIs
StatePublished - Feb 1 2016

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ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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