Does a change in end-tidal carbon dioxide level predict high altitude mountain sickness?

Autor: Thundiyil JG; Orlando Health, Department of Emergency Medicine, United States., Williams AT; Orlando Health, Department of Emergency Medicine, United States., Little I; Orlando Health, Department of Emergency Medicine, United States., Stutsman M; Orlando Health, Department of Emergency Medicine, United States., Ladde JG; Orlando Health, Department of Emergency Medicine, United States., Papa L; Orlando Health, Department of Emergency Medicine, United States.
Jazyk: angličtina
Zdroj: Heliyon [Heliyon] 2023 May 05; Vol. 9 (5), pp. e16000. Date of Electronic Publication: 2023 May 05 (Print Publication: 2023).
DOI: 10.1016/j.heliyon.2023.e16000
Abstrakt: Background: It is postulated that lack of hypoxic ventilatory response is a predictor for AMS. End-tidal carbon dioxide (ETCO 2 ) is an accurate, noninvasive surrogate measure of ventilation.
Objectives: We sought to determine if changes in baseline ETCO 2 predicts the development of AMS.
Methods: This prospective cohort study took place in three separate high-altitude hiking treks. Subjects included a convenience sample of hikers. Predictor variable was change in ETCO 2 levels and outcome variable was AMS. Measurements of ETCO 2 levels were obtained at the base and repeated daily at various elevations and the summit of each hike. Concurrently, hikers were scored for AMS by a trained investigator. We utilized correlation coefficients and developed a linear regression model for analysis.
Results: 21 subjects in 3 separate hikes participated: 10 ascended to 19,341 ft over 7 days, 6 ascended to 8900 ft in 1 day, and 4 ascended to 11,006 ft in 1 day. Mean age was 40 years, 67% were males, mean daily elevation gain was 2150 ft, and 5 hikers developed AMS. The correlation coefficients for ETCO 2 and development of AMS were -0.46 (95%CI -0.33 to -0.57), and -0.77 (95%CI -0.71 to -0.83) for ETCO 2 and altitude. ETCO 2 predicted the development of symptoms better than the elevation with AUCs of 0.90 (95%CI 0.81-0.99) versus 0.64 (95%CI 0.45-0.83). An ETCO 2 measurement of ≤22 mmHg was 100% sensitive and 60% specific for predicting AMS.
Conclusions: ETCO 2 was strongly correlated with altitude and moderately correlated with AMS and it was a better predictor than altitude.
Competing Interests: None of the authors have any financial or personal interests which would be perceived as influencing this work.
(© 2023 The Authors. Published by Elsevier Ltd.)
Databáze: MEDLINE
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