Controlled Hyperventilation as Prophylaxis for Acute Mountain Sickness

NCT ID: NCT02972411

Last Updated: 2016-11-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-31

Study Completion Date

2017-05-31

Brief Summary

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This study evaluates the safety and efficacy of the voluntary ventilatory response as prophylaxis for acute mountain sickness, measured by the Lake Louise Self-Report Score, comparing to a group using acetazolamide.

Detailed Description

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Rationale: Acute mountain sickness (AMS) is a common condition among people who go to altitude and stay at altitude. Acclimatization is the most important mechanism in order to reduce the risk of AMS, however, this is not possible or adequate in a large part of the cases. Recently, there are indications that adjustment of respiration by means of a voluntary increase in the respiratory minute volume can have a similar prophylactic effect. The purpose of this study is to measure the effect of the voluntary increase of the minute volume by means of controlled hyperventilation as prophylaxis for acute mountain sickness without prior acclimatization, with AMS being expressed in the Lake Louise Self-Report Score (LLSRS).

Objective: To investigate the safety and efficacy of the voluntary increase in minute ventilation by means of controlled hyperventilation as prophylaxis for AMS, measured by the LLSRS in a randomized controlled trial ascending to 4954m altitude.

Study design: Prospective randomized controlled trial, safety and efficacy.

Study population: 30 healthy subjects

Intervention: The investigational prophylaxis is controlled hyperventilation. Participants in the interventional group will be trained to hyperventilate in a controlled fashion doing a series of exercises during the 4 days prior to the ascent. They will also be taught in a practical way to recognize early clinical signs and symptoms of hypocapnia.

Main study parameters/endpoints: Safety and efficacy measured by comparing the LLSRS between the two groups. Target end-tidal CO2 ( PETCO2) will be measured to objectify adequate hyperventilation. Symptoms of hypocapnia due to the (pre-)intervention as well as any adverse events will be reported and analysed.

Conditions

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Altitude Sickness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Intervention

Voluntary increase in respiration

Group Type EXPERIMENTAL

Voluntary ventilatory response

Intervention Type BEHAVIORAL

Training of the subjects for voluntary increase in the respiratory minute ventilation

Acetazolamide

Administration of Acetazolamide 125mg. since 24 hours before ascent and until 48 hours post altitude exposure, and absence of altitude sickness symptoms

Group Type ACTIVE_COMPARATOR

Acetazolamide

Intervention Type DRUG

Acetazolamide 125mg. PO every 12 hours since 24 hours before ascent, until 48 hours at high altitude

Interventions

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Voluntary ventilatory response

Training of the subjects for voluntary increase in the respiratory minute ventilation

Intervention Type BEHAVIORAL

Acetazolamide

Acetazolamide 125mg. PO every 12 hours since 24 hours before ascent, until 48 hours at high altitude

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Living at lower altitude than 900 meters

Exclusion Criteria

* Cardiac or pulmonary comorbidity
* Smoking
* Infectious disease during the last 30 days
* BMI\> 30
* Pharmaceutical use as diuretics, corticosteroids, acetazolamide, or anti -inflammatory drugs during the 2 weeks prior to the study
* A history of high altitude cerebral edema or high altitude pulmonary edema
* Cardiovascular risk factors such as a personal history of cardiovascular disease, familial history of major adverse cardiovascular events (MACE) at age younger than 45 yrs, hypercholesterolemia and stroke.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hospital del Trabajador de Santiago

OTHER

Sponsor Role lead

Responsible Party

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Sebastián Drago Pérez

Orthopaedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sebastián Drago, MD

Role: PRINCIPAL_INVESTIGATOR

Hospital del Trabajador Santiago

Locations

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110 Sports and health center

Santiago, , Chile

Site Status RECRUITING

Countries

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Chile

Central Contacts

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Sebastián Drago, MD

Role: CONTACT

Phone: +56992191310

Email: [email protected]

Juan Campodónico, MD

Role: CONTACT

Phone: +56981379351

Email: [email protected]

Facility Contacts

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Mario Sandoval, MD

Role: primary

References

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Bartsch P, Swenson ER. Clinical practice: Acute high-altitude illnesses. N Engl J Med. 2013 Jun 13;368(24):2294-302. doi: 10.1056/NEJMcp1214870.

Reference Type BACKGROUND
PMID: 23758234 (View on PubMed)

Buijze GA, Hopman MT. Controlled hyperventilation after training may accelerate altitude acclimatization. Wilderness Environ Med. 2014 Dec;25(4):484-6. doi: 10.1016/j.wem.2014.04.009. Epub 2014 Oct 14. No abstract available.

Reference Type BACKGROUND
PMID: 25443751 (View on PubMed)

Luks AM, McIntosh SE, Grissom CK, Auerbach PS, Rodway GW, Schoene RB, Zafren K, Hackett PH; Wilderness Medical Society. Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med. 2010 Jun;21(2):146-55. doi: 10.1016/j.wem.2010.03.002. Epub 2010 Mar 10.

Reference Type BACKGROUND
PMID: 20591379 (View on PubMed)

Richalet JP, Larmignat P, Poitrine E, Letournel M, Canoui-Poitrine F. Physiological risk factors for severe high-altitude illness: a prospective cohort study. Am J Respir Crit Care Med. 2012 Jan 15;185(2):192-8. doi: 10.1164/rccm.201108-1396OC. Epub 2011 Oct 27.

Reference Type BACKGROUND
PMID: 22071330 (View on PubMed)

Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010 Jun 1;152(11):726-32. doi: 10.7326/0003-4819-152-11-201006010-00232. Epub 2010 Mar 24.

Reference Type BACKGROUND
PMID: 20335313 (View on PubMed)

Vargas M, Osorio J, Jimenez D, Moraga F, Sepulveda M, Del Solar J, Hudson C, Cortes G, Leon A. [Acute mountain sickness at 3500 and 4250 m. A study of symptom, incidence and severity]. Rev Med Chil. 2001 Feb;129(2):166-72. Spanish.

Reference Type BACKGROUND
PMID: 11351468 (View on PubMed)

Acetazolamide in control of acute mountain sickness. Lancet. 1981 Jan 24;1(8213):180-3.

Reference Type BACKGROUND
PMID: 6109857 (View on PubMed)

Bernardi L, Passino C, Spadacini G, Bonfichi M, Arcaini L, Malcovati L, Bandinelli G, Schneider A, Keyl C, Feil P, Greene RE, Bernasconi C. Reduced hypoxic ventilatory response with preserved blood oxygenation in yoga trainees and Himalayan Buddhist monks at altitude: evidence of a different adaptive strategy? Eur J Appl Physiol. 2007 Mar;99(5):511-8. doi: 10.1007/s00421-006-0373-8. Epub 2007 Jan 6.

Reference Type BACKGROUND
PMID: 17206440 (View on PubMed)

Bernardi L, Schneider A, Pomidori L, Paolucci E, Cogo A. Hypoxic ventilatory response in successful extreme altitude climbers. Eur Respir J. 2006 Jan;27(1):165-71. doi: 10.1183/09031936.06.00015805.

Reference Type BACKGROUND
PMID: 16387950 (View on PubMed)

Moore LG, Harrison GL, McCullough RE, McCullough RG, Micco AJ, Tucker A, Weil JV, Reeves JT. Low acute hypoxic ventilatory response and hypoxic depression in acute altitude sickness. J Appl Physiol (1985). 1986 Apr;60(4):1407-12. doi: 10.1152/jappl.1986.60.4.1407.

Reference Type BACKGROUND
PMID: 3084449 (View on PubMed)

Other Identifiers

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HospitalTS

Identifier Type: -

Identifier Source: org_study_id