treatment of mountain sickness

Last reviewed 10/2020

• acute mountain sickness
  • main principles of treating acute mountain sickness are to stop further ascent, to descend if symptoms do not improve over 24 hours or deteriorate, and to descend urgently if signs of high altitude pulmonary oedema or high altitude cerebral oedema occur
  • rest
    • resting at the same altitude often relieves the symptoms of acute mountain sickness, and most patients will improve without treatment at the same altitude in 24-48 hours
  • simple analgesics and antiemetics
    • may reduce headache and nausea in mild acute mountain sickness
  • carbonic anhydrase inhibitor, acetazolamide
    • effective in reducing the symptoms of acute mountain sickness, although the optimum dosage is unknown: 250 mg every eight hours is widely used and has been shown to be effective
      
  • dexamethasone
    • dexamethasone (8 mg initially, then 4 mg every 6 hours) may also be used to relieve symptoms
      
      
• high altitude cerebral oedema
  • person with symptoms of high altitude cerebral oedema should descend immediately. Delay may be fatal
  • steroids
    • dexamethasone (8 mg initially, then 4 mg every 6 hours orally or parenterally) will usually relieve some symptoms, making evacuation easier
  • oxygen
    • if available, should be used as an aid to evacuation
    • hyperbaric chambers improve oxygenation and relieve symptoms, making unaided descent easier
      
      
• high altitude pulmonary oedema
  • descent is the mainstay of treatment
    • even a few hundred metres may be beneficial
  • oxygen
    • supplemental oxygen should be given if available
    • a portable hyperbaric chamber has been developed that simulates descent
  • nifedipine
    • effective in preventing and treating high altitude pulmonary oedema in susceptible individuals (10 mg orally initially, then 20 mg slow release preparation every 12 hours

Reference:

• 1. Barry PW, Pollard AJ. Altitude illness. BMJ 2003;326:915-919