title: Prophylactic effect of erythropoietin injection to prevent acute mountain sickness: an open-label randomized controlled trial.
abstract: This study was performed to evaluate whether increasing hemoglobin before ascent by prophylactic erythropoietin injections prevents acute mountain sickness (AMS). This open-label, randomized, controlled trial involved 39 healthy volunteers with hemoglobin ≤ 15.5 g/dL who were divided randomly into erythropoietin (n=20) and control (n=19) groups. Epoetin alpha 10,000 IU injections were given weekly for four consecutive weeks. On day 1, and 7 days after the last injection (day 29), oxygen saturation (SaO2), and hemoglobin were measured. The subjects departed Seoul on day 30 and arrived at Annapurna base camp (ABC, 4,130 m) on day 34. AMS was diagnosed when headache and Lake Louise score (LLS) of ≥ 3 were present. Immediate descent criteria followed US Army recommendations. Two groups differ in hemoglobin levels on day 29 (15.4 ± 1.1 vs 14.2 ± 1.0 g/dL, P=0.001). At ABC, erythropoietin group had a significantly lower mean LLS, AMS incidence, and number of subjects who met immediate descent criteria. Multiple logistic regression analysis showed that SaO2<87% and control group, but not hemoglobin<15.0 g/dL, independently predicted satisfaction of immediate descent criteria. Erythropoietin-related adverse effects were not observed. In conclusion, erythropoietin may be an effective prophylaxis for AMS.(Clinical Trial Registry Number; NCT 01665781).
authors.affiliation: Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyoung
authors.identifier: 0000-0002-0790-9837
authors.initials: K
authors.lastname: Heo
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Joong Koo
authors.identifier: 0000-0003-0941-3824
authors.initials: JK
authors.lastname: Kang
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chang Min
authors.identifier: 0000-0002-2881-4669
authors.initials: CM
authors.lastname: Choi
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Moo Song
authors.identifier: 0000-0003-1085-9073
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyoung Woo
authors.identifier: 0000-0001-7149-435X
authors.initials: KW
authors.lastname: Noh
authors.affiliation: Division of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Soon Bae
authors.identifier: 0000-0003-1649-0318
authors.initials: SB
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000328:Adult; D000532:Altitude Sickness / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001794:Blood Pressure / Q000502:physiology; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006261:Headache / Q000503:physiopathology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010100:Oxygen / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa; D010100:Oxygen
keywords: Acute Mountain Sickness; Arterial Oxygen Saturation; Erythropoietin; Hemoglobins