Inhaled budesonide and oral dexamethasone prevent acute mountain sickness.
BACKGROUND
This double-blind, randomized controlled trial aimed to investigate inhaled budesonide and oral dexamethasone compared with placebo for their prophylactic efficacy against acute mountain sickness after acute high-altitude exposure.


METHODS
There were 138 healthy young male lowland residents recruited and randomly assigned to receive inhaled budesonide (200 μg, twice a day [bid]), oral dexamethasone (4 mg, bid), or placebo (46 in each group). They traveled to 3900 m altitude from 400 m by car. Medication started 1 day before high-altitude exposure and continued until the third day of exposure. Primary outcome measure was the incidence of acute mountain sickness after exposure.


RESULTS
One hundred twenty-four subjects completed the study (42, 39, and 43 in the budesonide, dexamethasone, and placebo groups, respectively). Demographic characteristics were comparable among the 3 groups. After high-altitude exposure, significantly fewer participants in the budesonide (23.81%) and dexamethasone (30.77%) groups developed acute mountain sickness compared with participants receiving placebo (60.46%) (P = .0006 and P = .0071, respectively). Both the budesonide and dexamethasone groups had lower heart rate and higher pulse oxygen saturation (SpO2) than the placebo group at altitude. Only the budesonide group demonstrated less deterioration in forced vital capacity and sleep quality than the placebo group. Four subjects in the dexamethasone group reported adverse reactions.


CONCLUSIONS
Both inhaled budesonide (200 μg, bid) and oral dexamethasone (4 mg, bid) were effective for the prevention of acute mountain sickness, especially its severe form, compared with placebo. Budesonide caused fewer adverse reactions than dexamethasone.
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Cheng-Rong
CR
Zheng
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China; PLA Institute of Cardiovascular Disease, Chongqing, China.
Guo-Zhu
GZ
Chen
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China; PLA Institute of Cardiovascular Disease, Chongqing, China.
Jie
J
Yu
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China; PLA Institute of Cardiovascular Disease, Chongqing, China.
Jun
J
Qin
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Pan
P
Song
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China; PLA Institute of Cardiovascular Disease, Chongqing, China.
Shi-Zhu
SZ
Bian
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Bai-Da
BD
Xu
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Xu-Gang
XG
Tang
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Yong-Tao
YT
Huang
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Xiao
X
Liang
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Jie
J
Yang
Institute of Cardiovascular Science, Xinqiao Hospital, Third Military Medical University, Chongqing, China; PLA Institute of Cardiovascular Disease, Chongqing, China. Electronic address: huanglan260@126.com.
Lan
L
Huang
D000208:Acute Disease; D000280:Administration, Inhalation; D000284:Administration, Oral; D000532:Altitude Sickness / Q000517:prevention & control*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D010092:Oximetry; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects / Q000502:physiology; D013147:Spirometry; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D019819:Budesonide; D003907:Dexamethasone
Acute mountain sickness; Budesonide; Dexamethasone; Prevention; Randomized controlled trial