title: Acute Mountain Sickness Symptom Severity at the South Pole: The Influence of Self-Selected Prophylaxis with Acetazolamide.
abstract: BACKGROUND
  Acetazolamide, a carbonic anhydrase inhibitor, remains the only FDA approved pharmaceutical prophylaxis for acute mountain sickness (AMS) though its effectiveness after rapid transport in real world conditions is less clear.
  
  
  METHODS
  Over 2 years, 248 healthy adults traveled by airplane from sea level (SL) to the South Pole (ALT, ~3200m) and 226 participants provided Lake Louise Symptom Scores (LLSS) on a daily basis for 1 week; vital signs, blood samples, and urine samples were collected at SL and at ALT. Acetazolamide was available to any participant desiring prophylaxis. Comparisons were made between the acetazolamide with AMS (ACZ/AMS) (n = 42), acetazolamide without AMS (ACZ/No AMS)(n = 49), no acetazolamide with AMS (No ACZ/AMS) (n = 56), and the no acetazolamide without AMS (No ACZ/No AMS) (n = 79) groups. Statistical analysis included Chi-squared and one-way ANOVA with Bonferroni post-hoc tests. Significance was p≤0.05.
  
  
  RESULTS
  No significant differences were found for between-group characteristics or incidence of AMS between ACZ and No ACZ groups. ACZ/AMS reported greater LLSS, BMI, and red cell distribution width. ACZ/No AMS had the highest oxygen saturation (O2Sat) at ALT. No significant differences were found in serum electrolyte concentrations or PFT results.
  
  
  CONCLUSIONS
  Acetazolamide during rapid ascent provided no apparent protection from AMS based on LLSS. However, it is unclear if this lack of effect was directly associated with the drug or if perhaps there was some selection bias with individuals taking ACZ more likely to have symptoms or if there may have been more of perceptual phenomenon related to a constellation of side effects.
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.|Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan, United States of America.
authors: Michael F
authors: MF
authors: Harrison
authors: Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Paul J
authors: PJ
authors: Anderson
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Jacob B
authors: JB
authors: Johnson
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Maile
authors: M
authors: Richert
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Andrew D
authors: AD
authors: Miller
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.
authors: Bruce D
authors: BD
authors: Johnson
mesh_terms: D000086:Acetazolamide / Q000494:pharmacology*; D000208:Acute Disease; D000328:Adult; D000532:Altitude Sickness / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control* / Q000652:urine; D002257:Carbonic Anhydrase Inhibitors / Q000494:pharmacology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D010100:Oxygen / Q000378:metabolism; D010953:Plasma Volume / Q000187:drug effects; D014186:Transportation; D016482:Urinalysis
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide; D010100:Oxygen