Contribution of Hypoxic Exercise Testing to Predict High-Altitude Pathology: A Systematic Review

Area of Science:

• Environmental Physiology
• Altitude Medicine
• Exercise Physiology

Background:

• High-altitude travel poses risks of serious pathologies.
• Individual susceptibility to altitude sickness varies, complicating prediction.
• Physiological adaptations to exercise in hypoxia are explored for predictive value.

Purpose of the Study:

• To evaluate the utility of normobaric hypoxic exercise testing in predicting severe high-altitude pathology.
• To systematically review existing research on this predictive capability.

Main Methods:

• Systematic review of PubMed, Science Direct, and Embase databases (October 2021).
• Inclusion of studies reporting physiological adaptations during hypoxic exercise testing and prediction of altitude pathology.
• Analysis of data from 8 eligible studies involving 3558 participants.

Main Results:

• Hypoxic exercise testing identified several variables associated with acute mountain sickness (AMS).
• These variables include ventilatory and cardiac responses, oxygen desaturation, cerebral oxygenation, and core temperature.
• A decision algorithm for AMS prediction using hypoxic exercise tests was proposed.

Conclusions:

• Hypoxic exercise testing offers a promising approach for predicting altitude-related complications.
• Further validation by independent research groups is recommended to confirm its predictive value.