[Etiology, clinical aspects and therapy of altitude sickness]

Experimental and clinical tests carried out over the last few years have brought many new and important insights into the pathophysiology of the so-called high-altitude sickness. Overall, new, scientifically proven methods for the acute therapy of various forms of high-altitude sickness have been made, which can be used for medical practice. Azetazolamide: The clinical effectiveness and the improvement of the exchange of body gases seem to be, to a large extent, scientifically proven. Dexamethasone: Several scientifically controlled studies have proven the effectiveness of dexamethasone regarding the relief of symptoms mainly concerning cerebral high-altitude oedema. Controlled studies confirm a significant reduction of symptoms, compared to placebo methods, the effects vanishing after a 12-hour therapy. Nifedipine: The prescription of nifedipine for radiologically proven high-altitude oedema often leads to a clinical improvement, to an improved oxygenation, to a reduction of the alveolar-arterial oxygen gradient, as well as the pulmonary-arterial pressure and, thus, to a great extent, leads to progrediental oedema dissolution. However, in the practice of high-altitude hiking, this therapy has its natural limits and therefore must not lead to the neglection of prophylactics, which means, consistent acclimatisation regarding the classical rules of high-altitude hiking.