Altitude related adverse health effects in lowlanders with COPD travelling to 3200m

Objective: We studied altitude related adverse health effects in lowlanders with COPD staying at 3200m, and whether dexamethasone (DEX) could prevent them. Methods: 112 COPD patients (mean±SD age 54.7±9.3y,FEV1 85±21%pred) were randomized to receive DEX (2x4mg/d) or placebo before ascent from 760m and while staying at 3200m. Main outcome during 3 days at 3200m was the cumulative incidence of one of the following: Acute Mountain Sickness (AMSc environmental symptom cerebral score ≥0.7), severe hypoxemia (SpO2 30min), or discomfort requiring descent to low altitude. Results: During 3 days at 3200m, 10 patients using DEX, 11 using placebo (p=ns), had an altitude related adverse effect (table 1). In the first day at 3200m, 2 patients using DEX and 8 using placebo had severe hypoxemia or discomfort (p=0.04). Conclusions: In lowlanders with COPD, GOLD grade 1-2, staying 3 days at 3200m the cumulative incidence of clinically relevant adverse health effects was low (19%). Preventive DEX did not alter the incidence or severity of adverse effects but improved severe hypoxemia and discomfort in the first day at 3200m.