Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington 98104, USA.
High Alt Med Biol. 2012 Sep;13(3):147-52. doi: 10.1089/ham.2012.1055.
Although pharmacologic strategies are available for decreasing the risk of acute altitude illness, the best means of preventing these problems remains undertaking an adequately slow ascent. Guidelines regarding appropriate ascent rates have been published in various forums, and while these guidelines are generally similar to each other in regards to the recommended ascent rates and use of rest days, there is actually little evidence in the literature supporting the particular recommendations. The purpose of this review is to consider these guidelines and the issue of ascent rates in greater detail. Following a discussion of the evidence regarding ascent rates and acclimatization, the review considers several unanswered questions regarding the current guidelines, including the applicability of the guidelines for all altitude travelers, how best to determine the ascent rate, how to implement rest days, and whether pre-acclimatization strategies can be used to facilitate faster than recommended ascents. Given the current state of evidence, there is no reason to alter the current guidelines, as they likely work for the substantial majority of high altitude travelers. It is individuals traveling to high altitude for the first time for whom they remain most important, while those individuals with substantial prior experience at high altitude may opt for faster or slower ascent rates based on their prior experience. Rest days should remain a part of any ascent profile and should be used following any large gains in elevation rather than simply at specified time intervals. Pre-acclimatization strategies may decrease the risk of acute altitude illness but there is insufficient evidence to suggest they can be used to facilitate faster than recommended ascents. Further research may allow changes in practice in the future but for the time being, adherence to the current recommendations is the prudent approach for the majority of high altitude travelers.
尽管有药物治疗策略可用于降低急性高原病的风险，但预防这些问题的最佳方法仍是缓慢上升。关于适当上升速度的指南已在各种论坛上发布，虽然这些指南在推荐的上升速度和使用休息日方面彼此相似，但实际上很少有文献支持这些特定建议的证据。本综述的目的是更详细地考虑这些指南和上升速度问题。在讨论了有关上升速度和适应的证据之后，本综述考虑了当前指南中的几个未解决的问题，包括这些指南对所有高原旅行者的适用性、如何确定最佳上升速度、如何实施休息日以及预先适应策略是否可以用于促进比推荐速度更快的上升速度。鉴于目前的证据状况，没有理由改变当前的指南，因为它们可能适用于绝大多数高原旅行者。对于首次前往高原的人来说，这些指南仍然是最重要的，而对于那些在高原地区有大量先前经验的人来说，他们可能会根据自己的先前经验选择更快或更慢的上升速度。休息日应仍然是任何上升轮廓的一部分，并应在海拔高度大幅增加后使用，而不仅仅是在指定的时间间隔使用。预先适应策略可能会降低急性高原病的风险，但没有足够的证据表明它们可以用于促进比推荐速度更快的上升速度。进一步的研究可能会在未来改变实践，但就目前而言，对于大多数高原旅行者来说，遵守当前的建议是明智的做法。
