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Abstract(s)
Introdução: O mal agudo da montanha é uma entidade clínica de etiologia não
inteiramente compreendida, mais comum em indivíduos que ascendem a altitudes
superiores a 2500 m, podendo, no entanto, ocorrer em altitudes mais baixas. Pode
manifestar-se com sintomas como cefaleias, tonturas, anorexia, náuseas e insónias e é
geralmente autolimitado. Pode, contudo, progredir para formas graves e potencialmente
fatais, como edema agudo cerebral e do pulmão. A sua prevenção farmacológica reduz a
sua incidência e gravidade, contudo, existe muita incerteza quanto à eficácia e segurança
desta.
Objetivo: Avaliar a eficácia clínica e segurança de diversas intervenções farmacológicas na
prevenção do mal agudo da montanha.
Métodos: Foi realizada uma pesquisa bibliográfica através do motor de busca PubMed. As
publicações foram selecionadas de acordo com a relevância do seu conteúdo, tendo sido
dada preferência a artigos mais recentes. Foram ainda consultados livros de texto
especializados e fontes de informação de sociedades científicas relevantes.
Resultados: Foram incluídos os resultados de 33 estudos nesta revisão. A acetazolamida é
o fármaco mais eficaz na prevenção do mal agudo da montanha, seguida da
dexametasona, contudo, nenhuma destas abordagens é inteiramente segura e livre de
efeitos secundários indesejáveis. O ibuprofeno, os corticoesteróides inalados e o Ginkgo
biloba apresentaram resultados não concordantes nos diferentes estudos. Diversas
intervenções não apresentaram evidência suficiente para poderem ser recomendadas. A
evidência é de baixa qualidade em muitos dos estudos revistos.
Discussão: A prevenção farmacológica do mal agudo da montanha justifica-se apenas
quando o benefício supera o risco, sendo portanto muito importante selecionar fármacos
seguros e sem efeitos adversos. Nenhuma abordagem farmacológica deverá substituir a
ascensão gradual. É importante produzir evidência de qualidade nesta área.
Introduction: Acute mountain sickness is a clinical identity, whose etiology is not fully understood. It’s more common in individuals who ascend above 2500 meters, but can be seen at lower elevations. It most commonly presents with the symptoms of headache, dizziness, anorexia, nausea and insomnia and is generally self limited, it can, however, progress to severe and potentially fatal forms, like high altitude pulmonary or cerebral edema. Its pharmacological prevention can reduce its incidence and severity, however, there is a great uncertainty regarding its benefits and harms. Objective: Assess the clinical efficacy and safety of pharmacological interventions in the prevention of acute mountain sickness. Methods: A literature research was conducted on PubMed database. Articles were selected according to the relevance of its content and recent articles were preferred. Specialized textbooks and other sources of relevant scientific societies were also consulted. Results: The results of 33 studies were included in this review. Acetazolamide is the most effective drug in preventing acute mountain sickness, followed by dexamethasone, however, none of these approaches is entirely safe and free of undesirable side effects. Ibuprofen, inhaled corticosteroids and Ginkgo biloba showed inconsistent results in different studies. Several interventions did not provide enough evidence to be recommended. The evidence is of poor quality in many of the reviewed studies. Discussion: The pharmacological prevention of acute mountain sickness is only justified when the benefit outweighs the risk, making it very important to select safe drugs with a favorable side effect profile. No pharmacological approach should replace gradual ascent. It is important to produce higher quality research in this field.
Introduction: Acute mountain sickness is a clinical identity, whose etiology is not fully understood. It’s more common in individuals who ascend above 2500 meters, but can be seen at lower elevations. It most commonly presents with the symptoms of headache, dizziness, anorexia, nausea and insomnia and is generally self limited, it can, however, progress to severe and potentially fatal forms, like high altitude pulmonary or cerebral edema. Its pharmacological prevention can reduce its incidence and severity, however, there is a great uncertainty regarding its benefits and harms. Objective: Assess the clinical efficacy and safety of pharmacological interventions in the prevention of acute mountain sickness. Methods: A literature research was conducted on PubMed database. Articles were selected according to the relevance of its content and recent articles were preferred. Specialized textbooks and other sources of relevant scientific societies were also consulted. Results: The results of 33 studies were included in this review. Acetazolamide is the most effective drug in preventing acute mountain sickness, followed by dexamethasone, however, none of these approaches is entirely safe and free of undesirable side effects. Ibuprofen, inhaled corticosteroids and Ginkgo biloba showed inconsistent results in different studies. Several interventions did not provide enough evidence to be recommended. The evidence is of poor quality in many of the reviewed studies. Discussion: The pharmacological prevention of acute mountain sickness is only justified when the benefit outweighs the risk, making it very important to select safe drugs with a favorable side effect profile. No pharmacological approach should replace gradual ascent. It is important to produce higher quality research in this field.
Description
Keywords
Agentes Físicos Altitude Fisiopatologia da Altitude Mal Agudo da Montanha Prevenção Farmacológica