Results and recommendations of the 7th European Hypoxia Symposium 2014

One of the main themes of the 7th European Hypoxia Symposium 2014 in Berchtesgaden, Germany was „Contraindications for Exposure to Hypoxia“. In this paper, we summarize the statements and recommendations for high-altitude sojourns with pre-existing medical conditions. Exposure to altitude is increasingly common even amongst elderly people. Therefore, the number of persons with pre-existing medical conditions is rising, as is the number of physicians’ consultations prior to a planned high-altitude sojourn. For persons with no previous altitude experience, risk assessment is difficult, because the most reliable predicting factor for developing high-altitude-related disease is previous episodes in the patients’ medical history. Risk assessment in clinical practice should start with a clinical examination and evaluation of any cardiopulmonary diseases that could worsen at high altitude. The fundamental question is: “Will the pre-existing condition aggravate during the high-altitude stay or can it compromise the safety of the patient respectively his partner?” Consensus: In general, even for people with pre-existing conditions, high-altitude sojourns (>2500m) should be possible, provided fundamental recommendations of acclimatization are followed. People with severe pre-existing conditions should avoid sojourns at extreme altitudes particularly when they have no or little experience in these environments. UIAA guidelines have been developed to assist physicians without high-altitude expertise to give advice in uncomplicated cases. In complex cases or severe pre-existing conditions, advice of a physician with expertise in high-altitude (and travel) medicine should be sought to assess specific individual risks.