Table 2.
Changes of standard coagulation parameters, coagulation factors, red blood cells and platelet count during exposure to moderate, high and extreme altitudes (16 studies, n = 388).
| Authors | Maximum altitude [m] |
Participants
M/F, age [years] |
Type of
physical activity |
Maximum duration | Parameter | Maximum change |
Level of
significance† |
|
|---|---|---|---|---|---|---|---|---|
| Active | Passive | |||||||
| Moderate altitude | ||||||||
| Bendz et al. (17) | 2400 (simulated) |
20 M 20–40 |
Activities of daily living | 8 h | F.VII (U/L) | +17% | p = 0.008 | |
| F.VII AG (%) | −5% | p = 0.003 | ||||||
| PTF 1+2 (nM/L) | +250% | p = 0.008 | ||||||
| TAT complex (μg/L) | +820% | p = 0.04 | ||||||
| High altitude | ||||||||
| Bartsch et al. (16) | 4559 (terrestrial) |
11 M 22–55 |
Climbing | 5 days | Fibrinogen (g/L) | +23% | p < 0.025 | |
| Kicken et al. (20) | 3883 (terrestrial) |
11 M, 7 F (only 17 results) 21–50 |
Ascent by car and cable car | 6 days | Hb (g/L) | +3% | p = 0.004 | |
| Hct (L/L) | +9% | p = 0.0002 | ||||||
| F.VIII (%) | +8% | p = 0.0075 | ||||||
| Kicken et al. (21) | 3375 (terrestrial) |
6 M 18–48 |
Vigorous exercise | 6 days | Hb (g/L) | +24% | p < 0.0001 | |
| vWF (%) | +53% | p = 0.0002 | ||||||
| vWF (%) | +59% | p = 0.0002 | ||||||
| F.VIII (%) | +43% | p = 0.0009 | ||||||
| Lehmann et al. (22) | 4559 (terrestrial) |
10b | Climbing | 18 h | PLT count (x 103/μL) | −23% | p ≤ 0.001 | |
| Maher et al. (23) | 4400 (simulated) |
8 M 22 ± 1 |
Activities of daily living | 48 h | Hct (L/L)c | +4% | p < 0.05 | |
| PTT (sec)c | −370%+ | p < 0.05 | ||||||
| Fibrinogen (g/L)c | +79% | p < 0.01 | ||||||
| F.VIII (%)c | −32% | p < 0.02 | ||||||
| Martin et al. (24) | 5300 (terrestial) |
12 M, 5 F 34.0 ± 9.8 |
Climbing | 17 days | Hb (g/L) | +20% | p < 0.01 | |
| Modesti et at. (25) | 5400 (terrestrial) |
25 M, 6 F 24–62 |
Climbing | 19 days | Hct (L/L) | +19% | p < 0.001 | |
| Ninivaggi et al. (26) | 3900 (terrestial) |
14 M,16 F 28-32 |
7 M, 8 F Climbing |
7 M, 8 F Ascent by cable car |
8 days | Active: vWF (%) | +21% | p < 0.05 |
| Active: F.VIII (%) | +25%a | p < 0.05 | ||||||
| Passive: vWF (%) | +5%+ | p < 0.05 | ||||||
| Passive: F.VIII (%) | +12%+ | p < 0.05 | ||||||
| Rocke et al. (28) | 5200 (terrestrial) |
37 M, 26 F 26.4 ± 3.9 G1: n = 41 G2: n = 22 |
Ascent by plane and car | 7 days | G1: Hb (g/L) | +12% | p < 0.005 | |
| G2: Hb (g/L) | +7% | p < 0.0001 | ||||||
| G1: Hct (L/L) | +14% | p < 0.005 | ||||||
| G2: Hct (L/L) | +17% | p < 0.0001 | ||||||
| G2: Fibrinogen (g/L) | +27% | p < 0.001 | ||||||
| G1: PLT count (x 103/μL) | +19% | p < 0.005 | ||||||
| G1: PLT count (x 103/μL) | +31% | p < 0.0001 | ||||||
| Schaber et al. (29) | 4500 (simulated) |
21 M, 16 F 19–42 |
Free movement | 12 h | PT (%) | +7% | p = 0.029 | |
| Singh et al. (33) | 3505 (terrestial) |
16 M 20–42 |
Free movement | 3 days | Fibrinogen | −20% | p < 0.01 | |
| Extreme altitude | ||||||||
| Albrecht and Albrecht (14) | 6200 (terrestrial) |
G2 (placebo) 11d (Age and sex NG) |
Climbing | 35 days | PT (%) | −46% | p < 0.001 | |
| Andrew et al. (15) | 7625 (simulated) |
8 M 21–31 |
Incremental cycling | 40 days | F.VIII:Complex (%) | +40% | p < 0.05 | |
| Doughty et al. (19) | 5700 (terrestrial) |
6 Me | Climbing | 48 days | Hb (g/L) | +44% | NG | |
| Bleeding time | +81% | NG | ||||||
| Pichler Hefti et al. (27) | 6865 (terrestrial) |
G1 (fast ascent): 15 M, 3 F G2 (slow ascent): 12 M, 4 F 46 (median) |
Climbing | 22 days | PT (%) | +16%+ | p < 0.001 | |
| aPTT (sec) | +38%+ | p < 0.001 | ||||||
| APC-R | −16% | p < 0.001 | ||||||
| G1: vWF-RCo (%) | −24%+ | p < 0.001 | ||||||
| G2: vWF-RCo (%) | −34%+ | p < 0.001 | ||||||
F, female; M, male; AG, antigen; APC-R, activated protein C resistance; aPTT, activated partial thromboplastin time; G1, group 1; G2, group 2; Hb, hemoglobin; Hct, hematocrit; μL, microliter; NG, not given; PLT, platelet; PT, prothrombin time; sec, second; vWF-Rco, von Willebrand factor-ristocetin cofactor activity. All p-values reflect intragroup comparisons unless otherwise indicated.
At 2045 m.
10 subjects out of 36 M and 4 F, aged 40 ± 9 yrs.
Results after 1 h at altitude.
Results after 1 h at altitude.
Age and sex not reported.
Age not reported.
Estimated from figures.
Reported in the original study.