Elevating Surgery Preparation: Altitude Training for Healthier Outcomes


In a groundbreaking study, researchers explore the potential benefits of simulated high altitude exposure for older patients facing surgery, introducing the concept of ‘altitude prehabilitation.’ 

The study, published in Anaesthesia by a collaborative team from King’s College London, Royal Melbourne Hospital, Oxford University Hospitals NHS Foundation Trust, Beth Israel Deaconess Medical Center, and the University of Limerick, sheds light on the potential advantages of altitude training in improving fitness and health outcomes for individuals at risk of complications related to surgery.

The Challenge: Preparing Older Patients for Surgery

Many patients awaiting major surgery face challenges such as low fitness levels, high BMI, sedentary lifestyles, or anemia, factors associated with increased complications and mortality post-surgery. Recognizing the need for more effective preoperative measures, anesthetists explore innovative approaches to enhance fitness, known as prehabilitation.

Athletes have long benefited from altitude training, which involves exposure to reduced oxygen levels, mimicking conditions at high altitudes. This exposure stimulates an increase in hemoglobin levels, promoting better oxygen transport in the body. Researchers pondered whether this strategy could be applied to older individuals facing surgery.

The Study: Altitude Exposure for Older Adults

Eight sedentary volunteers, averaging 64 years of age, participated in a two-week trial at the National Altitude Training Centre in Ireland. Living in a ‘hypoxic house,’ they experienced normal air conditions for one week and mildly reduced oxygen levels (simulating airline flight conditions) during the other.

The study revealed a significant increase in hemoglobin levels in participants exposed to simulated high altitudes. Although there were no major changes in aerobic fitness, the rise in hemoglobin could be clinically beneficial for preoperative preparation.

Practical Applications: Altitude Canopies for Surgery Prep

The findings suggest a potential avenue for enhancing the health of older and sedentary patients before major surgery. Practical applications could include the use of small-scale hypoxic canopies provided to patients for sleeping in the weeks leading up to surgery. Hypoxic technology, already present in various settings, could be incorporated into healthcare facilities to create hypoxic spaces for patients undergoing altitude prehabilitation.

Lead author Professor Thomas Smith emphasizes the need for further exploration, stating, “Whilst this study suggests that simulated altitude exposure may have potential advantages for older and sedentary patients, further studies are needed to explore this for home-based altitude prehabilitation.”

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