@article{ZHANG2025, 
author = {Xucheng ZHANG and Yukun REN and Zhuo WANG and Jiaxin LI and Yan LIU and Hong LI},
title = {Efficacies of remote ischemic preconditioning with different pressure modes on acclimatization in male trainees at a simulated altitude of 4 500 m},
year = {2025},
journal = {Journal of Army Medical University},
volume = {47},
number = {9},
pages = {1010-1017},
keywords = {remote ischemic preconditioning, acute mountain sickness, high-altitude acclimatization, cerebral oxygen saturation},
url = {https://www.sciopen.com/article/10.16016/j.2097-0927.202412016},
doi = {10.16016/j.2097-0927.202412016},
abstract = {ObjectiveTo compare the effects of upper limb remote ischemic preconditioning (RIPC) with different pressure modes on enhancing high-altitude acclimatization in healthy adult males rapidly exposed to high-altitude environments.MethodsIn May 2024, 86 male adult residents living plain areas planning a high-altitude travel were recruited through advertisements in Chongqing by Department of Anesthesiology at the Second Affiliated Hospital of Army Medical University. The participants were randomly divided into a variable pressure training group (n=29), a constant pressure training group (n=29), and a control group (n=28). The variable pressure training group underwent RIPC training in a variable pressure mode [occlusion pressure was set at systolic blood pressure (SBP) + 40 mmHg], while the constant pressure training group received RIPC training in a constant pressure mode (fixed occlusion pressure of 200 mmHg). Both groups completed a bilateral upper limb RIPC training (twice daily, 5 cycles per time of 10-min occlusion followed by 5-min reperfusion) for 14 d. The control group received no such training. On the 3rd day post-training, all participants entered a simulated 4 500 m altitude chamber for 7 h. The incidence and severity of acute mountain sickness (AMS) were observed and evaluated, and the vital signs and cerebral tissue oxygenation index (CTOI) were recorded.ResultsThe incidence of AMS was 23.1% in the variable pressure training group (RR=0.4, 95%CI: 0.2~0.8, Chi-square=9.433, P=0.002) and 16.0% in the constant pressure training group (RR=0.2, 95%CI: 0.1~0.6, Chi-square=12.833, P<0.001), and both incidences were significantly lower than that in the control group (65.4%). The AMS symptom score in the variable pressure training group [1.5 (0.8, 3.0) vs (3.1±1.9), P=0.018] and the score in the constant pressure training group [1.0 (1.0, 2.0) vs (3.1±1.9), P=0.001] were significantly lower than that in the control group. The dizziness score was obviously lower in the variable pressure training group [0 (0, 1.0) vs 1.0 (1.0, 1.0), P=0.001] and the constant pressure training group [1.0 (0,1.0) vs 1.0 (1.0,1.0), P=0.003] than the control group, so was the fatigue/weakness score in the variable pressure training group [0 (0, 0.3) vs 1.0 (0,1.0), P=0.006], the constant pressure training group [0 vs 1.0(0, 1.0), P<0.001], and the control group. The change of CTOI (ΔCTOI) in the variable pressure training group (P=0.010) and the constant pressure training group (P= 0.042) was significantly lower than that in the control group. There were no statistical differences in the 3 groups in terms of SpO2, HR, SBP or DBP (P>0.05). What’s more, no significant differences were observed in the incidence of AMS, AMS score, dizziness score, fatigue/weakness score, or ΔCTOI between the variable pressure training group and the constant pressure training group (P>0.05).ConclusionBoth upper limb RIPC protocols, variable-pressure (SBP+40 mmHg) and fixed-pressure (200 mmHg), can effectively enhance high-altitude acclimatization by reducing AMS incidence, symptom severity, and cerebral oxygen desaturation.}
}