Could Exercising at High Altitude Benefit Patients Before Surgery?

The latest research indicates that high altitude training could potentially have positive effects on the health of older patients at risk of surgical complications. A recent study, conducted by researchers from the University of Limerick, Kings College London, Royal Melbourne Hospital, Oxford University Hospitals NHS Foundation Trust, and Beth Israel Deaconess Medical Center, has uncovered that exposing older patients to reduced oxygen levels, similar to those experienced at high altitudes, may improve their physical health prior to surgery.

The findings of the study, which were published in Anaesthesia, shed light on the potential benefits of pre-surgery altitude training for patients with low fitness levels, high BMI, sedentary lifestyles, or anaemia, all of which are factors associated with a higher risk of postoperative complications and mortality. The concept of prehabilitation, aimed at enhancing a patient’s fitness before surgery, seeks to decrease the likelihood of such complications.

Altitude training is known to enhance fitness and increase haemoglobin levels, the protein responsible for oxygen transport in the body, in athletes. The study aimed to determine whether exposure to simulated high altitude could have similar effects for older individuals facing surgery. The researchers recruited eight sedentary volunteers with an average age of 64, who spent two weeks residing in a ‘hypoxic house’ in Ireland, where oxygen levels were regulated to simulate high altitude conditions.

The results revealed that exposure to reduced oxygen levels at the simulated high altitude led to a significant increase in haemoglobin levels in the participants, potentially benefiting those preparing for surgery. The findings suggest that small-scale hypoxic canopies could be provided to patients to use while sleeping in the weeks leading up to their surgery, offering a potentially valuable prehabilitation strategy.

Lead author Professor Thomas Smith from King’s College London acknowledged the promising results for older and sedentary patients, but also stressed the need for further research to investigate the potential of altitude prehabilitation for home-based use. He also pointed out the existing use of hypoxic technology in sports and professional settings, proposing that the same approach could be applied to healthcare settings for the benefit of surgical patients.

Professor Phil Jakeman, the lead principal investigator on the study and Professor of Sport and Exercise Sciences at the University of Limerick, highlighted the potential transferability of knowledge gained from the study of elite athletes using altitude training to the prehabilitation of patients. He noted that while the responses may differ, the potential benefits of hypoxic exposure for patients were evident in the study.

The research represents a significant step towards exploring innovative approaches to improving patient outcomes before surgery, underscoring the potential benefits of high altitude prehabilitation for older and sedentary individuals. As further studies are undertaken, it is crucial to consider the potential of implementing hypoxic technology in healthcare settings to provide patients with additional support in preparing for surgery.