Adaptation to High Altitude

Hypoxia is inconsequential for physiologically fit persons below an effective altitude of 2640 metres. At higher altitudes, the adaptation is brought about by four main factors, viz., hyperventilation, increased diffusion of oxygen across alveolar membrane, erythrocythemia and maintenance of body hydration. Carbon dioxide sensitivity is markedly elevated at high altitude, both in sojourners and acclimatized low-landers. The greater pulmonary diffusing capacity observed in high altitude natives is well documented. RBC count, haemoglobin and haematocrit increase whereas arterial oxyhaemoglobin saturation percentage decreases at high altitude. Diuretics (Furosemide) have no role in adaptation to high altitude and adequate body hydration must be maintained.The ultimate adaptive mechanisms occur at tissue level which facilitate the diffusion of oxygen from blood to tissue and its utilization. The work capacity decreases at high altitude and a relationship between load carried and speed of marching has been determined at various altitudes. Although altitude has an adverse effect on process of cold acclimatization, yet it is possible to induce cold acclimatization by exposing subjects to a temperature of 0° to -5°C for a period of three hours daily for three weeks. The caloric requirements increase at high altitudes and are 4,286 K Cal and 4,380 K Cal at 13000 feet (3950 m) and 17000 feet (5170 m), respectively.

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