European Journal of Applied Physiology

, Volume 90, Issue 3–4, pp 351–359 | Cite as

Oxygen transport in blood at high altitude: role of the hemoglobin–oxygen affinity and impact of the phenomena related to hemoglobin allosterism and red cell function

  • Michele SamajaEmail author
  • Tiziano Crespi
  • Marco Guazzi
  • Kim D. Vandegriff
Review Article


Altitude hypoxia is a major challenge to the blood O2 transport system, and adjustments of the blood–O2 affinity might contribute significantly to hypoxia adaptation. In principle, lowering the blood–O2 affinity is advantageous because it lowers the circulatory load required to assure adequate tissue oxygenation up to a threshold corresponding to about 5,000 m altitude, whereas at higher altitudes an increased blood–O2 affinity appears more advantageous. However, the rather contradictory experimental evidence raises the question whether other factors superimpose on the apparent changes of the blood–O2 affinity. The most important of these are as follows: (1) absolute temperature and temperature gradients within the body; (2) the intracapillary Bohr effect; (3) the red cell population heterogeneity in terms of O2 affinity; (4) control of altitude alkalosis; (5) the possible role of hemoglobin as a carrier of the vasodilator nitric oxide; (6) the effect of varied red cell transit times through the capillaries.


Altitude hypoxia Oxygen equilibrium curve Hemoglobin allosterism Red cell function 



We gratefully acknowledge the helpful advice by Professor Robert M. Winslow, Sangart, Inc., for the discussion of the RBC transit time.


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Michele Samaja
    • 1
    Email author
  • Tiziano Crespi
    • 1
  • Marco Guazzi
    • 1
  • Kim D. Vandegriff
    • 2
  1. 1.Dipartimento di Medicina, Chirurgia e Odontoiatria, Ospedale San PaoloUniversita' Di MilanoMilanItaly
  2. 2.Sangart, Inc.San DiegoUSA

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