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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

European Journal of Applied Physiology volume 90, pages 351–359 (2003)Cite this article

Abstract

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.

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Acknowledgement

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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Authors and Affiliations

  1. Dipartimento di Medicina, Chirurgia e Odontoiatria, Ospedale San Paolo, Universita' Di Milano, via di Rudini' 8, 20142 , Milan, Italy

    Michele Samaja, Tiziano Crespi & Marco Guazzi

  2. Sangart, Inc., San Diego, California, USA

    Kim D. Vandegriff

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  1. Michele Samaja
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  2. Tiziano Crespi
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  3. Marco Guazzi
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Correspondence to Michele Samaja.

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Samaja, M., Crespi, T., Guazzi, M. et al. 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. Eur J Appl Physiol 90, 351–359 (2003). https://doi.org/10.1007/s00421-003-0954-8

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Keywords

  • Altitude hypoxia
  • Oxygen equilibrium curve
  • Hemoglobin allosterism
  • Red cell function