A journey between high altitude hypoxia and critical patient hypoxia: What can it teach us about compression and the management of critical disease?

Abstract

High altitude sickness (hypobaric hypoxia) is a form of cellular hypoxia similar to that suffered by critically ill patients. The study of mountaineers exposed to extreme hypoxia offers the advantage of involving a relatively homogeneous and healthy population compared to those typically found in Intensive Care Units (ICUs), which are heterogeneous and generally less healthy. Knowledge of altitude physiology and pathology allows us to understanding how hypoxia affects critical patients. Comparable changes in mitochondrial biogenesis between both groups may reflect similar adaptive responses and suggest therapeutic interventions based on the protection or stimulation of such mitochondrial biogenesis. Predominance of the homozygous insertion (II) allele of the angiotensin-converting enzyme gene is present in both individuals who perform successful ascensions without oxygen above 8000 m and in critical patients who overcome certain disease conditions.

Keywords: Aclimatación a la altitud; Altitude acclimatization; Critically ill patient; Enfermo crítico; Factor inducible por la hipoxia; Hipoxia hipobárica; Hypobaric hypoxia; Hypoxia-inducible factor; Mitochondria; Mitocondria.