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author Martin, D. S.
Cobb, A.
Meale, P.
Mitchell, K.
Edsell, M.
Mythen, M. G.
Grocott, M. P. W.
Adams, Tom
Biseker, Lindsay
Booth, Adam
Burdall, Oliver
Cobb, Alexandra
Cumpstey, Andrew
Dauncey, Steve
Edsell, Mark
Farrant, James
Feelisch, Martin
Fernandez, Bernadette
Firth, Oliver
Gilbert, Edward
Grant, Daniel
Grocott, Michael
Hennis, Phil
Jackson, Laura
Jenner, Will
van der Kaaij, Jildou
Khosravi, Maryam
Kortekaas, Edith
Levett, Denny
Mahomed, Zeyn
Martin, Daniel
Meale, Paula
Milledge, Jim
Mitchell, Kay
Mole, Damian
Moses, Oliver
Mythen, Michael
Rigat, Fabio
O'Doherty, Alasdair
Salam, Alex
Sanborn, Matt
Sheperdigian, Adam
Shrubb, Fiona
Simpson, Jo
Talbot, Nick
Wandrag, Liesel
Wijesingha, Savini
Williamson, Wilby
Woolley, Tom
Yow, Heng
author_facet Martin, D. S.
Cobb, A.
Meale, P.
Mitchell, K.
Edsell, M.
Mythen, M. G.
Grocott, M. P. W.
Adams, Tom
Biseker, Lindsay
Booth, Adam
Burdall, Oliver
Cobb, Alexandra
Cumpstey, Andrew
Dauncey, Steve
Edsell, Mark
Farrant, James
Feelisch, Martin
Fernandez, Bernadette
Firth, Oliver
Gilbert, Edward
Grant, Daniel
Grocott, Michael
Hennis, Phil
Jackson, Laura
Jenner, Will
van der Kaaij, Jildou
Khosravi, Maryam
Kortekaas, Edith
Levett, Denny
Mahomed, Zeyn
Martin, Daniel
Meale, Paula
Milledge, Jim
Mitchell, Kay
Mole, Damian
Moses, Oliver
Mythen, Michael
Rigat, Fabio
O'Doherty, Alasdair
Salam, Alex
Sanborn, Matt
Sheperdigian, Adam
Shrubb, Fiona
Simpson, Jo
Talbot, Nick
Wandrag, Liesel
Wijesingha, Savini
Williamson, Wilby
Woolley, Tom
Yow, Heng
author_sort Martin, D. S.
collection PubMed
description BACKGROUND: Classic teaching suggests that diminished availability of oxygen leads to increased tissue oxygen extraction yet evidence to support this notion in the context of hypoxaemia, as opposed to anaemia or cardiac failure, is limited. METHODS: At 75 m above sea level, and after 7–8 days of acclimatization to 4559 m, systemic oxygen extraction [C(a−v)O(2)] was calculated in five participants at rest and at peak exercise. Absolute [C(a−v)O(2)] was calculated by subtracting central venous oxygen content (CcvO(2)) from arterial oxygen content [Formula: see text] in blood sampled from central venous and peripheral arterial catheters, respectively. Oxygen uptake [Formula: see text] was determined from expired gas analysis during exercise. RESULTS: Ascent to altitude resulted in significant hypoxaemia; median (range) [Formula: see text] 87.1 (82.5–90.7)% and [Formula: see text] 6.6 (5.7–6.8) kPa. While absolute C(a−v)O(2) was reduced at maximum exercise at 4559 m [83.9 (67.5–120.9) ml litre(−1) vs 99.6 (88.0–151.3) ml litre(−1) at 75 m, P=0.043], there was no change in oxygen extraction ratio (OER) [C(a−v)O(2)/CaO(2)] between the two altitudes [0.52 (0.48–0.71) at 4559 m and 0.53 (0.49–0.73) at 75 m, P=0.500]. Comparison of C(a−v)O(2) at peak [Formula: see text] at 4559 m and the equivalent [Formula: see text] at sea level for each participant also revealed no significant difference [83.9 (67.5–120.9) ml litre(1) vs 81.2 (73.0–120.7) ml litre(−1), respectively, P=0.225]. CONCLUSION: In acclimatized individuals at 4559 m, there was a decline in maximum absolute C(a−v)O(2) during exercise but no alteration in OER calculated using central venous oxygen measurements. This suggests that oxygen extraction may have become limited after exposure to 7–8 days of hypoxaemia.
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spelling pubmed-43640612015-03-25 Systemic oxygen extraction during exercise at high altitude Martin, D. S. Cobb, A. Meale, P. Mitchell, K. Edsell, M. Mythen, M. G. Grocott, M. P. W. Adams, Tom Biseker, Lindsay Booth, Adam Burdall, Oliver Cobb, Alexandra Cumpstey, Andrew Dauncey, Steve Edsell, Mark Farrant, James Feelisch, Martin Fernandez, Bernadette Firth, Oliver Gilbert, Edward Grant, Daniel Grocott, Michael Hennis, Phil Jackson, Laura Jenner, Will van der Kaaij, Jildou Khosravi, Maryam Kortekaas, Edith Levett, Denny Mahomed, Zeyn Martin, Daniel Meale, Paula Milledge, Jim Mitchell, Kay Mole, Damian Moses, Oliver Mythen, Michael Rigat, Fabio O'Doherty, Alasdair Salam, Alex Sanborn, Matt Sheperdigian, Adam Shrubb, Fiona Simpson, Jo Talbot, Nick Wandrag, Liesel Wijesingha, Savini Williamson, Wilby Woolley, Tom Yow, Heng Br J Anaesth Translational Research BACKGROUND: Classic teaching suggests that diminished availability of oxygen leads to increased tissue oxygen extraction yet evidence to support this notion in the context of hypoxaemia, as opposed to anaemia or cardiac failure, is limited. METHODS: At 75 m above sea level, and after 7–8 days of acclimatization to 4559 m, systemic oxygen extraction [C(a−v)O(2)] was calculated in five participants at rest and at peak exercise. Absolute [C(a−v)O(2)] was calculated by subtracting central venous oxygen content (CcvO(2)) from arterial oxygen content [Formula: see text] in blood sampled from central venous and peripheral arterial catheters, respectively. Oxygen uptake [Formula: see text] was determined from expired gas analysis during exercise. RESULTS: Ascent to altitude resulted in significant hypoxaemia; median (range) [Formula: see text] 87.1 (82.5–90.7)% and [Formula: see text] 6.6 (5.7–6.8) kPa. While absolute C(a−v)O(2) was reduced at maximum exercise at 4559 m [83.9 (67.5–120.9) ml litre(−1) vs 99.6 (88.0–151.3) ml litre(−1) at 75 m, P=0.043], there was no change in oxygen extraction ratio (OER) [C(a−v)O(2)/CaO(2)] between the two altitudes [0.52 (0.48–0.71) at 4559 m and 0.53 (0.49–0.73) at 75 m, P=0.500]. Comparison of C(a−v)O(2) at peak [Formula: see text] at 4559 m and the equivalent [Formula: see text] at sea level for each participant also revealed no significant difference [83.9 (67.5–120.9) ml litre(1) vs 81.2 (73.0–120.7) ml litre(−1), respectively, P=0.225]. CONCLUSION: In acclimatized individuals at 4559 m, there was a decline in maximum absolute C(a−v)O(2) during exercise but no alteration in OER calculated using central venous oxygen measurements. This suggests that oxygen extraction may have become limited after exposure to 7–8 days of hypoxaemia. Oxford University Press 2015-04 2014-12-13 /pmc/articles/PMC4364061/ /pubmed/25501722 http://dx.doi.org/10.1093/bja/aeu404 Text en © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Translational Research
Martin, D. S.
Cobb, A.
Meale, P.
Mitchell, K.
Edsell, M.
Mythen, M. G.
Grocott, M. P. W.
Adams, Tom
Biseker, Lindsay
Booth, Adam
Burdall, Oliver
Cobb, Alexandra
Cumpstey, Andrew
Dauncey, Steve
Edsell, Mark
Farrant, James
Feelisch, Martin
Fernandez, Bernadette
Firth, Oliver
Gilbert, Edward
Grant, Daniel
Grocott, Michael
Hennis, Phil
Jackson, Laura
Jenner, Will
van der Kaaij, Jildou
Khosravi, Maryam
Kortekaas, Edith
Levett, Denny
Mahomed, Zeyn
Martin, Daniel
Meale, Paula
Milledge, Jim
Mitchell, Kay
Mole, Damian
Moses, Oliver
Mythen, Michael
Rigat, Fabio
O'Doherty, Alasdair
Salam, Alex
Sanborn, Matt
Sheperdigian, Adam
Shrubb, Fiona
Simpson, Jo
Talbot, Nick
Wandrag, Liesel
Wijesingha, Savini
Williamson, Wilby
Woolley, Tom
Yow, Heng
Systemic oxygen extraction during exercise at high altitude
title Systemic oxygen extraction during exercise at high altitude
title_full Systemic oxygen extraction during exercise at high altitude
title_fullStr Systemic oxygen extraction during exercise at high altitude
title_full_unstemmed Systemic oxygen extraction during exercise at high altitude
title_short Systemic oxygen extraction during exercise at high altitude
title_sort systemic oxygen extraction during exercise at high altitude
topic Translational Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364061/
https://www.ncbi.nlm.nih.gov/pubmed/25501722
http://dx.doi.org/10.1093/bja/aeu404
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