Hypoxia and Altitude

Background:
 Hypoxia is a state of oxygen deficiency in the body
sufficient to impair functions of the brain and other organs.
 Altitude can be defined as the height of an object or point
in relation to sea level or ground level.
 When your body doesn't have enough oxygen, you could get
hypoxemia or hypoxia. These are dangerous conditions. Without
oxygen, your brain, liver, and other organs can be damaged just
minutes after symptoms start.

 The first hypoxia-related casualties were reported in 1878 by Paul

Bert as balloonists traveled high into the atmosphere.
 Introduction:
 The use of oxygen as an electron acceptor in the
respiratory chain and the consequent higher efficiency in
the production of chemical energy (adenosine 5'-
triphosphate - ATP) has allowed the development of
higher, multicellular forms of life.

 Hypoxia is a state where oxygen availability/ delivery is below

the level of necessary to maintain physiological O2 tensions of a

particular tissue i.e. when the tissue demand exceeds its O2
supply.
Introduction:
 In other words, hypoxia results from an imbalance between demand
and supply of oxygen. It is of note that different tissues have different
oxygenation levels already at sea levels.

 For instance, a mean pressure of oxygen of 18 mmHg (2.5%) was

measured at 1mm depth in the cerebral cortex (159) whereas in the
renal cortex 20-30 mmHg of oxygen (3-4%) have been measured (33,
130).

 Although these tissues appear hypoxic, this is their normal

physiological oxygen levels at which homeostasis is maintained.
Hypoxia can occur at both Local and Systemic Levels.
 Types:
 Local level
 Systemic level
 Systemic hypoxia in mammals occurs mostly in high
altitude, in case of congenital or acquired heart or lung
disease or in anemia whereas local (or tissue) hypoxia
results in most cases from impaired/insufficient
vascular supply as for example in stroke, coronary
insufficiency or solid tumors.
 Responses:
 Systemic hypoxic exposure triggers two main responses: a systemic
(organism) response and a cellular one.

 systemic response is mediated by chemoreceptors and the central and peripheral nervous system
causing changes in overall physiological parameters such as respiration and heart rate.

 The cellular response is mediated by the hypoxia-inducible factors (HIFs).

 The best studied factor of this group is the hypoxia inducible factor 1(HIF-I), a heterodimer consisting of
the subunits HIF-1α and HIF-β. HIF-1α protein is not detected under normoxic conditions but increase
exponentially with decreasing P O2 whereas HIF-1β is not affected by oxygenation levels.

 Activation of the HIF-I pathway has consequences for the cellular as well as systemic adaptation to
hypoxia.
Pathway of HIF:
 Signs and Symptoms:
Signs of Hypoxia
 Poor coordination

 Cyanosis ( the skin turns blue in color)

 Rapid breathing

 Poor judgment

 Lassitude/ Lethargy
 Symptoms of Hypoxia
 Hot and cold flashes

 Muscle and mental fatigue

 Headache

 Air Hunger

 Nausea

 Dizziness

 Euphoria

 Tingling

 Visual Impairment
 Anoxia - This is when there is no oxygen in the tissues or
arterial blood or in inspired gases. This is also known as
severe hypoxia.
 Altitude sickness - This is the result of less oxygen in
the tissue and blood at high altitudes.
 Asphyxiation, suffocation - This occurs when
breathing stops due to oxygen deprivation.