RESPIRATORY ADJUSTMENTS AT HIGH ALTITUDE

DEESHAN RAJ SIVASANKER 082013100017 IMS BANGALORE

LEARNING OUTCOMES
CHANGES OCCURING AT BODY IN HIGH ALTITUDE EFFECTS DURING RAPID ASCENT : PULMONARY OEDDEMA EFFECTS DURING SLOW ASCENT : MOTION SICKNESS ACCLIMATIZATION

INTRODUCTION
Height in excess of 10,000 feet (3000 meter) above the sea level is defined as HIGH ALTITUDE

Barometric Pressure -pressure decreases with increasing altitude -composition of air remains the same aa at the sea level -total pressure of air (P) will be equal to sum of partial pressure
P=pO2 + pCO2 + pN2 + pH2O

 Increase altitude causes : I. Decrease in Barometric Pressure ; hence total pressure of air decreases II. pH2O and pCO2 remains constant III. Progressive decrease in pO2 & pN2

Decrease in pN2 produces no effects on the body Therefore effects of high altitude entirely depends to decrease in pO2 ; effects of HYPOXIC HYPOXIA

 Effects of hypoxic hypoxia at high altitude depends on : I. Rate at which hypoxia develops i.e either Rapid Ascent or Slow Ascent II. Duration of stay : Long term stay e.g permanent residents at high altitude (Acclimatization)

EFFECTS OF HIGH ALTITUDE DURING RAPID ASCENT

Rapid ascent more than 10,000 feet can produce PULMONARY OEDEMA It is seen in individuals : I. Who engage in heavy physical work during 1st 3 days after arrival (75 80 % of subjects ) II. Who are acclimatized to high altitudes ; spend 2 weeks or more at sea level and then reascend

 CAUSES OF PULMONARY OEDEMA ARE : (A) Hypoxia - gets aggravated by work -increases membrane permeability of pulmonary capillaries -Hence producing Pulmonary Oedema (B) At high altitude sympathetic activity increases due to : I. Hypoxic stimulation of Vasomotor Center II. Cold (temperature falls by 2 degree for every 1000 feet or 300 meter increase altitude ) III. Increase physical work

Increase Sympathetic Activity

vasoconstriction Increase Pulmonary Capillary Pressure Drives the fluid out of Pulmonary Capillaries Pulmonary Oedema

EFFECTS OF HIGH ALTITUDE DURING SLOW ASCENT

At high altitude , individual suffers from MOUNTAIN SICKNESS Starts approximately 8 -12 hours after arrival at high altitude Last for about 4 - 8 days Mountain sickness are closely associated with CEREBRAL OEDEMA or ALKALOSIS

 It is characterised by : I. Nausea II. Vomitting III. Headache IV. Insomnia V. Dyspnoea Signs and Symptoms of Mountain Sickness can be prevented if : 1) Cerebral oedema is reduced by administration of large doses of GLUCOCORTICOIDS 2) Respiratory Alkalosis that results from HYPERVENTILATION is prevented by treatment with Acetazolamide

ACCLIMATIZATION
Definition -physiological readjustments and compensatory mechanism in the body that reduce the effects of hypoxia in permanent residents at high altitude These process permit a normal and prolonged life in people living in high altitudes

 Acclimation is possible by following process : 1) increase in Pulmanory Ventilation 2) Decrease Affinity of the Hemoglobin for O2 under hypoxic conditions 3) Rise in Hemoglobin Concentration 4) Increased Vascularity of Hypoxic Tissues 5) Increased Diffusion Capacity of lungs for O2 6) Changes at Tissue Level to Reduce the Effect of Hypoxia

REFERENCE
DIRECTOR PROFFESOR A.K.JAIN ,TEXT BOOK OF PHYSIOLOGY , PUBLISHED BY AVICHAL , 5TH EDITION , INDIA