Concepts in hypoxia reborn.


Martin, Daniel S., Khosravi, Maryam, Grocott, Mike P.W. and Mythen, Michael G. (2010) Concepts in hypoxia reborn. Critical Care, 14, (4), p. 315. (doi:10.1186/cc9078). (PMID:20727228).

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Description/Abstract

The human fetus develops in a profoundly hypoxic environment. Thus, the foundations of our physiology are built in the most hypoxic conditions that we are ever likely to experience: the womb. This magnitude of exposure to hypoxia in utero is rarely experienced in adult life, with few exceptions, including severe pathophysiology in critical illness and environmental hypobaric hypoxia at high altitude. Indeed, the lowest recorded levels of arterial oxygen in adult humans are similar to those of a fetus and were recorded just below the highest attainable elevation on the Earth's surface: the summit of Mount Everest. We propose that the hypoxic intrauterine environment exerts a profound effect on human tolerance to hypoxia. Cellular mechanisms that facilitate fetal well-being may be amenable to manipulation in adults to promote survival advantage in severe hypoxemic stress. Many of these mechanisms act to modify the process of oxygen consumption rather than oxygen delivery in order to maintain adequate tissue oxygenation. The successful activation of such processes may provide a new chapter in the clinical management of hypoxemia. Thus, strategies employed to endure the relative hypoxia in utero may provide insights for the management of severe hypoxemia in adult life and ventures to high altitude may yield clues to the means by which to investigate those strategies.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1186/cc9078
ISSNs: 1364-8535 (print)
Subjects: R Medicine > RJ Pediatrics
Organisations: Human Development & Health
ePrint ID: 348895
Date :
Date Event
30 July 2010Published
Date Deposited: 25 Feb 2013 10:28
Last Modified: 17 Apr 2017 15:59
Further Information:Google Scholar
URI: http://eprints.soton.ac.uk/id/eprint/348895

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