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| Kessler Peak in the Wasatch: 10,400 feet |
Several years ago,
I posted about empirical confirmation of West's theoretical blood gas results at altitude on Everest. (
Last week, an avalanche on Everest took more lives in a single day than any other in the history of the mountain.) The remarkably low PaO2 values (mean 26 mm Hg) demonstrated by those authors, (and the correspondingly low
estimated SaO2 values) are truly incredible and even bewildering especially from the perspective of clinical practice where we often get all bent out of shape with PaO2 values under 55 mm Hg or so. Documentation of the PaO2 values in the "natural experiment" that mountaineers subject themselves to serves as fodder for ponder for those of us who are prone to daydreaming about physiology: is tolerance of these low values possible only because of acclimatization and extreme physical fitness? (but they're exercising, not just standing there!) what is the lower safe limit of hypoxemia? does it vary by age? the presence of other illnesses? is there a role for
permissive hypoxemia in the practice of critical care?
