Mountains: physiological assessment of adverse mountain factors and prevention of complications in mountaineers

Physiological assessment of the effect of adverse factors of the mountains and prevention of complications in climbers.

Mountains - what associations generates this word? Transparent clean air, bright sun, blue sky. At the same time, mountaineering involves the performance of heavy physical exertion against the background of the continuing and constantly increasing hypobaric hypoxic hypoxia. The combination of hypoxia of physical activity with hypoxic hypoxia is quite a difficult condition for accomplishing the task of ascent. In the studies of Kolchinskaya AZ. It was shown that to increase the physical endurance of athletes physical training must be combined with hypoxic, applying them consistently, but not at the same time.

The effect on the body of the hypoxia factor when climbing the mountains is the worst option. To the combined effect of exercise hypoxia and hypoxic hypoxia, probable problems are added-weather instability, avalanches, rockfalls that intensify stress, and in combination can provoke trauma or a wrong decision, unpredictably prolong stay at altitude, and hence exposure to hypoxia on the body.

It is also unfavorable that the compensatory enhancement of respiration as a result of hypoxic hypoxia leads to the washing out of carbon dioxide-hypocapnia, an increase in the affinity of hemoglobin with oxygen, making it difficult to transition into tissues.

So, climbers are dealing with the worst variant of the action of overcome factors: the combination of hypoxia load and hypoxic hypoxia, with the difficulty of dissociation of oxyhemoglobin and its transition into tissues. The development of adaptation reactions in the oxygen transport system takes place under difficult conditions.

What is logical to undertake, anticipating the ascent? Naturally - physical training and adaptation to hypoxic hypoxia. Physical training programs are well developed and, as a rule, there are in view of climbers. With hypoxic adaptation at sea level is worse.

The fact that hypoxic adaptation is able to increase the body's resistance to external and internal adverse factors, including physical exertion and height hypoxia, is well known.

At the moment, we are talking about adaptation to the normobaric (at sea level) hypoxic hypoxia. The most important condition for the success of adaptation to hypoxia is the individual adaptation regime.

The individual adaptation regimen should be based on individual sensitivity to normobaric hypoxic hypoxia.

First of all, we are interested in the state of the elements of the functional system of oxygen transport: respiration, cardiovascular activity, blood.

Blood-the normal number and morphology of red blood cells, the amount of hemoglobin in them, the viscosity of the blood with a greater or lesser probability provide an adequate response to an additional external or internal load.

Easy-absence of acute or chronic disease also guarantees an adequate response.

Heart work, evaluated by electrocardiogram or echogram, according to the results of the exercise test, as normal, will not guarantee that the involvement of the heart in the adaptive reactions of the oxygen transport system to hypoxic hypoxia will be adequately and fully.

A peculiarity of the heart is that the primary source of energy in the myocardium under the normal mode of oxygen supply is fatty acids, the oxidation of which gives a greater effect of ATP synthesis than glucose.

In case of insufficient intake of oxygen, glycolysis inhibits the use of fatty acids, leading to a decrease in myocardial energy supply.

For this to happen it is not necessary, as it is done in modeling such situations in pathophysiological experiments, to pinch the coronary artery of the heart. It is enough to restrict the inflow of oxygenated blood from the small circle of blood circulation.

There is a physiological indicator characterizing the conditions of gas exchange in a small circle of circulation, - ventilation-perfusion ratio in the lungs - the ratio of ventilation of the lungs and perfusion of blood through the ventilated surface.

Instrumental measurement of this indicator is not easy, since it requires special equipment; in reality, an informative sample with an arbitrary respiratory hold (Stange's test) is available, indirectly reflecting how quickly the oxygen supply regime changes as a result of delay in breathing.

Normal fluctuations in the value of this indicator are considered to be from 40 to 60 seconds. The norm of the value of the ventilation-perfusion ratio measured by objective methods is equal to unity (1).

Changing the Stange sample gives grounds for suggesting a change in the sensitivity of the cardiovascular system to hypoxia.

In these circumstances, it can be assumed that the cardiovascular system is not fully adequate or limited in providing oxygen transport at additional loads.

Against the background of reduced energy supply, the additional burden on the myocardium, accompanied by the release of catecholamines, can aggravate the consequences of myocardial hypoxia up to necrosis - a heart attack.

What can be the reason for an unfavorable change in the ventilation-perfusion ratio in humans?

In the absence of any reason to think about ill-being in the lungs, vegetative regulation, most likely, the cause is a functional deficiency of cardiovascular reactivity due to hypoergosis of the heart, endothelial dysfunction and, as a consequence, the emergence of a trend towards centralization of the circulation.

What to do? After all, a person is not completely and not always able to clearly assess his condition.

     Dynamic physical load, for example, the test can pass without any obvious problems, since the involvement of muscle pumps contributes to a sharp increase in the volume flowing to the heart of the blood.

Another matter is the load without significant increase in blood circulation against the background of increasing hypoxic hypoxia.

This kind of "exercises" must be preceded by the diagnosis of cardiovascular reactivity and correction of even a hint of ill-being, the elimination of a functional deficit.

For this purpose, hypoxic training is needed in the form of "hypoxic fitness" - an automatically controlled and controlled normobaric hypoxic hypoxia.

The problem described above, the difficulty of an adequate assessment of cardiovascular reactivity is solved in the program "Hypoxic fitness" and the program "Physiological calculator" Blood circulation ".

The algorithm of the program controlling the process is based on a dynamic on-line analysis of cardiovascular reactivity as an element of the adaptive response of the oxygen transport system. The program is called - "Hypoxic fitness", involves ADAPTATION to hypoxia and does not require any special knowledge from the training subject.

The program is compatible with any of the existing single-site hypoxicators.

The program "Physiological calculator" Blood circulation "will help to fully appreciate the correspondence of real hemodynamics to weight, height and age, to observe the state during a hypoxic training session.

Hypoxic adaptation at sea level, prior to ascension in combination with consistently applied physical training will allow better prepare for the inevitable and dangerous, invisible and unwanted, but accompanying any ascent, factor - hypoxic hypoxia.