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    The oxygen saturation values reported in the high altitude literature are usually taken during a few minutes of measurement either at rest or during exercise. We aimed to investigate the daily hypoxic profile by monitoring oxygen saturation for 24h in 8 lowlanders (4 females, ages 26 to 59) during trekking from Lukla (2850m) to the Pyramid Laboratory (5050m). Oxygen saturation was measured (1) daily at each altitude (sm), (2) for 24-h during ascent to 3500m, 4200m, and on day 1 at 5050m (lm), and (3) during a standardized exercise (em). Results: (1) the sm and lm values were 90.9% (±0.5) and 86.4% (±1.1) at 3500m; 85.2%(±1.1), and 80% (±1.9) at 4200m; 83.8%(±1) and 77% (±1.7) at 5050m (p<0.05); (2) the daily time spent with oxygen saturation <90% was 56.5% at 3500m, 81% at 4200m, and 95.5% at 5050m; (3) during exercise, oxygen saturation decreased by 10.58%, 13.43%, and 11.24% at 3500, 4200, and 5050?m, respectively. In conclusion, our data show that the level of hypoxemia during trekking at altitude is more severe than expected on the basis of a short evaluation at rest and should be taken into account.

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    We tested the hypothesis that the individual ventilatory adaptation to high altitude (HA, 5050 m) may influence renal water excretion in response to water loading. In 8 healthy humans (33+/-4 S.D. years) we studied, at sea level (SL) and at HA, resting ventilation (VE), arterial oxygen saturation (SpO2), urinary output after water loading (WL, 20 mL/kg), and total body water (TBW). Ventilatory response to HA was defined as the difference in resting VE over SpO2 (DeltaVE/DeltaSpO2) from SL to HA. At HA, a significant increase in urinary volume after the first hour from WL (%WLt0-60) was observed. Significant correlations were found between DeltaVE/DeltaSpO2 versus %WLt0-60 at HA and versus changes in TBW, from SL to HA. In conclusion, in healthy subjects the ventilatory response to HA influences water balance and correlates with kidney response to WL. A higher ventilatory response at HA, allowing a more efficient water renal handling, is likely to be a protective mechanisms from altitude illness.