Tuesday, December 18, 2007

Recent publications in high altitude medicine

Dear colleagues and friends:

The organizing committee thanks all of those that expressed their interest in participating. We look forward to everyones participation with their interesting scientific work. You are all welcome.

We would like to inform you that some of our most recent publications are among the themes to be addressed at our forthcoming symposium:

High altitude diving depths.
Res Sports Med. 2007 Jul-Sep;15(3):213-23.
PMID: 17987509
Our pre-print copy can be read here

Thorsen HC, Zubieta-Calleja G, Paulev PE.
Decompression sickness following seawater hunting using underwater scooters.
Res Sports Med. 2007 Jul-Sep;15(3):225-39.
PMID: 17987510

Paulev PE, Siggaard-Andersen O.
Clinical application of the pO(2)-pCO(2) diagram.
Acta Anaesthesiol Scand. 2004 Oct;48(9):1105-14.
PMID: 15352956 [PubMed - indexed for MEDLINE]

Paulev PE, Zubieta-Calleja GR.
Essentials in the diagnosis of acid-base disorders and their high altitude application.
J Physiol Pharmacol. 2005 Sep;56 Suppl 4:155-70.
PMID: 16204789
Full pdf article. Read it here

Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Calleja N, Zubieta-Castillo G.
Hypoventilation in chronic mountain sickness: a mechanism to preserve energy.
J Physiol Pharmacol. 2006 Sep;57 Suppl 4:425-30.
PMID: 17072073
Full pdf article. Read it here

Zubieta-Castillo G Sr, Zubieta-Calleja GR Jr, Zubieta-Calleja L.
Chronic mountain sickness: the reaction of physical disorders to chronic hypoxia.
J Physiol Pharmacol. 2006 Sep;57 Suppl 4:431-42.
PMID: 17072074
Full pdf article. Read it here

Zubieta-Castillo G, Zubieta-Calleja GR, Zubieta-Calleja L, Zubieta-Calleja, Nancy.
Adaptation to life at the altitude of the summit of Everest.
Fiziol Zh. 2003;49(3):110-7. Review.
PMID: 12918259
Full pdf article. Read it here

Hope you enjoy them,


Poul-Erik Paulev, Gustavo Zubieta-Calleja and Gustavo Zubieta-Castillo (Sr).

Friday, December 14, 2007

Space Travel

Energy-efficient space travel alternative:

Hypobaric cabin pressure?

Gustavo Zubieta-Calleja (Jr)

The Panum Institute, Faculty of Health Sciences, University of Copenhagen

High Altitude Pathology Institute, Clinica IPPA. http://www.Altitudeclinic.com. La Paz, Bolivia

The following comments are conclusions of a “Doctor of Medical Sciences” dissertation, presented to the University of Copenhagen, entitled “Human Adaptation to High Altitude and Sea Level; Acid-Base Equilibrium, Ventilation and Circulation in Chronic Hypoxia” accepted for assessment on Sept 7th, 2007.

Based on 36 years of research related to high altitude polycythemia with Prof. Gustavo Zubieta-Castillo (Sr) in Bolivia and recently high altitude to sea level adaptation with Prof. Poul-Erik Paulev in Denmark, a greater understanding of the hematologic response to inspired oxygen pressure changes has led to the following:

Astronauts in the micro-gravity environment of space suffer many changes and among those anemia [1]. Thus far unexplained, neocytolisis has been described as the possible underlying mechanism [2, 3]. The adaptation to micro-gravity involves less use of muscle work and changes in ventilation and perfusion at lung level that the organism finds convenient to reduce the hematocrit following the least energy expenditure concept [4]. The knowledge and understanding of physiologic polycythemia (now known as polyerythrocythemia) upon ascent to high altitude and relative anemia following descent of high altitude residents to sea level [5, 6], allows for a logical proposal to bloodletting of high altitude residents on travel to sea level for periods longer than 20 days (an outstanding humanitarian blood resource) and similarly in astronauts when going into space. The logic is that they would economize energy avoiding the destructive hemolytic phase of adaptation. However, in astronauts, upon return to sea level, re-infusion of the phlebotomized blood could return the hematocrit to normal levels, although blood transfusion efficiency has lately been questioned. Erythropoyetine administration is also a possibility but less physiologic, more complicated and time limited.

Original space flights were carried out in a pure oxygen environment and one third the sea level pressure until serious fire accidents were encountered. Currently, the cabin pressure is normal sea level pressure at 760 mmHg with 20 % oxygen and 80 % nitrogen [7].

An alternative to the complication of space travel anemia would be to reduce the ambient oxygen tension within space vehicles, down to 2/3 the sea level pressure to around 495 mmHg (similar to the altitude of the city of La Paz with over 1.5 million inhabitants), in order to maintain a hypoxic stimulus and sustain the number of red blood cells for re-entry to Earth. Furthermore, the weightlessness space conditions require less oxygen consumption as there is less muscular use and hence tolerance to hypoxia can be increased. After an uncomplicated acute adaptation phase to hypoxia, with the adequate procedures, the astronauts can proceed with their normal routine during space travel. Upon return to sea level and the “relative hyperoxia”, the blood count should remain unchanged. This would create important advantages as there would be lower need for oxygen generation and pressure build-up, both high energy consumption processes. Likewise the Extravehicular Mobility Unit could benefit from a lower oxygen tension, less pressure difference with the space capsule, a speedier preparation and additionally more autonomy. Long space flights in the near future, would require less wasted resources in excess oxygen production and pressure. The return to the normal (relative hyperoxic) environment of sea level, would ease adaptation, as there would have been no reduction of the hematocrit during space flight [8]. Man faces future space travel where oxygen tensions will be a crucial life saving variable, and this proposal provides a physiological and physical energy-efficient alternative.


[1] Tavassoli M. Anemia of spaceflight. Blood. 1982 Nov;60(5):1059-67.

[2] De Santo NG, Cirillo M, Kirsch KA, Correale G, Drummer C, Frassl W, et al. Anemia and erythropoietin in space flights. Semin Nephrol. 2005 Nov;25(6):379-87.

[3] Rice L, Alfrey CP. The negative regulation of red cell mass by neocytolysis: physiologic and pathophysiologic manifestations. Cell Physiol Biochem. 2005;15(6):245-50.

[4] Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Calleja N, Zubieta-Castillo G. Hypoventilation in chronic mountain sickness: a mechanism to preserve energy. J Physiol Pharmacol. 2006 Sep;57 Suppl 4:425-30.

[5] Zubieta-Calleja GR, Paulev P-E, Zubieta-Calleja L, Zubieta-Castillo G. Altitude adaptation through hematocrit changes. J of Physiol and Pharmacol. 2007;58(Supplement in print).

[6] Zubieta-Castillo G, Sr., Zubieta-Calleja GR, Jr., Zubieta-Calleja L. Chronic mountain sickness: the reaction of physical disorders to chronic hypoxia. J Physiol Pharmacol. 2006 Sep;57 Suppl 4(2):431-42.

[7] NASA. Crew Compartment Cabin Pressurization. [cited 2007 June15, 2007]; Available from: http://spaceflight.nasa.gov/shuttle/reference/shutref/orbiter/eclss/cabinpress.html

[8] Zubieta-Calleja GR. Human adaptation to high altitude and to sea level: Acid-base equilibrium, ventilation, and circulation in chronic hypoxia. [Dissertation]. Copenhagen: University of Copenhagen; Sept 7th, 2007.

Photo courtesy of NASA, downloaded from http://www.geekphilosopher.com/MainPage/bkgStars.htm

Thursday, December 06, 2007

The new Poul-Erik High Altitude Diving Laboratory

The Zubieta University proudly presents the new

Poul-Erik Paulev High Altitude Diving Laboratory

open to anyone interested in pursuing research related to high altitude diving in the Lake Titicaca (1 hour from La Paz) and also up to Lake Licancabur "the highest diving lagoon in the world". We welcome theoretical studies and discussions with Prof. Paulev, for the constant improvement of diving science.
Visit the website....

Sunday, June 24, 2007

Two Danish Physiologist and one Bolivian support soccer at high altitude

FIFA (Fédération Internationale de Football Association), Football's governing body, has once more banned international matches from being played at more than 2,500m (8,200ft) above sea level. It then changed to 3000 m. They said the decision was made because of concerns over players' health and possible distortion of competition.

Just want to pass along a letter mailed this week to Bolivia's president, Evo Morales, by my colleague Gustavo Zubieta of the Institute of High Altitude Pathology in La Paz, in reference to the recent FIFA effort to ban high altitude soccer games.

Dr. Zubieta, one of the world's leading authorities on high altitude physiology, is presently at the University of Copenhagen. The letter is also signed by Prof. Jens Bangsbo, an international authority on soccer physiology and Prof. Poul-Erik Paulev exercise physiologist from the University of Copenhagen.

The letter specifically notes that "based on extensive knowledge over many years of work in research on exercise, pressure changes, environmental changes and different conditions that the human body can tolerate during the practice of sports", that "the world games of soccer can and should be played in the high altitude cities of La Paz."

You can download a copy by clicking on the image above or accesing this link:


En Español:

Michael Moretti
High Altitude Medical Anthropologist
La Paz, Bolivia

June 24, 2007

Sunday, June 10, 2007

Dear Colleagues and friends from around the globe:

We are proud to send this 1st Announcement of the forthcoming:

Lake Titicaca 3800 m. One place of the itinerant symposium.

II Symposium

Aug 2-9, 2008

La Paz, Bolivia

Lake Titicaca 3800 m. Part of the itinerant symposium

Please visit our website:

We look forward to seeing you in 2008 !!!

Prof. Dr. Gustavo Zubieta-Castillo (Sr) and Prof. Dr. Gustavo Zubieta-Calleja (Jr)

Thursday, March 29, 2007

Hanns-Christian Gunga visits La Paz

Once more our good friend Hanns-Christian Gunga was in La Paz in Dec, 2006 and we had a wonderful visit at the High Altitude Pathology Clinic and a great dinner at a local ***** restaurant. This time he came with Prof. Karl Kirsch of the Department of Physiology, Charite-Universitatsmedizin and Center of Space Medicine, Berlin, Germany. We made plans for joint research in our Pyramid in Chacaltaya.
This photo is in the waiting room of IPPA.