High Altitude Medicine and Physiology

Abstract

This book is written by four eminent physicians and physiologists from the UK and the USA, the most well known of whom, Professor John West, continues to be very active in research and teaching in respiratory physiology. The authority of the authors is unquestionable. The audience will include anyone with an interest in the effects of altitude on human physiology and the medical consequences of ascent to altitude. Although prin- cipally targeted at those working with mountain dwellers and climbers, the content has some relevance in aviation, especially in the basic understanding of human cardiorespiratory physiology. This latest edition of a well-respected textbook of the physiology and related pathophysiology of ascent to high altitude has been revised, extended and updated. It broadly follows a similar layout to previous editions. Thus, there are chapters describing the history of the scientific study of the physics and physiology of manned exploration of high terrestrial altitudes, the geography of exploration, the cardiorespiratory and metabolic physiology in detail and the medical consequences of ascent, especially the most severe forms of acute and chronic mountain sickness. It also adds a new chapter bringing the genetics of the topic together and a greatly expanded section on hypoxia-inducible factors. Women, children and the elderly receive more detailed attention too, as do pre-existing medical conditions at altitude. Despite this, the overall chapter count has been reduced by incorporating topics such as frostbite and non-freezing cold injury within broader topics. Overall, this seems to make the text feel more focused. There is a logical flow to this very readable text. It is perfectly possible to sit down to read this book for interest as much as scientific study and yet the well-referenced details are there too. The updating has been comprehensive, even so far as including short sections on the current debate about the effects of normobaric versus hypobaric hypoxia and the effects of altitude exposure on patients with obstructive sleep apnoea. The book also includes updated sections on metabolic and renal functions, as well as a description of the role of pharmacological interventions. This book addresses the biomedical effects of mountain climbing and high-altitude residence. It does not address specifically the acute effects of flight. Nevertheless, the clear descriptions of the relevant areas of physiology have much wider value for both the student and researcher. A new facet of purchasing a book such as this is the opportunity included with it of accessing the text online, which may save carrying the volume about and which allows the publisher to add more colour to the illustrations in some cases. There is a scratch panel in the insider front cover of the book, which reveals a code number to be used when you have registered for the specific retrieval system. Somewhat less convenient was the 15-min conversation, with a very helpful representative in South Carolina, to get the system to work! However, I would not let that put me off this book. It is an excellent update of a valuable text and one I am happy to recommend to all those with an interest in high altitude medicine and the care of those who go there.