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FIVE FI(tUEE6Among the physiological adjustments to a low barometric pressure an increase in ventilation is perhaps one of the most important. In consequence we may suppose that the native of high altitude possesses a respiratory mechanism adapted for a better ventilation and for an efficient interchange of respiratory gases. But, curiously enough, this logical supposition has not been adequately investigated, and throughout the extensive literature related to high altitude it is only briefly mentioned, or considered as being of secondary importance. This is due to the erroneous idea of interpreting the changes which occur in the organism under the influence of short time exposures to a low oxygen tension as indicating adaptation. It has not been emphasized that, regardless of the time which a man from sea level spends at high altitude, he is always physically, and possibly mentally too, inferior to the native of these high places. Adaptation in its true meaning will be revealed only by studying the man who has been an inhabitant of high altitude for centuries. We have already discussed (Hurtado, '32) the blood morphology of the Indian natives of the Peruvian Andes. The present observations are related to the respiratory adaptation, from the anatomic and anthropomorphic points of view, These investigations have been partly supported by the Medical Faculty of the University of San Marcos (Lima, Peru).

To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

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In a previous paper (5) we have presented the results of 50 determinations of pulmonary capacity made in an equal number of healthy males.It was demonstrated that the relative capacities (expressed in percentages of the total volume) fluctuated within narrow limits, but that there were wide variations in the absolute figures found for the total volume and its subdivisions. This fact makes rather difficult the recognition of moderate, and perhaps important, deviations in a given case, and also prevents a clear understanding of any alterations in the relative values. Thus a low ratio (Vital capacity/Total volume) X 100 may be caused by either increased residual air, low vital capacity, or a combination of both factors, and the proper interpretation will be obtained only if normal values are available for comparison. To standardize the procedure, it appears to be necessary to find a correlation between the pulmonary capacity and certain bodily characteristics, so that from a knowledge of the latter it may be possible to predict the normal volumes. If we have at our disposal reliable criteria to permit judgment of changes in absolute, as well as in relative pulmonarv capacity a clearer view of the underlying pathological physiology may be obtained. A basis may also be provided for the proper classification and grouping of cases of respiratory inefficiency in which defective alveolar ventilation is an important factor.Although numerous investigations have been made to correlate the vital capacity to body or chest measurements, there have been very few attempts to correlate these characteristics with the total pulmonary capacity or with any one of its subdivisions, other than vital capacity. Lundsgaard and Van Slyke (7) in 1918 found in a few cases a definite correlation between the total capacity, vital capacity, mid capacity and residual air, and the so-called " chest volume," calculated from the external measurement of the three diameters of the chest obtained at the end of full inspiration and expiration under resting conditions. This investigation was later confirmed by Lundsgaard and Schierbeck (6) who found a similar relationship and also conTravelling Fellow of the Rockefeller Foundation. 807

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