Effects of altitude on spleen volume: Sonographic assessment

Sönmez, Güner; Öztürk, Ersin; Başekim, C. Çınar; Mutlu, Hakan; Kılıç, Selim; Önem, Yalçın; Kızılkaya, Eşref

doi:10.1002/jcu.20346

Cited by 20 publications

(26 citation statements)

References 19 publications

(22 reference statements)

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“…Both our present study and the results cited above seem to be conflicting with a study by Sonmez et al (2007), in which it was reported that long-term exposure to high altitude in lowlanders resulted in reduced splenic volume and increased Hb across 6 months. In that time, substantial altitude acclimatization has elevated Hb via increased erythropoiesis, and it is not clear how this relates to the relatively short-term adjustments seen in the current study.…”

Section: Discussioncontrasting

confidence: 99%

Spleen contraction elevates hemoglobin concentration at high altitude during rest and exercise

et al. 2020

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Purpose Hypoxia and exercise are known to separately trigger spleen contraction, leading to release of stored erythrocytes. We studied spleen volume and hemoglobin concentration (Hb) during rest and exercise at three altitudes. Methods Eleven healthy lowlanders did a 5-min modified Harvard step test at 1370, 3700 and 4200 m altitude. Spleen volume was measured via ultrasonic imaging and capillary Hb with Hemocue during rest and after the step test, and arterial oxygen saturation (SaO2), heart rate (HR), expiratory CO2 (ETCO2) and respiratory rate (RR) across the test. Results Resting spleen volume was reduced with increasing altitude and further reduced with exercise at all altitudes. Mean (SE) baseline spleen volume at 1370 m was 252 (20) mL and after exercise, it was 199 (15) mL (P < 0.01). At 3700 m, baseline spleen volume was 231 (22) mL and after exercise 166 (12) mL (P < 0.05). At 4200 m baseline volume was 210 (23) mL and after exercise 172 (20) mL (P < 0.05). After 10 min, spleen volume increased to baseline at all altitudes (NS). Baseline Hb increased with altitude from 138.9 (6.1) g/L at 1370 m, to 141.2 (4.1) at 3700 m and 152.4 (4.0) at 4200 m (P < 0.01). At all altitudes Hb increased from baseline during exercise to 146.8 (5.7) g/L at 1370 m, 150.4 (3.8) g/L at 3700 m and 157.3 (3.8) g/L at 4200 m (all P < 0.05 from baseline). Hb had returned to baseline after 10 min rest at all altitudes (NS). The spleen-derived Hb elevation during exercise was smaller at 4200 m compared to 3700 m (P < 0.05). Cardiorespiratory variables were also affected by altitude during both rest and exercise. Conclusions The spleen contracts and mobilizes stored red blood cells during rest at high altitude and contracts further during exercise, to increase oxygen delivery to tissues during acute hypoxia. The attenuated Hb response to exercise at the highest altitude is likely due to the greater recruitment of the spleen reserve during rest, and that maximal spleen contraction is reached with exercise.

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Section: Discussioncontrasting

confidence: 99%

Spleen contraction elevates hemoglobin concentration at high altitude during rest and exercise

et al. 2020

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“…This formula is often used for predicting the volume of many irregularly shaped organs (Asghar et al, 2011b;Yetter et al, 2003;Sonmez et al, 2007). In literature findings, it was seen that elipsoid formula was used.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Determination of Normal Spleen Size in Turkish Adults

et al. 2015

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“…Using ultrasonography, Sonmez et al (2007) conWrmed that 3-6 months exposure to altitude through relocation of lowlanders resulted in reduced splenic volume and concomitant increases in Hb and Hct, but no speciWc focus was directed toward the ascent and descent phases. Richardson and associates (2007) discovered that the transient elevation in Hb during apnea was attenuated and eventually disappeared as individuals travelled to progressively higher altitudes, during which time an overall polycythemia occurred.…”

Section: Introductionmentioning

confidence: 97%

Short-term effects of normobaric hypoxia on the human spleen

Richardson

Lodin

Reimers³

et al. 2007

Eur J Appl Physiol

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Spleen contraction resulting in an increase in circulating erythrocytes has been shown to occur during apnea. This effect, however, has not previously been studied during normobaric hypoxia whilst breathing. After 20 min of horizontal rest and normoxic breathing, five subjects underwent 20-min of normobaric hypoxic breathing (12.8% oxygen) followed by 10 min of normoxic breathing. Ultrasound measurements of spleen volume and samples for venous hemoglobin concentration (Hb) and hematocrit (Hct) were taken simultaneously at short intervals from 20 min before until 10 min after the hypoxic period. Heart rate, arterial oxygen saturation (SaO(2)) and respiration rate were recorded continuously. During hypoxia, a reduction in SaO(2) by 34% (P < 0.01) was accompanied by an 18% reduction in spleen volume and a 2.1% increase in both Hb and Hct (P < 0.05). Heart rate increased 28% above baseline (P < 0.05). Within 3 min after hypoxia SaO(2) had returned to pre-hypoxic levels, and spleen volume, Hb and Hct had all returned to pre-hypoxic levels within 10 min. Respiratory rate remained stable throughout the protocol. This study of short-term exposure to eupneic normobaric hypoxia suggests that hypoxia plays a key role in triggering spleen contraction and subsequent release of stored erythrocytes in humans. This response could be beneficial during early altitude acclimatization.

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Effects of altitude on spleen volume: Sonographic assessment

Abstract: Our data show that splenic volume in healthy individuals who begins to live at high altitudes decreases gradually.

Cited by 20 publications

References 19 publications

Spleen contraction elevates hemoglobin concentration at high altitude during rest and exercise

Spleen contraction elevates hemoglobin concentration at high altitude during rest and exercise

Sonographic Determination of Normal Spleen Size in Turkish Adults

Short-term effects of normobaric hypoxia on the human spleen

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