The effects of high altitude ascent on splenic contraction and the diving response during voluntary apnoea

New Findings What is the central question of this study? What is the relative contribution of a putative tonic splenic contraction to the haematological acclimatization process during high altitude ascent in native lowlanders? What is the main finding and its importance? Spleen volume decreased by −14.3% (−15.2 ml) per 1000 m ascent, with an attenuated apnoea‐induced [Hb] increase, attesting to a tonic splenic contraction during high altitude ascent. The [Hb]‐enhancing function of splenic contraction may contribute to restoring oxygen content early in the acclimatization process at high altitude. Voluntary apnoea causes splenic contraction and reductions in heart rate (HR; bradycardia), and subsequent transient increases in haemoglobin concentration ([Hb]). Ascent to high altitude (HA) induces systemic hypoxia and reductions in oxygen saturation (SpO2), which may cause tonic splenic contraction, which may contribute to haematological acclimatization associated with HA ascent. We measured resting cardiorespiratory variables (HR, SpO2, [Hb]) and resting splenic volume (via ultrasound) during incremental ascent from 1400 m (day 0) to 3440 m (day 3), 4240 m (day 7) and 5160 m (day 10) in non‐acclimatized native lowlanders during assent to HA in the Nepal Himalaya. In addition, apnoea‐induced responses in HR, SpO2 and splenic volume were measured before and after two separate voluntary maximal apnoeas (A1–A2) at 1400, 3440 and 4240 m. Resting spleen volume decreased −14.3% (−15.2 ml) per 1000 m with ascent, from 140 ± 41 ml (1400 m) to 108 ± 28 ml (3440 m; P > 0.99), 94 ± 22 ml (4240 m; P = 0.009) and 84 ± 28 ml (5160 m; P = 0.029), with concomitant increases in [Hb] from 125 ± 18.3 g l−1 (1400 m) to 128 ± 10.4 g l−1 (3440 m), 138.8 ± 12.7 g l−1 (4240 m) and 157.5 ± 8 g l−1 (5160 m; P = 0.021). Apnoea‐induced splenic contraction was 50 ± 15 ml (1400 m), 44 ± 17 ml (3440 m; P > 0.99) and 26 ± 8 ml (4240 m; P = 0.002), but was not consistently associated with increases in [Hb]. The apnoea‐induced bradycardia was more pronounced at 3440 m (A1: P = 0.04; A2: P = 0.094) and at 4240 m (A1: P = 0.037 A2: P = 0.006) compared to values at 1400 m. We conclude that hypoxia‐induced splenic contraction at rest (a) may contribute to restoring arterial oxygen content through its [Hb]‐enhancing contractile function and (b) eliminates further apnoea‐induced [Hb] increases in hypoxia. We suggest that tonic splenic contraction may contribute to haematological acclimatization earl