Potential for use of hypoxic preconditioning in aviation medicine

The paper evaluates Russian and foreign literature on the positive effects of dosed hypoxia on human body in the setting of training stimulation. This model can serve as a theoretical basis for the development of a hypoxic preconditioning technique, which can be extremely useful for air medical officers to maintain the professional health of pilots in modern conditions. The aim of this review was to inform a wide range of stakeholders about the various effects of hypoxic preconditioning, including cardioprotective, neuroprotective and vasoprotective effects. Existing hypoxic training techniques were reviewed, especially the advantages of normobaric hypoxic training to improve the functional status of pilots. The main advantages of this technique include possibility of wide use on flat terrain, the absence of changes in atmospheric pressure during training, no need for specially trained personnel and special premises, the possibility of selecting an individual training program, combination of hypoxic training with everyday tasks, minimal side effects, and long-term maintenance of training results. The mechanisms underlying hypoxic preconditioning are discussed, including the activation of genes encoding proteins involved in the regulation of oxygen homeostasis. The latest research data in hypoxic training are described. The paper also addresses issues that are not generally understood by practitioners who use hypoxia for therapeutic and preventive purposes (effectiveness of different techniques, role of blood saturation levels during hypoxic training, difference between preconditioning and postconditioning, and other aspects of practical hypoxic therapy). All these questions need to be answered in the near future in order to better understand the activation of human internal defense mechanisms by non-drug methods. Further studies are needed to determine the optimal preconditioning technique, including the duration and intensity of hypoxia exposure.