Uphill Athlete Podcast Gas Exchange and Altitude Acclimatization with Dr Patrycja Jonetzko
Feb 24, 2026
Patrycja Jonetzko, a cardiothoracic anesthetist and high-altitude medicine specialist with decades in the Himalaya, joins to unpack oxygen’s journey from air to muscle. She explains why partial pressure matters, how diffusion and breathing technique shape altitude performance, and the roles of hydration, hematocrit, and pre-acclimatization strategies. Practical physiology meets expedition hard-won wisdom in concise, science-forward advice.
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Fittest Climbers Often Suffered Most From Altitude
- Patrycja observed that the fittest climbers were often the sickest because they pushed too hard and ignored normal adaptation signals.
- Less driven or more cautious clients often acclimatized better and avoided severe HACE/HAPE episodes.
Altitude Performance Is Diffusion Limited
- At altitude exercise becomes diffusion-limited rather than VO2max-limited.
- Lung mechanics and diffusion capacity determine performance, so cardiovascular fitness alone won't overcome low partial pressures.
Avoid Mouth Breathing Keep Air Warm And Humid
- Avoid mouth breathing because cold, dry, dirty air increases energy cost and hampers diffusion.
- Breathe through the nose to warm and humidify air so alveoli maintain efficient gas exchange.