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o2max, blood doping, and erythropoietin
  1. M J Joyner
  1. Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA
  1. Correspondence to: 
 Professor Joyner, Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; 

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Methods (legal and illegal) of increasing total body haemoglobin and thereby o2max are discussed

By the 1930s it was clear that champion endurance athletes had remarkably high maximal O2 uptake (o2max).1 In the 1950s, 1960s, and 1970s, classic studies were performed on the physiological determinants of o2max and on its key role in endurance performance.2–4 During this time there was much debate on O2 delivery versus O2 extraction as the “limiting factor” for o2max.5,6 Observations during this era clearly established the role of maximal cardiac output as a determinant of o2max, and very high maximal cardiac output values were seen in champion endurance athletes.2 In addition, the important role of blood volume and total body haemoglobin as determinants of o2max also emerged (fig 1).2,7–9 In an effort to better understand the physiological determinants of o2max, studies were then conducted that attempted to manipulate O2 delivery using a variety of approaches including altered concentrations of inspired O2, drugs that speed or slow the heart, and, as will be discussed here, techniques that altered total body haemoglobin and haemoglobin concentration.10,11

In general, by the 1970s it was clear that manoeuvres that increased total body haemoglobin increased o2max and manoeuvres that reduced total body haemoglobin reduced o2max. …

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