Research Topic

Survival in Extreme Environments – Adaptation or Decompensation?

About this Research Topic

Preclinical and Clinical New Documentation to Facilitate Adaptation and to Manage Critical Care Conditions

The history of human migration is also the history of successful biological interactions with new environments, where maintenance of body homeostasis is the fundamental property of this ...

Preclinical and Clinical New Documentation to Facilitate Adaptation and to Manage Critical Care Conditions

The history of human migration is also the history of successful biological interactions with new environments, where maintenance of body homeostasis is the fundamental property of this adaptation. Equilibrium of body homeostasis is the product of many regulatory physiologic mechanisms and seems to be the consequence of a natural resistance to change from a pre-existing optimal biological condition. Adaptation to a new equilibrium may take place within seconds, whereas chronic or functional adaptation is the product of processes, which may run for the whole life of an individual. Challenges to maintain biological equilibrium in a new environment, or more simply, to stay alive, include climate, ambient temperature, high altitude, and the immediate access to nature-given resources like food, water, and shelter. When exposed to extreme environments accidents may take place; the victims are suddenly no longer adapted and may decompensate due to hyper-/hypothermia, high-/low ambient pressures, and drowning. Professional workers like divers, extraction industry workers, anglers and hunters, seamen, or people seeking these elements during leisure or recreational activity, all depend on their ability to adapt, but share the same potential threat that their biological homeostasis will disrupt in case of an accident. The rescuers, on the other hand, may often meet other challenges, like the lack of practice or institutes without the proper care of patients with these relative rare conditions, or worse, attempting to treat such decompensated patients where the guidelines for treatment are not yet written.

To write these guidelines, we need new knowledge. However, due to obvious reasons, new knowledge of the complex pathophysiologic mechanisms evoked by these accidents can only be collected from experiments in preclinical models. Due to the very intrinsic integrative nature of the physiological mechanisms involved in adaptation – or not – to extreme environmental challenges, it is sometimes difficult to understand them in their entirety. Fortunately, new opportunities have arisen with the advent of biomolecular techniques, providing tools to better understand the interactions between the different levels of integration within the body, allowing us to see the bigger picture.

This Research Topic welcomes review papers and original research describing biologic interactions during exposure to extreme environments leading to adaptive or maladaptive responses, and eventual decompensation. New knowledge is needed to continuously create interventions, which may facilitate adaptation, prevent maladaptation, and to optimize life-saving procedures. It focuses on the following themes but is not limited to them:

• Physiologic consequences of hypothermia and rewarming on organ function.
• Effects of rewarming procedures to restore organ function.
• Biological underpinnings of adaptive and maladaptive responses to diving.
• Effects of treatment for diving related medical conditions.
• Pharmacological interventions to alleviate harmful effects of exposure to extreme environments.
• Countermeasures to mitigate and/ or support the physiological and physical challenges of extreme environmental exposures (e.g. nutritional strategies).
• Strategies to promote adaptations in extreme environmental conditions for a range of purposes, such as occupational, mountaineering or athletic performance.

Topic Editor Sanjoy Deb received financial support from Equinor. The other Topic Editors declare no competing interests with regard to the Research Topic subject.


Keywords: Extreme Environments, Homeostasis, Critical Care, Adaptation, Decompensation


Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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Submission Deadlines

31 July 2021 Manuscript

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Manuscripts can be submitted to this Research Topic via the following journals:

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Topic Editors

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Submission Deadlines

31 July 2021 Manuscript

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

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