In 2019, the scientists who discovered how cells sense and adapt to oxygen availability were awarded the Nobel Prize. This elegant sensing pathway is conserved throughout evolution, and it underpins the physiology and pathology that we, as clinicians in anaesthesia and critical care, encounter on a daily basis. The purpose of this review is to bring hypoxia-inducible factor, and the oxygen-sensing pathway as a whole, to the wider clinical community. We describe how this unifying mechanism was discovered, and how it orchestrates diverse changes such as erythropoiesis, ventilatory acclimatisation, pulmonary vascular remodelling and altered metabolism. We explore the lessons learnt from genetic disorders of oxygen sensing, and the wider implications in evolution of all animal species, including our own. Finally, we explain how this pathway is relevant to our clinical practice, and how it is being manipulated in new treatments for conditions such as cancer, anaemia and pulmonary hypertension.

中文翻译：

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氧传感、麻醉和重症监护：叙述性回顾

2019 年，发现细胞如何感知和适应氧气供应的科学家获得了诺贝尔奖。这种优雅的传感途径在整个进化过程中都是保守的，它支撑着我们作为麻醉和重症监护的临床医生每天遇到的生理学和病理学。本综述的目的是将缺氧诱导因子和整个氧传感通路带给更广泛的临床社区。我们描述了这种统一机制是如何被发现的，以及它如何协调各种变化，例如红细胞生成、通气适应、肺血管重塑和新陈代谢改变。我们探索从氧气感应遗传疾病中吸取的教训，以及对包括我们自己在内的所有动物物种进化的更广泛影响。最后，