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Transient hypoxic ventilatory response tests lack feasibility and fail to capture the integrated steady\u2010state responses to chronic hypoxic exposure in HA fieldwork. We recently characterized a novel index of steady\u2010state respiratory chemoreflex drive (SSCD), accounting for integrated contributions from central and peripheral respiratory chemoreceptors during steady\u2010state breathing at prevailing chemostimuli. Acetazolamide is often utilized during ascent for prevention or treatment of altitude\u2010related illnesses, eliciting metabolic acidosis and stimulating respiratory chemoreceptors. To determine if SSCD reflects VA during ascent to HA, we characterized SSCD in 25 lowlanders during incremental ascent to 4240\u2009m over 7\u2009days. We subsequently compared two separate subgroups: no acetazolamide (NAz; <jats:italic>n<\/jats:italic>\u00a0=\u200914) and those taking an oral prophylactic dose of acetazolamide (Az; 125\u2009mg BID; <jats:italic>n<\/jats:italic>\u00a0=\u200911). At 1130\/1400\u2009m (day zero) and 4240\u2009m (day seven), steady\u2010state measurements of resting ventilation (V\u0307<jats:sub>I<\/jats:sub>; L\/min), pressure of end\u2010tidal (P<jats:sub>ET<\/jats:sub>)CO<jats:sub>2<\/jats:sub> (Torr), and peripheral oxygen saturation (SpO<jats:sub>2<\/jats:sub>; %) were measured. A stimulus index (SI; P<jats:sub>ET<\/jats:sub>CO<jats:sub>2<\/jats:sub>\/SpO<jats:sub>2<\/jats:sub>) was calculated, and SSCD was calculated by indexing V\u0307<jats:sub>I<\/jats:sub> against SI. We found that (a) both V\u0307<jats:sub>I<\/jats:sub> and SSCD increased with ascent to 4240\u2009m (day seven; V\u0307<jats:sub>I<\/jats:sub>: +39%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001, Hedges' <jats:italic>g<\/jats:italic>\u00a0=\u20091.52; SSCD: +56.%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.0001, Hedges' <jats:italic>g<\/jats:italic>\u00a0=\u20091.65), (b) and these responses were larger in the Az versus NAz subgroup (V\u0307<jats:sub>I<\/jats:sub>: <jats:italic>p<\/jats:italic>\u00a0=\u20090.02, Hedges' <jats:italic>g<\/jats:italic>\u00a0=\u20091.04; SSCD: <jats:italic>p<\/jats:italic>\u00a0=\u20090.02, Hedges' <jats:italic>g<\/jats:italic>\u00a0=\u20091.05). The SSCD metric may have utility in assessing VA during prolonged stays at altitude, providing a feasible alternative to transient chemoreflex tests.<\/jats:p>","DOI":"10.14814\/phy2.15521","type":"journal-article","created":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T06:57:10Z","timestamp":1670050630000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Steady\u2010state chemoreflex drive captures ventilatory acclimatization during incremental ascent to high altitude: Effect of acetazolamide"],"prefix":"10.14814","volume":"10","author":[{"given":"Valerie C.","family":"Cates","sequence":"first","affiliation":[{"name":"Department of Biology, Faculty of Science and Technology Mount Royal University  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina D.","family":"Bruce","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Science and Technology Mount Royal University  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony L.","family":"Marullo","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Science and Technology Mount Royal University  Calgary Alberta Canada"},{"name":"Department of Physiology. 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