Final answer:
The major factor that drives the acute altitude-associated decrease in VO2max is inadequate alveolar PO2.
Step-by-step explanation:
The major factor that drives the acute altitude-associated decrease in VO2max is inadequate alveolar PO2. When exposed to high altitudes, the atmospheric pressure is lower, resulting in a low partial pressure of oxygen in the air. This leads to a decrease in the amount of oxygen that crosses the respiratory membrane and enters the blood of the pulmonary capillaries. As a result, there is a lower oxygen saturation level of hemoglobin in the blood, causing a decrease in VO2max.