Name: a model to simulate clinically relevant hypoxia in humans
Uploaded: 2016-12-22T14:00:00
Description: Watch this Scientific Journal Video about A Model to Simulate Clinically Relevant Hypoxia in Humans at JoVE.com

Special thanks to all volunteers who participated in the original study. The work of L. Eichhorn was supported through a scholarship of the Else-Kr&#246;ner-Fresenius Foundation. The authors would like to thank Springer, Part of Springer Science+Business Media, for copyright clearance (License Number 3894660871180) and the kind permission of reusing previously published data.

ethiek statement Alle procedures uitgevoerd in studies met mensen deelnemers waren in overeenstemming met de ethische normen van de Verklaring van Helsinki 1964 en de latere wijzigingen. Het ontwerp van deze studie werd goedgekeurd door de lokale ethische commissie van het Universitair Ziekenhuis van Bonn, Duitsland. LET OP: Zorg ervoor dat de onderwerpen zijn in goede en gezonde conditie, vrij van bloeddrukverlagende medicijnen en ten minste 24 uur gratis catecholamine inducerende middelen zoals cafeïne of ...

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De totale apneu tijd wordt vooral veroorzaakt door longkanker grootte en het zuurstofverbruik per minuut en beïnvloed door het vermogen van een individu om de ademhaling reflex, veroorzaakt door het verhogen van pCO 2 of verlagen pO 2 te weerstaan. Apneu duikers zijn opgeleid om hun adem-hold duur te maximaliseren en worden gebruikt om dit te doen in maximale inspiratie. Daarom is de tijd totdat hypoxie detecteerbaar verschilt tussen individuen en afhankelijk van de fysieke conditie en training st...

Klinisch relevante acute hypoxie en gelijktijdige hypercapnie wordt meestal gezien bij patiënten met obstructieve slaapapneusyndroom (OSAS), acute luchtwegobstructie of tijdens reanimatie. Grote beperkingen op het gebied van OSAS en andere hypoxemie omvatten de beperkte overdraagbare kennis over de pathofysiologie afkomstig van dierstudies en menselijke modellen onbestaande 1. Hypoxie bij mensen na te bootsen, zijn hypoxische gasmengsels dusver gebruikt 2-7. Echter, deze voorwaarden representatiever grote hoogte omgeving dan klinische situaties waarin hypoxie in het algemeen gepaard gaat met hypercapnia. Weefsel oxygenatie tijdens een hartstilstand en reanimatie te controleren, zijn dierproeven uitgevoerd 8 tot fysiologische compensatiemechanismen te onderzoeken. Apneu duikers gezonde sporters in staat om het indrukken van de ademhaling impulsdie wordt opgeroepen door lage arteriële zuurstofverzadiging 9 en een verhoogde pCO 2 10,11. We onderzochten apneu duikers om klinische situaties van acute hypoxie en gelijktijdige hypercapnie 12 na te bootsen. Dit model kan worden gebruikt om klinische opstellingen evalueren verbeteren pathofysiologische begrip van patiënten met OSAS of pathologische ademhalingsstoornissen en onthullen nieuwe mogelijkheden voor het bestuderen van een mogelijk compenserend mechanisme in geval van apneu. Voorts verschillende technieken voor het detecteren hypoxie bij mensen kunnen worden getest op haalbaarheid en nauwkeurigheid bij dynamische hypoxie die in noodsituaties is (dwz luchtweg obstructies, laryngospasme of niet intuberen, kan niet situaties ventileren) of intermitterende hypoxie bij patiënten simuleren met OSAS. Invasieve technieken hypoxie detecteren bij mensen beperkt. Perifere pulsoximetrie (SpO 2) is een erkend instrument in de pre-hospiTal en het ziekenhuis instellingen hypoxie 13 detecteren. De methode is gebaseerd op de lichtabsorptie van hemoglobine. Echter SpO 2 meting beperkt tot perifere arteriële oxygenatie en kan niet worden gebruikt in geval van polsloze elektrische activiteit (PEA) of centrale 14 minimale circulatie. Daarentegen kan Near-Infrared Spectroscopy worden gebruikt om hersenweefsel zuurstofsaturatie (RSO 2) tijdens PEA evalueren in real-time tijdens hemorrhagische shock of na subarachnoïdale bloeding 15-19. Het gebruik ervan wordt steeds groter 20 en methodologische studies hebben een positieve correlatie tussen de SpO 2 en RSO 2 3,4 onthuld. In deze studie geven we een model om klinisch relevante hypoxie bij mensen simuleren alsook een stap voor stap methode perifere pulsoximetrie en NIRS vergelijken bij de- en herverzadiging. Door het analyseren van fysiologische gegevens bij eenpnea, ons begrip van teller balanceringsmechanismen kan worden verbeterd.

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			<td height="60" style="height:60px;width:88px;">SpO2</td>
			<td style="width:88px;">Dr&#228;ger Medical AG&#38;CO.KG</td>
			<td style="width:88px;">SHP ACC MCABLE-Masimo Set</td>
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			<td height="80" style="height:80px;width:88px;">Non Invasive Blood Pressure (NIBP)</td>
			<td style="width:88px;">Dr&#228;ger Medical AG&#38;CO.KG</td>
			<td style="width:88px;">NIBP cuff M+,&#160; MP00916&#160;</td>
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			<td height="60" style="height:60px;width:88px;">Electrocardiographic (ECG) &#160;</td>
			<td style="width:88px;">Dr&#228;ger Medical AG&#38;CO.KG</td>
			<td style="width:88px;">Infinity M540 Monitor</td>
			<td style="width:88px;">ECG monitoring</td>
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			<td height="60" style="height:60px;width:88px;">Docking station</td>
			<td style="width:88px;">Dr&#228;ger Medical AG&#38;CO.KG</td>
			<td style="width:88px;">M500 Docking Station</td>
			<td style="width:88px;">connection of M540 to laptop</td>
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			<td height="80" style="height:80px;width:88px;">NIRS</td>
			<td style="width:88px;">NONIN Medical&#8217;s EQUANOX</td>
			<td style="width:88px;">Model 7600 Regional Oximeter System</td>
			<td style="width:88px;">measuring of cerebral and&#160; tissue oxygenation</td>
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		<tr height="120">
			<td height="120" style="height:120px;width:88px;">NIRS diodes</td>
			<td style="width:88px;">EQUANOX Advance Sensor</td>
			<td style="width:88px;">Model 8004CA</td>
			<td style="width:88px;">suited for measuring cerebral and somatic oxygen-saturation</td>
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			<td height="20" style="height:20px;width:88px;">Laptop&#160;</td>
			<td style="width:88px;"></td>
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			<td height="80" style="height:80px;width:88px;">DataGrabber</td>
			<td style="width:88px;">Dr&#228;ger Medical AG&#38;CO.KG</td>
			<td style="width:88px;">DataGrabber v2005.10.16</td>
			<td style="width:88px;">software to synchronize M540 with laptop</td>
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		<tr height="80">
			<td height="80" style="height:80px;width:88px;">eVision</td>
			<td style="width:88px;">Nonin Medical. Inc.</td>
			<td style="width:88px;">Version 1.3.0.0</td>
			<td style="width:88px;">software to synchronize NONIN with laptop</td>
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a model to simulate clinically relevant hypoxia in humans

In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to hypoxia sensitive organs such as the brain, compensatory circulatory mechanisms help to maintain an adequate oxygen supply. This is mainly achieved by increased cerebral blood flow. Intermittent hypoxia is a commonly seen phenomenon in patients with obstructive sleep apnea. Acute airway obstruction can also result in hypoxia and hypercapnia. Until now, no adequate model has been established to simulate these dynamics in humans. Previous investigations focusing on human hypoxia used inhaled hypoxic gas mixtures. However, the resulting hypoxia was combined with hyperventilation and is therefore more representative of high altitude environments than of apnea. Furthermore, the transferability of previously performed animal experiments to humans is limited and the pathophysiological background of apnea induced physiological changes is poorly understood. In this study, healthy human apneic divers were utilized to mimic clinically relevant hypoxia and hypercapnia during apnea. Additionally, pulse-oximetry and Near Infrared Spectroscopy (NIRS) were used to evaluate changes in cerebral and peripheral oxygen saturation before, during, and after apnea.

Figuur 1 toont gelijktijdige opnames van SpO 2 en NIRS-waarden (NIRS cerebraal en NIRS weefsel) tijdens apneu bij één patiënt. Totale apneu tijd was 363 sec. Naar aanleiding van apneu NIRS en SpO 2 waarden bleef stabiel gedurende ongeveer 140 sec. Een daling van de SpO 2 werd ontdekt na 204 sec door perifere SpO 2, terwijl een daling van NIRS cerebrale werd ontdekt na 238 sec. De laagst gemet...

Watch this Scientific Journal Video about A Model to Simulate Clinically Relevant Hypoxia in Humans at JoVE.com

A Model to Simulate Clinically Relevant Hypoxia in Humans

Hypoxie simulatie bij de mens is meestal uitgevoerd door het inademen van hypoxie gasmengsels. Voor deze studie werden apneu duikers gebruikt om dynamische hypoxie bij de mens simuleert. Bovendien, fysiologische veranderingen in desaturatie en re-verzadigingskinetiek werden geëvalueerd met niet-invasieve instrumenten zoals Near-Infrared-Spectroscopie (NIRS) en perifere zuurstof verzadiging (SpO 2).

Een Model klinisch relevante Hypoxie bij mensen simuleren

In case of apnea, arterial partial pressure of oxygen (pO2) decreases, while partial pressure of carbon dioxide (pCO2) increases. To avoid damage to ...

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Glutamaat en hypoxie als Stress Model voor de geïsoleerde perfusie gewervelde Retina

Neuroprotection has been a strong field of investigation in ophthalmological research in the past decades and affects diseases such as glaucoma, retinal ...

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms

Implementation of In Vitro Drug Resistance Assays: Maximizing the Potential for Uncovering Clinically Relevant Resistance Mechanisms

Invoer van<em&gt; In Vitro</em&gt; Drug Resistance Testen: maximaliseren van het potentieel voor het blootleggen van klinisch relevante resistentiemechanismen

Although targeted therapies are initially effective, resistance inevitably emerges. Several methods, such as genetic analysis of resistant clinical ...

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Een Trombotische Stroke model op basis van Transient Cerebrale hypoxie-ischemie

Stroke research has endured many setbacks in translating neuroprotective therapies into clinical practice. In contrast, the real-world therapy (tPA ...

A Protocol to Acquire the Degenerative Tenocyte from Humans

Een Protocol bij het verwerven van de degeneratieve Tenocyte van de mens

Tendinopathy, a painful condition that develops in response to tendon degeneration, is on the rise in the developed world due to increasing physical ...

Isometric Contractility Measurement of the Mouse Mesenteric Artery Using Wire Myography

Isometrische Contractility meting van de muis mesenterische slagader met behulp van draad Myography

The wire myograph technique is used to assess the contractility of vascular smooth muscles in response to depolarization, GPCR agonists/inhibitors and ...