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.

déclaration éthique Toutes les procédures effectuées dans des études impliquant des participants humains étaient en conformité avec les normes éthiques de la déclaration d&#39;Helsinki de 1964 et ses amendements ultérieurs. La conception de cette étude a été approuvée par le comité d&#39;éthique local de l&#39;hôpital universitaire de Bonn, en Allemagne. NOTE: Veiller à ce que les sujets sont en bonne santé et condition, libre de tout médicament anti-hypertenseur et au moins 24 heures sans...

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Le temps d&#39;apnée totale est causée principalement par la taille du poumon et de la consommation d&#39;oxygène par minute et influencée par la capacité d&#39;un individu à supporter le réflexe respiratoire causée par l&#39; augmentation ou la diminution de la pCO 2 pO 2. plongeurs d&#39;apnée sont formés pour maximiser leur durée d&#39;apnée et sont utilisés pour faire en inspiration maximale. Par conséquent, le temps jusqu&#39;à ce que l&#39;hypoxie est diffère décelables entre...

hypoxie aiguë cliniquement pertinente et hypercapnie concomitante est surtout observée chez les patients avec syndrome d&#39;apnée obstructive du sommeil (SAOS), obstruction des voies respiratoires aiguë ou pendant la réanimation cardio-pulmonaire. Les principales limitations dans le domaine du SAOS et d&#39; autres conditions hypoxiques comprennent les connaissances transférables limitées sur la physiopathologie provenant d&#39;études animales et que les modèles humains sont inexistants 1. Pour imiter l&#39; hypoxie chez les humains, les mélanges de gaz hypoxiques ont jusqu&#39;à présent été utilisés 2-7. Cependant, ces conditions sont plus représentatifs d&#39;un environnement de haute altitude que des situations cliniques où l&#39;hypoxie, en général, est accompagnée d&#39;hypercapnie. Pour surveiller l&#39; oxygénation des tissus lors de l&#39; arrestation et de la réanimation cardiaque, des études animales ont été effectuées 8 pour étudier les mécanismes compensatoires physiologiques. les plongeurs en apnée sont des athlètes en bonne santé capables de peser sur l&#39;impulsion de la respirationqui est évoqué par une faible saturation artérielle en oxygène 9 et une augmentation de la pCO 2 10,11. Nous avons étudié les plongeurs apnéiques afin d&#39;imiter des situations cliniques d&#39;hypoxie aiguë et hypercapnie concomitante 12. Ce modèle peut être utilisé pour évaluer les configurations cliniques, améliorer la compréhension physiopathologique des patients atteints de SAOS ou de troubles respiratoires pathologiques, et de révéler de nouvelles possibilités pour étudier un mécanisme potentiel compteur d&#39;équilibrage dans les cas d&#39;apnée. En outre, différentes techniques pour détecter l&#39; hypoxie chez l&#39; homme peut être testé pour la faisabilité et la précision dans le cas d&#39;hypoxie dynamique qui est présent dans les situations d&#39;urgence ( par exemple, les obstructions des voies respiratoires, laryngospasme ou ne peut pas intuber, ne peut pas ventiler les situations) ou pour simuler l&#39; hypoxie intermittente chez les patients avec SAOS. techniques non invasives pour détecter l&#39;hypoxie chez l&#39;homme sont limitées. Peripheral oxymétrie de pouls (SpO 2) est un outil approuvé en pré-hospital et les milieux hospitaliers pour détecter l&#39; hypoxie 13. La méthode est basée sur l&#39;absorption de la lumière de l&#39;hémoglobine. Cependant, SpO 2 mesure est limitée à l&#39; oxygénation artérielle périphérique et ne peut pas être utilisé dans les cas d&#39;activité pulseless électrique (PEA) ou la circulation minimale centralisée 14. En revanche, spectroscopie proche infrarouge peut être utilisé pour évaluer cérébrale saturation en oxygène tissulaire (RSO 2) en temps réel lors de PEA, lors d&#39;un choc hémorragique ou après une hémorragie méningée 15-19. Son utilisation est en constante augmentation 20 et des études méthodologiques ont révélé une corrélation positive entre la SpO 2 et RSO 2 3,4. Dans cette étude, nous proposons un modèle pour simuler l&#39;hypoxie cliniquement pertinente chez l&#39;homme et de présenter une méthodologie étape par étape pour comparer l&#39;oxymétrie de pouls périphérique et SPIR en cas de dé- et re-saturation. En analysant les données physiologiques en cas dePNEA, notre compréhension des mécanismes d&#39;équilibrage de compteur peut être améliorée.

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	<colgroup>
		<col span="4" />
	</colgroup>
	<tbody>
		<tr height="60">
			<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>
			<td style="width:88px;">peripheral SpO2-Monitoring</td>
		</tr>
		<tr height="80">
			<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>
			<td style="width:88px;"></td>
		</tr>
		<tr height="60">
			<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>
		</tr>
		<tr height="60">
			<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>
		</tr>
		<tr height="80">
			<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>
		</tr>
		<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>
		</tr>
		<tr height="20">
			<td height="20" style="height:20px;width:88px;">Laptop&#160;</td>
			<td style="width:88px;"></td>
			<td style="width:88px;"></td>
			<td style="width:88px;"></td>
		</tr>
		<tr height="80">
			<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>
		</tr>
		<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>
		</tr>
	</tbody>
</table>

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.

Figure 1 affiche des enregistrements simultanés de SpO 2 et les valeurs NIRS (NIRS de tissu cérébral et NIRS) lors de l&#39; apnée chez un patient. le temps d&#39;apnée totale était de 363 sec. Après l&#39; apnée NIRS et SpO 2 valeurs sont restées stables pendant environ 140 secondes. Une diminution de la SpO 2 a été détectée après 204 secondes par SpO périphérique 2 alors qu&#39;une diminu...

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

simulation de l&#39;hypoxie chez l&#39;homme a généralement été réalisée par l&#39;inhalation de mélanges gazeux hypoxiques. Pour cette étude, les plongeurs apnéiques ont été utilisés pour simuler l&#39;hypoxie dynamique chez l&#39;homme. En outre, des changements physiologiques dans désaturation et re-saturation cinétiques ont été évaluées avec des outils non invasifs tels que Near-Infrared-Spectroscopy (NIRS) et périphérique saturation d&#39;oxygénation (SpO 2).

Un modèle pour Simuler Hypoxie cliniquement importants chez les humains

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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Glioblastomas, the most common and aggressive form of astrocytoma, are refractory to therapy, and molecularly heterogeneous. The ability to establish cell ...

Candida albicans Biofilm Development on Medically-relevant Foreign Bodies in a Mouse Subcutaneous Model Followed by Bioluminescence Imaging

Candida albicans Biofilm Development on Medically-relevant Foreign Bodies in a Mouse Subcutaneous Model Followed by Bioluminescence Imaging

Candida albicans biofilm développement sur ​​les organismes étrangères médicalement pertinents dans une souris modèle sous-cutanée Suivi par bioluminescence Imaging

Candida albicans biofilm development on biotic and/or abiotic surfaces represents a specific threat for hospitalized patients. So far, C. albicans ...

Glutamate and Hypoxia as a Stress Model for the Isolated Perfused Vertebrate Retina

Glutamate et hypoxie comme un modèle de stress pour la isolé perfusé vertébrés 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

Implémentation de<em&gt; In Vitro</em&gt; Résistance au médicament Essais: Maximiser le potentiel pour découvrir cliniquement importants mécanismes de résistance

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

Un modèle de course thrombotique Basé sur cérébrale transitoire hypoxie-ischémie

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

Un protocole en vue d’acquérir la Tenocyte dégénérative de l’homme

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

Mesure de la contractilité isométrique de l’artère mésentérique de souris à l’aide de fil myographie

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