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.

Ethik - Anweisung Alle in den Studien durchgeführten Aktionen im Zusammenhang mit menschlichen Teilnehmer waren in Übereinstimmung mit den ethischen Normen der 1964 Deklaration von Helsinki und seine späteren Änderungen. Das Design dieser Studie wurde von der Ethikkommission des Universitätsklinikums Bonn, Deutschland zugelassen. HINWEIS: Stellen Sie sicher, dass die Probanden in einem guten und gesunden Zustand sind, frei von jeder antihypertensiven Medizin und mindestens 24 Stunden fre...

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Die Gesamtapnoezeit wird hauptsächlich durch Lungengröße und Sauerstoffverbrauch pro Minute verursacht und durch einen Menschen die Fähigkeit beeinflusst die Atmung Reflex durch die Erhöhung pCO 2 oder abnimmt pO 2 verursacht zu widerstehen. Apnea Taucher sind darauf trainiert, ihre Atemanhaltedauer zu maximieren und zu tun, so in maximaler Inspiration verwendet. Daher ist die Zeit, bis Hypoxie nachweisbar unterscheidet sich zwischen den Individuen und hängt von der Kondition und Trainingszus...

Klinisch relevante akuter Hypoxie und begleitende Hyperkapnie ist vor allem bei Patienten beobachtet mit obstruktiver Schlafapnoe-Syndrom (OSAS), akute Atemwegsobstruktion oder während der kardiopulmonalen Reanimation. Haupteinschränkungen auf dem Gebiet des OSAS und andere hypoxämischer Bedingungen umfassen die begrenzte übertragbare Erkenntnisse über die Pathophysiologie von Tierstudien abgeleitet und dass menschliche Modelle sind nicht vorhanden 1. 7 - Zur Hypoxie beim Menschen, hypoxischen Gasgemische wurden bisher 2 verwendet imitieren. Jedoch sind diese Bedingungen repräsentativer für Höhenlage Umgebung als von klinischen Situationen, in denen Hypoxie, im allgemeinen durch Hyperkapnie begleitet wird. Zur Sauerstoffversorgung des Gewebes während des Herzstillstand und Reanimation, Tierstudien wurden 8 durchgeführt , um zu untersuchen physiologischen Kompensationsmechanismen zu überwachen. Apnoe-Taucher sind gesunde Athleten der Lage, die Atmung Impuls des Drückensdass sich durch niedrige arterielle Sauerstoffsättigung 9 und einem erhöhten pCO 2 10,11 hervorgerufen. Wir untersuchten apneic Taucher um 12 klinischen Fällen von akuter Hypoxie und die gleichzeitige Hyperkapnie zu imitieren. Dieses Modell kann verwendet werden, klinische Setups zu bewerten, die pathophysiologischen Verständnis von Patienten mit OSAS oder pathologischen Atmungsstörungen zu verbessern und neue Möglichkeiten offenbaren für ein potenzielles Gegenausgleichsmechanismus bei der Apnoe zu studieren. Weiterhin verschiedene Techniken Hypoxie beim Menschen erkennen kann für Durchführbarkeit und Genauigkeit im Falle von dynamischen Hypoxie getestet werden, die in Notfallsituationen vorhanden ist (dh, Atemwegsobstruktionen, laryngospasm oder nicht intubieren, kann nicht Situationen belüften) oder intermittierende Hypoxie bei Patienten zu simulieren , mit OSAS. Nicht-invasive Techniken zur Detektion von Hypoxie bei Menschen begrenzt sind. Periphere Pulsoxymetrie (SpO 2) ist ein anerkanntes Werkzeug in pre-hospital und Krankenhaus - Einstellungen Hypoxie 13 zu erkennen. Das Verfahren beruht auf der Lichtabsorption von Hämoglobin basiert. Allerdings ist SpO 2 Messung auf periphere arterielle Sauerstoffversorgung beschränkt und kann nicht in den Fällen von pulslose elektrische Aktivität (PEA) oder zentrale minimale Zirkulation 14 verwendet werden. Im Gegensatz dazu kann Nah-Infrarot - Spektroskopie verwendet werden , um Hirngewebe Sauerstoffsättigung (rSO 2) in Echtzeit während der PEA, während hämorrhagischen Schock oder nach Subarachnoidalblutung 15 bewerten - 19. Sein Einsatz wird immer größer 20 und methodische Studien haben eine positive Korrelation zwischen der SpO 2 und rSO 2 3,4 ergab. In dieser Studie stellen wir ein Modell klinisch relevante Hypoxie beim Menschen zu simulieren und eine Schritt-für-Schritt-Methode präsentieren periphere Pulsoximetrie und NIRS bei De- und Re-Sättigung zu vergleichen. Durch die Analyse von physiologischen Daten im Falle einerpnea, unser Verständnis von Gegenausgleichsmechanismen verbessert werden kann.

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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>
			<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>
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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.

Abbildung 1 zeigt die gleichzeitige Aufnahmen von SpO 2 und NIRS - Werte (NIRS zerebralen und NIRS Gewebe) während der Apnoe bei einem Patienten. Insgesamt Apnoezeit war 363 Sekunden. Nach Apnoe NIRS und SpO 2 -Werte blieb für etwa 140 Sekunden stabil. Eine Abnahme der SpO 2 wurde nach 204 Sekunden durch periphere SpO 2 erfasst wird, während ein Rückgang von NIRS zerebralen nach 238 sec fest...

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-Simulation beim Menschen ist in der Regel durch das Einatmen hypoxischen Gasgemischen durchgeführt. Für diese Studie wurden Apnoen Tauchern verwendet dynamische Hypoxie beim Menschen zu simulieren. Zusätzlich physiologischen Veränderungen in Desaturierung und Wieder Sättigungskinetik wurden mit nicht-invasive Werkzeuge wie Near-Infrared-Spektroskopie (NIRS) und periphere Oxygenierung Sättigung (SpO 2) bewertet.

Ein Modell Simulieren von klinisch relevanter Hypoxie beim Menschen

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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Candida albicans Biofilm-Entwicklung über die medizinisch relevanten Fremdkörper in einem Maus-Modell durch subkutane Biolumineszenz Imaging Gefolgt

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

Glutamat und Hypoxie als Stress-Modell für die isolierten perfundierten Wirbel 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

Implementierung von<em&gt; In-vitro-</em&gt; Drug Resistance Assays: Maximierung des Potenzials für die Aufdeckung klinisch relevanter Resistenzmechanismen

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

A thrombotischer Schlaganfall Modell basierend auf Transient zerebrale Hypoxie-Ischämie

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

Ein Protokoll der degenerativen Tenocyte von Menschen zu erwerben

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

Messung der isometrischen Kontraktilität der Maus mesenterialen Arterie mit Draht Myographie

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