Name: a model to simulate clinically relevant hypoxia in humans
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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.

etikk uttalelse Alle prosedyrer utført i studier som involverer menneskelige deltakere var i samsvar med de etiske standardene i 1964 Helsinki deklarasjonen og dets senere endringer. Utformingen av denne studien ble godkjent av lokale etikkutvalg ved Universitetssykehuset i Bonn, Tyskland. MERK: Kontroller at fagene er i god og sunn tilstand, fri for anti-hypertensive medisin og minst 24 timer fri for katekolaminer induserende stoffer som koffein eller lik stoffer. 1. Utarbeidelse ...

<ol>
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Den totale apnea tid er hovedsakelig forårsaket av lunge størrelse og oksygenforbruk per minutt og påvirket av en enkeltpersoner evne til å tåle puste refleks forårsaket av økende pCO 2 eller redusere pO 2. Apnea dykkere er opplært til å maksimere sin pust-hold varighet og er vant til å gjøre det i maksimal inspirasjon. Derfor er tiden til hypoksi påvisbare skiller mellom individer og avhenger av vedkommendes fysiske tilstand og trening status og kanskje til og med variere fra deres dag...

Klinisk relevant akutt hypoksi og samtidig hyperkapni er mest sett hos pasienter med obstruktiv søvnapné syndrom (OSAS), akutt luftveisobstruksjon eller under hjerte-lungeredning. Store begrensninger innen OSAS og andre hypoxemic tilstander omfatter den begrensede overførbar kunnskap om patofysiologien avledet fra dyrestudier og at menneskelige modellene er fraværende 1. For å etterligne hypoksi hos mennesker, har hypoksiske gassblandinger hittil blitt anvendt 2 - 7. Men disse betingelser er mer representative for høytliggende omgivelser enn kliniske situasjoner hvor hypoksi i alminnelighet er ledsaget av hyperkapni. For å overvåke vevsoksygeneringen under hjertestans og gjenoppliving, har dyrestudier utført 8 for å undersøke fysiologiske kompenserende mekanismer. Apné dykkere er sunne idrettsutøvere i stand til å trykke ned puste impulssom er fremkalt av lav arteriell oksygenmetning 9 og en økt pCO 2 10,11. Vi undersøkte apné dykkere for å etterligne kliniske tilfeller med akutt hypoksi og samtidig hyperkapni 12. Denne modellen kan brukes til å evaluere klinisk oppsett, forbedre den patofysiologiske forståelsen av pasienter med OSAS eller patologiske pusteforstyrrelser, og gir helt nye muligheter for å studere en potensiell teller balanserende mekanisme i tilfeller av apnea. Videre er forskjellige teknikker for å påvise hypoksi hos mennesker kan bli testet for gjennomførbarhet og nøyaktighet i tilfelle av dynamiske hypoksi som er til stede i nødssituasjoner (dvs. luftveishindringer, laryngospasmer eller kan ikke intubere, ikke kan ventilere situasjoner) eller for å simulere intermitterende hypoksi hos pasienter med OSAS. Noninvasive teknikker for å oppdage hypoksi hos mennesker er begrenset. Peripheral pulsoksymetri (SpO2) er en godkjent verktøy i pre-hospital og sykehus innstillinger for å oppdage hypoksi 13. Metoden er basert på lys absorpsjon av hemoglobin. Imidlertid er SpO2 måling begrenset til perifer arteriell oksygenering og kan ikke brukes i tilfeller av pulseless elektrisk aktivitet (PEA) eller sentralisert minimal sirkulasjon 14. I kontrast, kan nær-infrarød spektroskopi brukes til å vurdere hjernevev oksygenmetning (RSO 2) i sanntid under PEA, under hemoragisk sjokk eller etter subaraknoidalblødning 15-19. Bruken er i stadig vekst 20 og metodiske studier har avdekket en positiv sammenheng mellom SpO2 og RSO to 3,4. I denne studien gir vi en modell for å simulere klinisk relevant hypoksi hos mennesker og presentere en steg-for-trinn metode for å sammenligne perifer pulsoksymetri og NIRS i tilfelle av de- og re-metning. Ved å analysere fysiologiske data i tilfelle av enpnea, kan vår forståelse av benke balanserende mekanismer forbedres.

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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>
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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>
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			<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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			<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>
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			<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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			<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.

Figur 1 viser samtidige opptak av SpO2 og NIRS verdier (NIRS cerebral og NIRS vev) under apné hos en pasient. Total apnea tid var 363 sek. Etter apnea NIRS og spo 2 verdier holdt seg stabilt i ca 140 sek. En reduksjon i SpO2 ble oppdaget etter 204 sek ved perifer SpO2 mens en nedgang på NIRS cerebral ble oppdaget etter 238 sek. Den laveste målte SpO2 følgende apnea var 58% og lave...

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

Hypoksi simulering hos mennesker har vanligvis blitt utført ved å inhalere hypoksiske gassblandinger. For denne studien ble apné dykkere brukes til å simulere dynamisk hypoksi hos mennesker. I tillegg ble fysiologiske endringer i desaturation og re-metning kinetikk evaluert med ikke-invasive verktøy som nær-infrarød-spektroskopi (NIRS) og perifer oksygenmetning (SpO2).

En modell for å simulere klinisk relevant Hypoksi i Humans

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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Glutamat og Hypoksi som en Stress Modell for den isolerte perfuserte Vertebrate 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

Implementering av<em&gt; In Vitro</em&gt; Legemiddelresistens Analyser: maksimere potensialet for Avdekke klinisk relevante resistensmekanismer

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

En trombotisk hjerneslag modell basert på Transient Cerebral Hypoksi-iskemi

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

En protokoll for å skaffe det utarte Tenocyte fra mennesker

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

Isometrisk Contractility måling av musen hvem arterien bruker Wire Myography

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