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.

Declaração de ética Todos os procedimentos realizados em estudos envolvendo participantes humanos estavam de acordo com os padrões éticos da Declaração de Helsínquia de 1964 e suas alterações posteriores. O projeto deste estudo foi aprovado pelo comitê de ética local do Hospital da Universidade de Bonn, na Alemanha. NOTA: Certifique-se de que os sujeitos estão em boa e saudável condição, livre de qualquer medicamento anti-hipertensivo e pelo menos 24 horas livre de agentes de catecolaminas ind...

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O tempo total de apnéia é causada principalmente pelo tamanho do pulmão e do consumo de oxigênio por minuto e influenciada pela capacidade de um indivíduo para suportar o reflexo respiratório causada pelo aumento da pCO2 ou diminuindo pO 2. mergulhadores de apneia são treinados para maximizar a sua duração de apneia e são usados ​​para fazê-lo na inspiração máxima. Portanto, o tempo até a hipóxia é diferente detectáveis ​​entre as pessoas e depende do estado condição e t...

hipóxia aguda clinicamente relevante e hipercapnia concomitante é visto principalmente em pacientes com síndrome da apneia obstrutiva do sono (SAOS), obstrução das vias respiratórias aguda ou durante a ressuscitação cardiopulmonar. As principais limitações do domínio da SAOS e outras condições hipoxêmicas incluem o conhecimento limitado transferível sobre a fisiopatologia derivada de estudos em animais e humanos que os modelos são inexistentes 1. Para imitar a hipoxia em seres humanos, as misturas de gases hipóxicas têm até agora sido utilizados 2-7. No entanto, estas condições são mais representativos de um ambiente de alta altitude do que de situações clínicas em que a hipóxia, em geral, é acompanhado por hipercapnia. Para monitorar a oxigenação dos tecidos durante a parada cardíaca e ressuscitação, estudos com animais foram realizados de 8 a investigar os mecanismos compensatórios fisiológicas. mergulhadores apnéia são atletas saudáveis, capazes de pressionar o impulso de respiraçãoque é evocada pela baixa saturação arterial de oxigênio 9 e um aumento da pCO2 10,11. Nós investigamos os mergulhadores de apnéia, a fim de imitar situações clínicas de hipóxia aguda e hipercapnia concomitante 12. Este modelo pode ser utilizado para avaliar configurações clínicos, melhorar o entendimento fisiopatológico de pacientes com SAOS ou distúrbios respiratórios patológicos, e revelar novas possibilidades para o estudo de um potencial mecanismo de contagem de equilíbrio em casos de apneia. Além disso, diferentes técnicas para detectar hipoxia nos seres humanos podem ser testadas quanto à sua viabilidade e a precisão no caso de hipoxia dinâmica que está presente em situações de emergência (por exemplo, obstruções das vias respiratórias, laringospasmo ou não pode entubar, não pode ventilar situações) ou para simular hipóxia intermitente em pacientes com SAOS. técnicas não invasivas para detectar hipoxia em seres humanos são limitados. Periférica oximetria de pulso (SpO2) é uma ferramenta aprovada em pré-hospiTal e ambientes hospitalares para detectar a hipóxia 13. O método é baseado na absorção de luz de hemoglobina. No entanto, a medição de SpO 2 está limitado a oxigenação arterial periférica e não pode ser utilizado em casos de actividade sem pulso eléctrico (PEA) ou centralizado circulação mínima 14. Em contraste, Near-Infrared Spectroscopy pode ser usado para avaliar a saturação de oxigénio no tecido cerebral (OSR 2) em tempo real durante a PEA, durante o choque hemorrágico ou após hemorragia subaracnóide 15-19. A sua utilização está em constante crescimento 20 e estudos metodológicos têm revelado uma correlação positiva entre SpO 2 e RSO 2 3,4. No presente estudo, nós fornecemos um modelo para simular a hipóxia clinicamente relevante em seres humanos e apresentam um método passo-a-passo para comparar oximetria de pulso periférica e no caso de NIRS mento e re-saturação. Ao analisar os dados fisiológicos no caso de umPNEA, a nossa compreensão dos mecanismos de equilibragem de contador pode ser melhorado.

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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>
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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>
			<td style="width:88px;"></td>
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		<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>
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		<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>
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		<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>
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		<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>
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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>
		</tr>
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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.

Figura 1 mostra gravações simultâneas de SpO2 e valores NIRS (tecido cerebral e NIRS NIRS) durante a apnéia em um paciente. O tempo total de apneia foi 363 sec. Seguindo apnéia NIRS e SpO2 valores permaneceram estáveis por aproximadamente 140 segundos. A diminuição da SpO 2 foi detectada após 204 segundos por periférica SpO2 passo que foi detectada uma diminuição de NIRS cerebral ap?...

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

simulação de hipoxia em seres humanos tem sido geralmente realizada por inalação de misturas de gases hipóxicas. Para este estudo, os mergulhadores apneic foram usadas para simular hipoxia dinâmica em seres humanos. Além disso, as mudanças fisiológicas em dessaturação e re-saturação cinética foram avaliados com ferramentas não-invasivas, como a Near-Infrared-Spectroscopy (NIRS) e saturação de oxigenação periférica (SpO2).

Um modelo para simular hipóxia clinicamente relevantes em humanos

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 biofilme Desenvolvimento on Foreign Bodies medicamente relevantes numa subcutânea modelo do rato Seguido por bioluminescência Imagem

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

Glutamato e hipóxia como um modelo de estresse para o isolado perfundido 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

Implementação de<em&gt; In Vitro</em&gt; Droga de Resistência Ensaios: maximizar o potencial para Descobrindo clinicamente relevantes mecanismos de resistência

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

Um Modelo de acidente vascular cerebral trombótico Baseado em Transient isquemia-hipoxia cerebral

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

Um protocolo para adquirir o Tenocyte degenerativa dos humanos

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

Medição de contratilidade isométrica da artéria mesentérica Mouse usando fio miografia

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