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.

etik uttalande Alla ingrepp i studier med mänskliga deltagare var i enlighet med de etiska normerna i 1964 Helsingforsdeklarationen och dess senare ändringar. Utformningen av denna studie har godkänts av lokala etiska kommittén för Universitetssjukhuset i Bonn, Tyskland. OBS: Se till att ämnena är i god och hälsosam kondition, utan alla blodtryckssänkande läkemedel och åtminstone 24 timmar utan katekolamin inducerande medel som koffein eller lika ämnen. 1. Framställning...

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Den totala apnétiden orsakas främst av lung storlek och syreförbrukning per minut och påverkas av en individs förmåga att motstå andningsreflexen som orsakas av att öka pCO 2 eller minskar PO2. Apnea dykare är utbildade för att maximera andan håll varaktighet och används för att göra det i maximal inspiration. Därför tiden tills hypoxi är detekterbara skiljer mellan individer och beror på patientens fysiska tillstånd och utbildning status och kan även variera med deras dagliga t...

Kliniskt relevant akut syrebrist och samtidig hypercapnia oftast hos patienter med obstruktiv sömnapnésyndrom (OSAS), akut luftvägsobstruktion eller under hjärt-lungräddning. Stora begränsningar inom OSAS och andra hypoxemisk villkor inkluderar begränsad överförbar kunskap om patofysiologi härrör från djurstudier och att mänskliga modeller är obefintlig en. Att efterlikna hypoxi hos människor, har hypoxiska gasblandningar hittills använts 2-7. Dessa villkor är mer representativa för hög höjd omgivning än kliniska situationer där syrebrist i allmänhet åtföljs av hyperkapni. Att övervaka vävnadsoxygenering under hjärtstillestånd och återupplivning, har djurstudier utförts 8 för att undersöka fysiologiska kompensationsmekanismer. Apnéiska dykare är friska idrottare kan trycka andnings impulssom framkallas av låg arteriell syremättnad 9 och en ökad PCO2 10,11. Vi undersökte apnéiska dykare för att efterlikna kliniska situationer av akut syrebrist och samtidig hyperkapni 12. Denna modell kan användas för att utvärdera kliniska inställningar, förbättra den patofysiologiska förståelse av patienter med OSAS eller patologiska andningsstörningar, och avslöjar nya möjligheter för att studera en potentiell utbalansering mekanismen i fall av apné. Dessutom olika tekniker upptäcka syrebrist hos människa kan testas för genomförbarhet och noggrannhet när det gäller dynamiska hypoxi som finns i nödsituationer (dvs., luftvägshinder, laryngospasm eller kan inte intuberas, kan inte ventilera situationer) eller för att simulera intermittent hypoxi hos patienter med OSAS. Icke-invasiva metoder för att upptäcka syrebrist hos människa är begränsad. Perifer pulsoximetri (SpO 2) är ett godkänt verktyg i pre-hospital och sjukhusmiljö för att upptäcka hypoxi 13. Metoden är baserad på ljusabsorption av hemoglobin. Dock är SpO 2 mätning begränsad till perifer arteriell syresättning och kan inte användas i fall av pulslös elektrisk aktivitet (PEA) eller centraliserad minimal cirkulation 14. I motsats härtill kan Near-Infrared Spectroscopy användas för att utvärdera cerebralt vävnadssyremättnad (RSO 2) i realtid under PEA, under hemorragisk chock eller efter subaraknoidalblödning 15-19. Dess användning växer ständigt 20 och metodstudier har visat ett positivt samband mellan SpO 2 och RSO 2 3,4. I denna studie, ger vi en modell för att simulera kliniskt relevant hypoxi hos människor och presentera en steg-för-steg metod för att jämföra perifera pulsoximetri och NIRS vid de- och återmättnad. Genom att analysera fysiologiska data i händelse av enpnea kan vår förståelse av disk balanseringsmekanismer förbättras.

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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>
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			<td height="60" style="height:60px;width:88px;">Docking station</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>
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			<td style="width:88px;">measuring of cerebral and&#160; tissue oxygenation</td>
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			<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 style="width:88px;">Nonin Medical. Inc.</td>
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			<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 visar samtidiga inspelningar av SpO 2 och NIRS värden (NIRS cerebral och NIRS vävnad) under apné i en patient. Total apnétiden var 363 sek. Efter apné NIRS och SpO 2 värden förblev stabil under cirka 140 sekunder. En minskning av SpO 2 upptäcktes efter 204 sekunder av perifera SpO 2, medan en minskning med NIRS cerebral upptäcktes efter 238 sek. Den lägsta uppmätta SpO 2<...

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

Hypoxi simulering i människa har vanligtvis utförts genom inandning hypoxiska gasblandningar. För denna studie var apnéiska dykare används för att simulera dynamiska hypoxi hos människor. Dessutom har fysiologiska förändringar i desaturation och återmättnads kinetik utvärderades med icke-invasiva verktyg som nära infraröd-spektroskopi (NIRS) och perifer syresättning mättnad (SpO 2).

En modell för att simulera kliniskt relevanta Hypoxi i människor

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 utveckling på Medicinskt-relevanta främmande föremål i en mus Subkutan Model Följt av 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

Glutamat och Hypoxi som stress modell för isolerade perfusion Ryggradsdjur 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

Genomförande av<em&gt; In Vitro</em&gt; Läkemedelsresistens Analyser: maximera potentialen för att avslöja kliniskt relevant 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 stroke modell baserad på gående cerebral hypoxi-ischemi

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

Ett protokoll för att förvärva den degenerativa Tenocyte från människor

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 kontraktilitet mätning av mus mesenterica artär med Wire Myography

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