反复屏气时的全身和局部血流动力学和(脱)氧反应。

IF 3.3 3区 医学 Q1 PHYSIOLOGY
Antonis Elia, Mikael Gennser, Ola Eiken, Michail E Keramidas
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引用次数: 0

摘要

在孤立的尝试中,主要检查了局部大脑和外周组织(去)氧反应对屏气(呼吸暂停)的反应。这些反应是如何在重复的努力中演变的尚不清楚,因为之前的研究要么是在回合中平均数据,要么只关注最后的重复。因此,本研究绘制了连续屏气过程中的氧合动力学图。方法:15名非潜水员进行3次最大静态屏气,间隔休息2分钟。评估系统心血管变量、气体交换、大脑额皮质和前臂肌肉(缺氧)氧合。结果:每次屏气时,脑氧合血红蛋白(cO2Hb)和动脉压均出现短暂性下降,并伴有心动过速。随后心血管稳定状态一直持续到不自主呼吸运动(IBMs)的发生。在IBM发作时,cO2Hb仅在第一次尝试时升高(Δ8±5μM),p2Hb和hb在屏气发作时升高,短暂的中间平台期,在IBM发作时进一步分化。cO2Hb、脑组织氧指数、潮末氧指数依次降低(p≤0.034),cHHb依次升高(p≤0.034),但潮末二氧化碳水平相似(p>0.912)。结论:在重复屏气过程中,局部(去)氧反应的幅度和时间变化很大。大脑氧合在第一次尝试中明显增加,但在随后的几次中变化逐渐变小。相比之下,外周组织氧合在连续尝试中表现出时间依赖性下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systemic and regional hemodynamic and (de)oxygenation responses across repeated breath-holds.

Introduction: Regional cerebral and peripheral tissue (de)oxygenation responses to breath-holding (apnea) have predominantly been examined during isolated attempts. How these responses evolve across repeated efforts remains unclear, as previous studies either averaged data across bouts or focused solely on the final repetition. Accordingly, this study mapped the (de)oxygenation dynamics across successive breath-holds. Methods: Fifteen non-divers performed three repeated maximal static breath-holds, separated by two-minute rest-intervals. Systemic cardiovascular variables, gas exchange, and cerebral frontal-cortex and forearm-muscle (de)oxygenation were assessed. Results: At each breath-hold onset, a transient fall in cerebral oxygenated hemoglobin (cO2Hb) and arterial pressure occurred, coinciding with tachycardia. A cardiovascular steady state followed which persisted until the onset of involuntary breathing movements (IBMs). At IBM onset, cO2Hb increased only during the first attempt (Δ8±5μM,p<0.001), with smaller changes in subsequent breath-holds (apnea-2,Δ3±6μM;apnea-3,Δ3±5μM,p≤0.014). Cerebral deoxygenated hemoglobin (cHHb) increased progressively across breath-holds (apnea-1,Δ3±4μM;apnea-2,Δ5±4μM;apnea-3,Δ7±5μM,p≤0.001), whereas arterial pressure increases were of similar magnitude (p≥0.064). Forearm (de)oxygenation profiles were comparable across attempts (p≥0.085). In 9 subjects, a triphasic peripheral response emerged: initial rapid decline in O2Hb and rise in HHb at breath-holding onset, a transient intermediate-plateau, and further divergence near IBM onset. Breath-holds were terminated at successively lower cO2Hb, cerebral tissue oxygen index, and end-tidal oxygen, and higher cHHb (p≤0.034), but similar end-tidal carbon dioxide levels (p>0.912). Conclusion: The magnitude and timing of regional (de)oxygenation responses vary greatly over repeated breath-holds. Cerebral oxygenation showed a pronounced increase during the first attempt, but progressively smaller changes across subsequent bouts. In contrast, peripheral tissue oxygenation, demonstrated a time-dependent decline across successive attempts.

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来源期刊
CiteScore
6.00
自引率
9.10%
发文量
296
审稿时长
2-4 weeks
期刊介绍: The Journal of Applied Physiology publishes the highest quality original research and reviews that examine novel adaptive and integrative physiological mechanisms in humans and animals that advance the field. The journal encourages the submission of manuscripts that examine the acute and adaptive responses of various organs, tissues, cells and/or molecular pathways to environmental, physiological and/or pathophysiological stressors. As an applied physiology journal, topics of interest are not limited to a particular organ system. The journal, therefore, considers a wide array of integrative and translational research topics examining the mechanisms involved in disease processes and mitigation strategies, as well as the promotion of health and well-being throughout the lifespan. Priority is given to manuscripts that provide mechanistic insight deemed to exert an impact on the field.
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