scholarly journals Brain Blood Flow in Andean and Himalayan High-Altitude Populations: Evidence of Different Traits for the Same Environmental Constraint

2010 ◽  
Vol 31 (2) ◽  
pp. 706-714 ◽  
Author(s):  
Gerard FA Jansen ◽  
Buddha Basnyat
Keyword(s):  
Blood Flow ◽  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Oxygen Demand ◽  
Arterial Oxygen ◽  
The Tibetan Plateau ◽  
Brain Blood Flow ◽  
Organ Systems ◽  
Andean Altiplano ◽  
The Difference

Humans have populated the Tibetan plateau much longer than the Andean Altiplano. It is thought that the difference in length of occupation of these altitudes has led to different responses to the stress of hypoxia. As such, Andean populations have higher hematocrit levels than Himalayans. In contrast, Himalayans have increased circulation to certain organ systems to meet tissue oxygen demand. In this study, we hypothesize that cerebral blood flow ( CBF) is higher in Himalayans than in Andeans. Using a MEDLINE and EMBASE search, we included 10 studies that investigated CBF in Andeans and Himalayans between 3,658 and 4,330 m altitude. The CBF values were corrected for differences in hematocrit and arterial oxygen saturation. The data of these studies show a mean hematocrit of 50% in Himalayans and 54.1% in Andeans. Arterial oxygen saturation was 86.9% in Andeans and 88.4% in Himalayans. The CBF in Himalayans was slightly elevated compared with sea-level subjects, and was 24% higher compared with Andeans. After correction for hematorit and arterial oxygen saturation, CBF was ~20% higher in Himalayans compared with Andeans. Altered brain metabolism in Andeans, and/or increased nitric oxide availability in Himalayans may have a role to explain this difference in brain blood flow.

Experimental hypoxemia in older and younger healthy men

1961 ◽  
Vol 16 (4) ◽  
pp. 639-640 ◽  
Author(s):  
Ernst Simonson
Keyword(s):  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Older Men ◽  
Arterial Oxygen ◽  
Healthy Men ◽  
The Difference

Arterial oxygen saturation was measured by means of an earlobe oximeter in 68 older (mean age 59.5) and 58 younger, (mean age 23.4 years) healthy men while breathing a 10% O2, 90% N2 mixture for a period of 10 min. The drop of the arterial oxygen saturation was more pronounced in the older men, and the difference in reaction was statistically highly significant. Submitted on January 9, 1961

Effects of graded reduction of brain blood flow on chemical control of breathing

1979 ◽  
Vol 47 (6) ◽  
pp. 1289-1294 ◽  
Author(s):  
R. W. Chapman ◽  
T. V. Santiago ◽  
N. H. Edelman
Keyword(s):  
Blood Flow ◽  
Brain Ischemia ◽  
Arterial Oxygen Saturation ◽  
Venous Blood ◽  
Control Of Breathing ◽  
Cerebrovascular Reactivity ◽  
Respiratory Neurons ◽  
Arterial Oxygen ◽  
Brain Blood Flow ◽  
Ventilatory Responses

We measured ventilatory responses to CO2 (delta VI/delta PCO2) and transient hypoxia (delta VI/delta SaO2) during reductions of brain blood flow (BBF) to 70% and 50% of control in unanesthetized goats. Increase in inspiratory volume per change in CO2 tension (delta VI/delta PCO2) was measured during rebreathing with sampling of both arterial and cerebral venous blood; increase in inspiratory volume per fall in arterial oxygen saturation (delta VI/delta SaO2) was assessed by the transient N2 inhalation method. Delta VI/delta SaO2 did not significantly change at 70% BBF, but was depressed at 50% BBF. Delta VI/delta PCO2 increased (0.94 +/- 0.18 to 1.29 +/- 0.24 l . min-1 . Torr-1) at 70% BBF if arterial CO2 tension were used to represent the CO2 stimulus but was unchanged if venous CO2 tension were used. At 50% BBF, delta VI/delta PCO2 was depressed (0.38 +/- 0.13 l . min-1 . Torr-1) for both representations of the CO2 stimulus. Brain ischemia increased blood pressure and heart rate but blunted the increase in BBF caused by hypercapnia. We conclude that 1) moderate brain ischemia (70% BBF) does not affect chemosensitivity to hypoxia and CO2, 2) delta VI/delta PCO2 may not be accurately determined from PaCO2 during brain ischemia because cerebrovascular reactivity to CO2 is depressed, and 3) severe brain ischemia (50% BBF) blunts delta VI/delta SaO2 and delta VI/delta PCO2, probably as a consequence of hypoxic depression of the respiratory neurons.

scholarly journals Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?

2021 ◽  
Author(s):  
Aslıhan Gürün Kaya ◽  
Miraç Öz ◽  
İREM AKDEMİR KALKAN ◽  
Ezgi Gülten ◽  
güle AYDIN ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Lymphocyte Count ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Reactive Protein ◽  
Arterial Blood ◽  
The Difference ◽  
Clinical Conditions

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

Effects of protoveratrine on coronary blood flow of the renal hypertensive dog

1963 ◽  
Vol 204 (5) ◽  
pp. 895-898 ◽  
Author(s):  
James W. West ◽  
Elwood L. Foltz
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Oxygen Saturation ◽  
Coronary Blood Flow ◽  
Arterial Oxygen Saturation ◽  
Renal Hypertension ◽  
Peripheral Resistance ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Venous Oxygen Saturation

In renal hypertension, protoveratrine decreased coronary blood flow, cardiac oxygen consumption, arterial and venous oxygen saturation, coronary arteriovenous oxygen difference, mean arterial blood pressure, cardiac output, cardiac work, cardiac efficiency, cardiac rate, total peripheral resistance, coronary resistance, respiratory rate, and minute volume. The decrease was significant in all functions except coronary blood flow, coronary venous oxygen saturation, and cardiac output. The results of these experiments indicate that in the renal hypertensive animal, a therapeutically beneficial effect was derived from protoveratrine on the circulation by its ability to decrease the work of the heart (lowering the elevated mean arterial pressure) and the coronary vascular resistance while maintaining coronary blood flow and cardiac output within normal levels. The less advantageous effect of protoveratrine on circulation resulted from its respiratory inhibiting effect which reduced the arterial blood oxygen saturation. Although a small decline in coronary venous oxygen saturation was noted, the coronary flow and oxygen delivery in face of the reduced arterial oxygen saturation was apparently adequate to maintain a normal cardiac activity.

Fetal neuromuscular blockade: effect on oxygen demand and placental transport

1989 ◽  
Vol 257 (3) ◽  
pp. H734-H738
Author(s):  
R. B. Wilkening ◽  
D. W. Boyle ◽  
G. Meschia
Keyword(s):  
Blood Flow ◽  
Oxygen Saturation ◽  
Neuromuscular Blockade ◽  
Umbilical Vein ◽  
Oxygen Demand ◽  
Arterial Oxygen ◽  
Uterine Blood Flow ◽  
Umbilical Blood ◽  
Steady State Method ◽  
Umbilical Blood Flow

To study mechanisms by which variations in fetal oxygen demand alter fetal oxygen saturation and PO2, we measured uterine and umbilical blood flow and transplacental oxygen diffusion rate in eight chronically prepared pregnant ewes before and during fetal neuromuscular blockade with pancuronium bromide (0.2 mg/kg). Uterine and umbilical blood flows were measured by applying the steady-state method using ethanol as the test substance. Fetal oxygen uptake decreased 7.5% (P less than 0.05). Umbilical blood flow increased 6% (P less than 0.05), whereas uterine blood flow did not change significantly. Fetal arterial oxygen saturation increased markedly (54.8–60.9%; P less than 0.001). There were also significant increases in umbilical vein oxygen saturation (83.6–86.9%; P less than 0.01), uterine vein oxygen saturation (70.7–72.2%; P less than 0.01), umbilical vein PO2 (29.4–32.1 Torr; P less than 0.001), and uterine vein PO2 (49.4–50.7 Torr; P less than 0.01). The uterine-umbilical venous PO2 difference decreased significantly (20.0–18.6 Torr; P less than 0.001), whereas there was no significant change in the uterine-umbilical venous PCO2 difference or in the umbilical ethanol shunt. The data indicate that follows a small decrease in fetal oxygen demand is caused by two aspects of placental oxygen transport: 1) umbilical and uterine blood flow do not react homeostatically to prevent the rise of PO2 in the placental circulation, and 2) the decrease in oxygen flux from placenta to fetus is associated with a decrease in the transplacental PO2 gradient.

Quantification of adult cerebral hemodynamics by near-infrared spectroscopy

1994 ◽  
Vol 77 (6) ◽  
pp. 2753-2760 ◽  
Author(s):  
C. E. Elwell ◽  
M. Cope ◽  
A. D. Edwards ◽  
J. S. Wyatt ◽  
D. T. Delpy ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Arterial Oxygen Saturation ◽  
Cerebral Hemodynamics ◽  
Arterial Oxygen ◽  
The Mean

Near-infrared spectroscopy was used to measure global cerebral blood flow and volume in 10 healthy adult volunteers. High- and low-cerebral blood flow compartments were detected with mean flows for all 10 subjects of 59 +/- 21 (SD) and 11 +/- 4 ml.100 g-1.min-1, respectively. The mean cerebral blood volume of the group was 2.85 +/- 0.97 ml/100 g. Analysis of spontaneous changes in the cerebral concentrations of oxyhemoglobin and deoxyhemoglobin demonstrated strong correlations between respiratory rate and the oscillation frequency of cerebral oxyhemoglobin concentration (r = 0.99) and arterial oxygen saturation (SaO2) (r = 0.99). An estimate of the mean cerebral oxygen saturation for all subjects averaged 59.4 +/- 12.4% when their mean SaO2 was 91.8 +/- 2.4% (equivalent to 67.6 +/- 13.8% at a normoxic SaO2 of 98%). These results demonstrate that near-infrared spectroscopy can be used as a noninvasive bedside technique for both qualitative and quantitative evaluation of cerebral hemodynamics and oxygenation in adults.

Effect of Almitrine on Hypoxic Ventilatory Drive Measured by Transient and Progressive Isocapnic Hypoxia in Normal Men

1989 ◽  
Vol 77 (4) ◽  
pp. 431-437 ◽  
Author(s):  
M. A. A. Airlie ◽  
D. C. Flenley ◽  
P. M. Warren
Keyword(s):  
Oxygen Saturation ◽  
Ventilatory Response ◽  
Minute Ventilation ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Controlled Study ◽  
Peripheral Chemoreceptor ◽  
Ventilatory Drive ◽  
The Difference ◽  
Normal Men

1. In a double-blind placebo-controlled study, we have investigated the effect of the peripheral chemoreceptor stimulant drug almitrine bismesylate on hypoxic ventilatory drive (expressed as the slope of the minute ventilation/arterial oxygen saturation relationship in litres min−1 %−1) as measured by both progressive isocapnic hypoxia at rest and transient hypoxia (three breaths of 100% N2) during moderate exercise, in seven normal men, to determine if the ventilatory response to the transient hypoxic stimulus is a more specific measure of peripheral chemoreceptor sensitivity to hypoxia. 2. Hypoxic ventilatory drive measured using progressive isocapnic hypoxia ranged from −0.13 to −2.65 litres min−1 % −1 after placebo and from − 0.20 to − 6.48 litres min−1 %−1 after almitrine. The response was greater after almitrine in six of the seven subjects, and the difference was significant for the whole group (P < 0.05). 3. Hypoxic ventilatory drive measured using transient hypoxia ranged from −0.19 to −1.59 litres min−1 %−1 after placebo and from −0.09 to −1.62 litres min−1 %−1 after almitrine. The response was not consistently greater after almitrine, and the difference was not significant for the group. 4. Difficulties in accurately quantifying a brief rise in minute ventilation after transient hypoxia, particularly in subjects with a low hypoxic ventilatory drive, may have masked small changes in the slope of the minute ventilation/arterial oxygen saturation relationship with this method. However, the significant increase in the response to progressive isocapnic hypoxia after almitrine suggests that the failure to demonstrate an effect using transient hypoxic stimuli was not solely due to between-day variation in hypoxic ventilatory drive or the small numbers of subjects studied. 5. We conclude that, although transient hypoxia avoids any central depression of ventilation that might result from the prolonged hypoxia used in the conventional steady state or progressive isocapnic methods (thereby leading to underestimation of the hypoxic ventilatory drive), the ventilatory response to such transient stimuli is also affected by factors other than peripheral chemoreceptor activity.

scholarly journals Cardiovascular adjustments to acute hypoxemia superimposed on chronic hypoxemia in lambs

1995 ◽  
Vol 268 (3) ◽  
pp. H974-H979
Author(s):  
M. Dalinghaus ◽  
J. W. Gratama ◽  
W. G. Zijlstra ◽  
J. R. Kuipers
Keyword(s):  
Blood Flow ◽  
Oxygen Saturation ◽  
Oxygen Supply ◽  
Pulmonary Stenosis ◽  
Arterial Oxygen Saturation ◽  
Cardiovascular Responses ◽  
Arterial Oxygen ◽  
Blood Flows ◽  
Regional Blood Flows ◽  
Chronic Hypoxemia

Cardiovascular responses to acute hypoxemia are in part mediated through adrenergic and chemoreceptor stimulation. In chronic hypoxemia the response to these stimuli may be blunted. Therefore, we determined whether the cardiovascular responses to acute hypoxemia superimposed on 3–4 wk of chronic hypoxemia were blunted in lambs with an experimental cardiac right-to-left shunt (combination of atrial septal defect and variable pulmonary stenosis). Cardiovascular variables and regional blood flows were determined during chronic hypoxemia and after acutely reducing the arterial oxygen saturation by increasing the cardiac right-to-left shunt. Arterial oxygen saturation decreased (65 +/- 7 to 40 +/- 7%, P < 0.001) and systemic blood flow increased (164 +/- 63 to 233 +/- 100 ml.min-1.kg-1, P < 0.01), maintaining systemic oxygen supply and oxygen uptake. Blood flow to the myocardium (P < 0.01), the adrenals (P < 0.05), and the brain (0.05 < P < 0.10) increased, and oxygen supply to these organs was maintained. Conversely, blood flow to the kidneys and the gastrointestinal tract was unaltered, so that oxygen supply to these organs was decreased. The responses to acute hypoxemia in chronically hypoxemic lambs were similar to those previously reported in normoxemic lambs. We conclude that the cardiovascular responses to acute hypoxemia in chronically hypoxemic lambs are not blunted.

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