scholarly journals Neutrophil Gelatinase-Associated Lipocalin: Its Response to Hypoxia and Association with Acute Mountain Sickness

2013 ◽  
Vol 35 ◽  
pp. 537-542 ◽  
Author(s):  
Adrian Mellor ◽  
Christopher Boos ◽  
Mike Stacey ◽  
Tim Hooper ◽  
Chris Smith ◽  
...  
Keyword(s):  
Biochemical Marker ◽  
Point Of Care ◽  
Acute Mountain Sickness ◽  
Normobaric Hypoxia ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Clinical Challenge ◽  
Significant Difference ◽  
Mountain Sickness ◽  
Neutrophil Gelatinase ◽  
And Oxidative Stress

Acute Mountain Sickness (AMS) is a common clinical challenge at high altitude (HA). A point-of-care biochemical marker for AMS could have widespread utility. Neutrophil gelatinase-associated lipocalin (NGAL) rises in response to renal injury, inflammation and oxidative stress. We investigated whether NGAL rises with HA and if this rise was related to AMS, hypoxia or exercise. NGAL was assayed in a cohort (n=22) undertaking 6 hours exercise at near sea-level (SL); a cohort (n=14) during 3 hours of normobaric hypoxia (FiO2 11.6%) and on two trekking expeditions (n=52) to over 5000 m. NGAL did not change with exercise at SL or following normobaric hypoxia. During the trekking expeditions NGAL levels (ng/ml, mean ± sd, range) rose significantly (P<0.001) from 68 ± 14 (60–102) at 1300 m to 183 ± 107 (65–519); 143 ± 66 (60–315) and 150 ± 71 (60–357) at 3400 m, 4270 m and 5150 m respectively. At 5150 m there was a significant difference in NGAL between those with severe AMS (n=7), mild AMS (n=16) or no AMS (n=23): 201 ± 34 versus 171 ± 19 versus 124 ± 12 respectively (P=0.009for severe versus no AMS;P=0.026for mild versus no AMS). In summary, NGAL rises in response to prolonged hypobaric hypoxia and demonstrates a relationship to the presence and severity of AMS.

scholarly journals Urine neutrophil gelatinase-associated lipocalin concentration in healthy newborns during the first three postnatal days

2020 ◽  
Vol 30 (3) ◽  
pp. 466-470
Author(s):  
Vinka Mikulić ◽  
Ivanka Mikulić ◽  
Helena Radić Mišković ◽  
Vajdana Tomić ◽  
Ana Ćuk ◽  
...  
Keyword(s):  
Birth Weight ◽  
Biochemical Marker ◽  
Kidney Injury ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Median Concentration ◽  
Significant Difference ◽  
Term Newborns ◽  
Chemiluminescent Microparticle Immunoassay ◽  
Neutrophil Gelatinase

Introduction: Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a biochemical marker significant for early prediction of acute kidney injury in adults. However, it has not been examined sufficiently among the infant population, particularly newborns in terms of reference values. The aim of our study was to determine the concentration of uNGAL in healthy term newborns and to determine if there was a difference in uNGAL concentration according to gender, postnatal age and birth weight. Materials and methods: Our study involved 81 healthy term newborns birth (≥ 37 weeks, Apgar score ≥ 8 in the first minute after birth, CRP < 5 mg/L). Urine NGAL was measured using chemiluminescent microparticle immunoassay (CMIA) within 72 hours after birth, on Architect plus ci8200 analyser (Abbott, Chicago, USA). Data were analysed using Statistica software. Results: The median concentration of uNGAL in the whole study group of healthy term newborns was 27.1 ng/mL (16.5-56.0 ng/mL) (newborn girls, 27.1 ng/mL (15.8-47.9 ng/mL); newborn boys, 27.9 ng/mL (16.5-61.0 ng/mL), P = 0.941). Median uNGAL concentration according to postnatal age expressed in days was 28.2 ng/mL (11.7-57.2 ng/mL) 1st day, 28.9 ng/mL (16.5-64.2 ng/mL ) 2nd day and 23.9 ng/mL (20.2-46.6) 3rd day, P = 0.863. Regarding birth weight for newborns < 3500 g, median concentration was 25.0 ng/mL (16.5-45.4 ng/mL ) and for weight ≥ 3500 g 30.6 ng/mL (16.5-64.2 ng/mL), P = 0.455. Conclusions: There were no significant difference in uNGAL concentration in relation to gender, postnatal age and birth weight.

Exercise intensity typical of mountain climbing does not exacerbate acute mountain sickness in normobaric hypoxia

2012 ◽  
Vol 113 (7) ◽  
pp. 1068-1074 ◽  
Author(s):  
Kai Schommer ◽  
Moritz Hammer ◽  
Lorenz Hotz ◽  
Elmar Menold ◽  
Peter Bärtsch ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Oxygen Saturation ◽  
Maximal Oxygen Uptake ◽  
Arterial Oxygen Saturation ◽  
Acute Mountain Sickness ◽  
Normobaric Hypoxia ◽  
Arterial Oxygen ◽  
Moderate Exercise ◽  
Significant Difference ◽  
Mountain Sickness

Physical exertion is thought to exacerbate acute mountain sickness (AMS). In this prospective, randomized, crossover trial, we investigated whether moderate exercise worsens AMS in normobaric hypoxia (12% oxygen, equivalent to 4,500 m). Sixteen subjects were exposed to altitude twice: once with exercise [3 × 45 min within the first 4 h on a bicycle ergometer at 50% of their altitude-specific maximal workload (maximal oxygen uptake)], and once without. AMS was evaluated by the Lake Louise score and the AMS-C score of the Environmental Symptom Questionnaire. There was no significant difference in AMS between the exposures with and without exercise, neither after 5, 8, nor 18 h (incidence: 64 and 43%; LLS: 6.5 ± 0.7 and 5.1 ± 0.8; AMS-C score: 1.2 ± 0.3 and 1.1 ± 0.3 for exercise vs. rest at 18 h; all P > 0.05). Exercise decreased capillary Po2 (from 36 ± 1 Torr at rest to 31 ± 1 Torr), capillary arterial oxygen saturation (from 72% at rest to 67 ± 2%), and cerebral oxygen saturation (from 49 ± 2% at rest to 42 ± 1%, as assessed by near-infrared spectroscopy; P < 0.05), and increased ventilation (capillary Pco2 27 ± 1 Torr; P < 0.05). After exercise, the increase in ventilation persisted for several hours and was associated with similar levels of capillary and cerebral oxygenation at the exercise and rest day. We conclude that moderate exercise at ∼50% maximal oxygen uptake does not increase AMS in normobaric hypoxia. These data do not exclude that considerably higher exercise intensities exacerbate AMS.

No effect of patent foramen ovale on acute mountain sickness and pulmonary pressure in normobaric hypoxia

2021 ◽  
Author(s):  
Kaitlyn G. DiMarco ◽  
Kara M. Beasley ◽  
Karina Shah ◽  
Julia P. Speros ◽  
Jonathan E. Elliott ◽  
...  
Keyword(s):  
Patent Foramen Ovale ◽  
Acute Mountain Sickness ◽  
Normobaric Hypoxia ◽  
Foramen Ovale ◽  
Pulmonary Pressure ◽  
Mountain Sickness

scholarly journals Diagnostic relevance of neutrophil gelatinase-associated lipocalin in early detection of acute kidney injury

2020 ◽  
Vol 7 (2) ◽  
pp. 88-92
Author(s):  
Madhusudhan Mahadevaiah ◽  
Murali Mohan Nidasale Thimmaiah ◽  
Venu Sashank Yerramsetty ◽  
Jeevan Kumar ◽  
Ranjith Kumar
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Accuracy ◽  
Point Of Care ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Point Of Care Test ◽  
Reliable Marker ◽  
Neutrophil Gelatinase

Objective: To evaluate the predictive and diagnostic accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in acute kidney injury (AKI) and also to predict the renal replacement therapy (RRT) using NGAL as a marker. Methods: This prospective study was conducted among the patients admitted to intensive care units. Plasma samples were collected 24 hours after admission and NGAL was measured using Triage® NGAL test, a specific point of care test which is based on the mechanism of fluorescence immunoassay. The diagnostic accuracy of plasma NGAL (pNGAL) to predict AKI in critically ill patients of ICU was assessed by applying receiver operator curve (ROC) analysis and calculating the area under the curve (AUC). Results: In this study, 100 patients with the mean age of 49.56±19.2 years were included for the period of 18 months. The blood samples were withdrawn from the patients 24 and 44 hours after admission. Totally, 55% (n=55) of ICU patients were diagnosed with AKI. Plasma NGAL level was significantly increased in AKI patients as compared to non-AKI patients (742.65±734.72 vs. 255.62±440.09 μg/L; P<0.01). The sensitivity and specificity of NGAL for diagnosing AKI was 83.6% and 88.9%, respectively. The overall diagnostic accuracy was 86%. Diagnostic accuracy of NGAL for requirement of RRT was 51%. Conclusion: Plasma NGAL is a reliable marker for patients with AKI in ICU, in case the cause of kidney injury is not known. In addition, NGAL also predicts the RRT need based on AKI severity.

The Effect of an Expiratory Resistance Mask with Dead Space on Sleep, Acute Mountain Sickness, Cognition, and Ventilatory Acclimatization in Normobaric Hypoxia

2019 ◽  
Vol 20 (1) ◽  
pp. 61-70 ◽  
Author(s):  
Alexander Patrician ◽  
Michael M. Tymko ◽  
Hannah G. Caldwell ◽  
Connor A. Howe ◽  
Geoff B. Coombs ◽  
...  
Keyword(s):  
Dead Space ◽  
Acute Mountain Sickness ◽  
Normobaric Hypoxia ◽  
Expiratory Resistance ◽  
Mountain Sickness

Effect of repeated normobaric hypoxia exposures during sleep on acute mountain sickness, exercise performance, and sleep during exposure to terrestrial altitude

2011 ◽  
Vol 300 (2) ◽  
pp. R428-R436 ◽  
Author(s):  
Charles S. Fulco ◽  
Stephen R. Muza ◽  
Beth A. Beidleman ◽  
Robby Demes ◽  
Janet E. Staab ◽  
...  
Keyword(s):  
Heart Rate ◽  
Exercise Performance ◽  
Hypobaric Hypoxia ◽  
Sham Group ◽  
Acute Mountain Sickness ◽  
Time Trial ◽  
Normobaric Hypoxia ◽  
Performance Decrement ◽  
Mountain Sickness ◽  
End Tidal

There is an expectation that repeated daily exposures to normobaric hypoxia (NH) will induce ventilatory acclimatization and lessen acute mountain sickness (AMS) and the exercise performance decrement during subsequent hypobaric hypoxia (HH) exposure. However, this notion has not been tested objectively. Healthy, unacclimatized sea-level (SL) residents slept for 7.5 h each night for 7 consecutive nights in hypoxia rooms under NH [ n = 14, 24 ± 5 (SD) yr] or “sham” ( n = 9, 25 ± 6 yr) conditions. The ambient percent O2 for the NH group was progressively reduced by 0.3% [150 m equivalent (equiv)] each night from 16.2% (2,200 m equiv) on night 1 to 14.4% (3,100 m equiv) on night 7, while that for the ventilatory- and exercise-matched sham group remained at 20.9%. Beginning at 25 h after sham or NH treatment, all subjects ascended and lived for 5 days at HH (4,300 m). End-tidal Pco2, O2 saturation (SaO2), AMS, and heart rate were measured repeatedly during daytime rest, sleep, or exercise (11.3-km treadmill time trial). From pre- to posttreatment at SL, resting end-tidal Pco2 decreased ( P < 0.01) for the NH (from 39 ± 3 to 35 ± 3 mmHg), but not for the sham (from 39 ± 2 to 38 ± 3 mmHg), group. Throughout HH, only sleep SaO2 was higher (80 ± 1 vs. 76 ± 1%, P < 0.05) and only AMS upon awakening was lower (0.34 ± 0.12 vs. 0.83 ± 0.14, P < 0.02) in the NH than the sham group; no other between-group rest, sleep, or exercise differences were observed at HH. These results indicate that the ventilatory acclimatization induced by NH sleep was primarily expressed during HH sleep. Under HH conditions, the higher sleep SaO2 may have contributed to a lessening of AMS upon awakening but had no impact on AMS or exercise performance for the remainder of each day.

scholarly journals Neutrophil Gelatinase-Associated Lipocalin: A New Marker of Renal Function in C-Related End Stage Liver Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Omkolsoum Mohamed Alhaddad ◽  
Ayman Alsebaey ◽  
Mohamed Omar Amer ◽  
Hala Hany El-Said ◽  
Tary Abdel Hamid Salman
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Common Complication ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
End Stage Liver Disease ◽  
Group I ◽  
Significant Difference ◽  
Isotope Scanning ◽  
End Stage ◽  
Neutrophil Gelatinase

Background/Aims. Renal impairment is a common complication of cirrhosis. Serum creatinine is less sensitive in these patients. Measurement of the glomerular filtration rate (GFR) is the gold standard but time consuming. The aim is to validate plasma NGAL (pNGAL) and urinary NGAL (uNGAL) as markers of renal function in patients with HCV related cirrhosis.Patient and Methods. One hundred HCV related end stage liver cirrhosis patients were randomized into two groups: Group I (n=35), patients with GFR < 60 mL/m measured by isotope scanning of the kidney (Renogram), and Group II (n=65), patients with GFR ≥ 60 mL/m. The pNGAL and uNGAL were measured within 2 days of the Renogram.Results. Both groups were matched with age, sex, and Child Pugh score. There was statistically significant difference between both groups regarding serum creatinine (1.98 ± 1.04 versus 1.38 ± 0.88 mg/dL;p=0.003) and pNGAL level (5.79 ± 2.06 versus 7.25 ± 3.30 ng/dL;p=0.019). Both groups were comparable (p>0.05) for the uNGAL (6.00 ± 0.78 versus 6.03 ± 0.96 ng/mL). Unlike uNGAL, the pNGAL positively correlated with total GFR by Renogram (r=0.3;p=0.001). With a cutoff ≥4 ng/mL, pNGAL had 94.3% sensitivity and 1.5% specificity and PPV = 34, NPV = 33.3, LR+ = −175.1, and LR− = −60.6.Conclusion. The pNGAL is a promising marker of the renal function in patients with cirrhosis.

scholarly journals Remote ischemic preconditioning delays the onset of acute mountain sickness in normobaric hypoxia

2015 ◽  
Vol 3 (3) ◽  
pp. e12325 ◽  
Author(s):  
Marc M. Berger ◽  
Hannah Köhne ◽  
Lorenz Hotz ◽  
Moritz Hammer ◽  
Kai Schommer ◽  
...  
Keyword(s):  
Ischemic Preconditioning ◽  
Acute Mountain Sickness ◽  
Normobaric Hypoxia ◽  
Remote Ischemic Preconditioning ◽  
Mountain Sickness

scholarly journals Comparison of urine and serum neutrophil gelatinase-associated lipocalin after open and endovascular thoraco-abdominal aortic surgery and their meaning as indicators of acute kidney injury

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Alexander Gombert ◽  
Lukas Martin ◽  
Ann Christina Foldenauer ◽  
Clara Krajewski ◽  
Andreas Greiner ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Aortic Aneurysms ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Abdominal Aortic ◽  
Potential Biomarker ◽  
Significant Difference ◽  
Neutrophil Gelatinase

Abstract. Background: Neutrophil gelatinase-associated lipocalin (NGAL) has been described as a potential biomarker of acute kidney injury (AKI) in different settings, but its behaviour under influence of open and endovascular repair of thoraco-abdominal aortic aneurysms (TAAA) has not been assessed yet. In this study, the course of NGAL was observed and differences of serum- (sNGAL) and urine-NGAL (uNGAL) levels following TAAA repair, especially with regard to AKI, were evaluated. Patients and methods: In this retrospective single centre study, 52 patients (mean age 64.5 years, [43–85 years]), including 39 (75 %) men, were enrolled (2014–2015, 13.2 months mean follow-up). Levels of sNGAL and uNGAL were measured perioperatively for 48 hours on intensive care unit. Twenty-three patients were treated by endovascular and 29 by open TAAA-repair. Results: Logistic regression revealed an increase in NGAL (sNGAL p = 0.0263, uNGAL p = 0.0080) corresponding with an increase in serum creatinine within the first 48 hours. Fourteen patients (26.9 %) developed AKI and 11 (21.1 %) required dialysis. The course of NGAL differed significantly (uNGAL p < .0001, sNGAL p = 0.0002) between patients suffering from AKI requiring dialysis and patients without AKI. The predictive power of uNGAL was three times higher than that of sNGAL (estimate of the regression slope 0.1382 vs. 0.0460). No significant difference between patients undergoing open or endovascular TAAA repair regarding the perioperative course of sNGAL and uNGAL was observed. Conclusion: serum-NGAL and urine-NGAL correlate with serum creatinine levels and AKI requiring dialysis. Furthermore, the postoperative course of sNGAL and uNGAL after open and endovascular TAAA repair is not significantly different. Taken together, the results indicate that uNGAL and, to a lesser extent, sNGAL could be considered biomarkers for early detection of perioperative AKI after open and endovascular TAAA surgery.

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