Positive expiratory pressure improves arterial and cerebral oxygenation in acute normobaric and hypobaric hypoxia.

Details

Serval ID
serval:BIB_3CA0E665007D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Positive expiratory pressure improves arterial and cerebral oxygenation in acute normobaric and hypobaric hypoxia.
Journal
American journal of physiology. Regulatory, integrative and comparative physiology
Author(s)
Rupp T., Saugy J.J., Bourdillon N., Verges S., Millet G.P.
ISSN
1522-1490 (Electronic)
ISSN-L
0363-6119
Publication state
Published
Issued date
01/11/2019
Peer-reviewed
Oui
Volume
317
Number
5
Pages
R754-R762
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Positive expiratory pressure (PEP) has been shown to limit hypoxia-induced reduction in arterial oxygen saturation, but its effectiveness on systemic and cerebral adaptations, depending on the type of hypoxic exposure [normobaric (NH) versus hypobaric (HH)], remains unknown. Thirteen healthy volunteers completed three randomized sessions consisting of 24-h exposure to either normobaric normoxia (NN), NH (inspiratory oxygen fraction, = 13.6%; barometric pressure, BP = 716 mmHg; inspired oxygen partial pressure, = 90.9 ± 1.0 mmHg), or HH (3,450 m, = 20.9%, BP = 482 mmHg, = 91.0 ± 0.6 mmHg). After the 6th and the 22nd hours, participants breathed quietly through a facemask with a 10-cmH <sub>2</sub> O PEP for 2 × 5 min interspaced with 5 min of free breathing. Arterial ( , pulse oximetry), quadriceps, and cerebral (near-infrared spectroscopy) oxygenation, middle cerebral artery blood velocity (MCAv; transcranial Doppler), ventilation, and cardiovascular responses were recorded continuously. without PEP was significantly lower in HH (87 ± 4% on average for both time points, P < 0.001) compared with NH (91 ± 3%) and NN (97 ± 1%). PEP breathing did not change in NN but increased it similarly in NH and HH (+4.3 ± 2.5 and +4.7 ± 4.1% after 6h; +3.5 ± 2.2 and +4.1 ± 2.9% after 22h, both P < 0.001). Although MCAv was reduced by PEP (in all sessions and at all time points, -6.0 ± 4.2 cm/s on average, P < 0.001), the cerebral oxygenation was significantly improved (P < 0.05) with PEP in both NH and HH, with no difference between conditions. These data indicate that PEP could be an attractive nonpharmacological means to improve arterial and cerebral oxygenation under both normobaric and hypobaric mild hypoxic conditions in healthy participants.
Keywords
Adult, Altitude Sickness/blood, Altitude Sickness/diagnosis, Altitude Sickness/physiopathology, Altitude Sickness/therapy, Blood Flow Velocity, Cerebrovascular Circulation, Double-Blind Method, Humans, Hypoxia/blood, Hypoxia/diagnosis, Hypoxia/physiopathology, Hypoxia/therapy, Male, Middle Cerebral Artery/diagnostic imaging, Middle Cerebral Artery/physiopathology, Oximetry, Oxygen/blood, Oxygen Consumption, Positive-Pressure Respiration, Quadriceps Muscle/blood supply, Spectroscopy, Near-Infrared, Time Factors, Ultrasonography, Doppler, Transcranial, acute mountain sickness, cerebral perfusion, positive expiratory pressure breathing, simulated and terrestrial altitude, tissue oxygenation
Pubmed
Web of science
Create date
20/09/2019 22:29
Last modification date
27/04/2020 6:20
Usage data