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Cerebral hypoxemia

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https://www.readbyqxmd.com/read/29766271/obstructive-sleep-apnea-and-cerebral-white-matter-change-a-systematic-review-and-meta-analysis
#1
Bo-Lin Ho, Ping-Tao Tseng, Chiou-Lian Lai, Meng-Ni Wu, Ming-Ju Tsai, Cheng-Fang Hsieh, Tien-Yu Chen, Chung-Yao Hsu
Obstructive sleep apnea (OSA) can cause sleep fragmentation and intermittent hypoxemia, which are linked to oxidative stress. White matter changes (WMCs) representing cerebrovascular burden and are at risk factor for oxidative ischemic injury. The current study explores the mutual relationships between OSA and WMCs. We performed a systematic review of electronic databases for clinical studies investigating OSA and WMCs. Random-effects models were used for pooled estimates calculation. A total of 22 studies were included in the meta-analysis...
May 15, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29675862/hemodialysis-a-model-for-extreme-physiology-in-a-vulnerable-patient-population
#2
REVIEW
Jeroen P Kooman, Krassimir Katzarski, Frank M van der Sande, Karel M Leunissen, Peter Kotanko
Hemodialysis (HD) is a lifesaving treatment for patients with end-stage renal disease, which is very efficient in the correction of abnormalities of the internal environment. However, this efficiency also induces significant hemodynamic, thermal, and respiratory stressors. These have parallels with the extreme physiologic demands which are normally mainly experienced by healthy subjects under adverse environmental conditions, with the difference that they must be endured by a vulnerable patient population. Hemodynamic stress induced by ultrafiltration leads to a decline in circulating blood volume, which may result in intradialytic hypotension (IDH) and changes in tissue perfusion, which may have long-term consequences for the function of vital organs such as the brain and the heart...
April 19, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29622334/pediatric-major-head-injury-not-a-minor-problem
#3
REVIEW
Aaron N Leetch, Bryan Wilson
Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Initial Glasgow Coma Score, hyperglycemia, and imaging are often prognostic of outcome. Surgically amenable lesions should be evacuated promptly...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29574504/ventilatory-and-cerebrovascular-regulation-and-integration-at-high-altitude
#4
REVIEW
Ryan L Hoiland, Connor A Howe, Geoff B Coombs, Philip N Ainslie
Ascent to high-altitude elicits compensatory physiological adaptations in order to improve oxygenation throughout the body. The brain is particularly vulnerable to the hypoxemia of terrestrial altitude exposure. Herein we review the ventilatory and cerebrovascular changes at altitude and how they are both implicated in the maintenance of oxygen delivery to the brain. Further, the interdependence of ventilation and cerebral blood flow at altitude is discussed. Following the acute hypoxic ventilatory response, acclimatization leads to progressive increases in ventilation, and a partial mitigation of hypoxemia...
March 24, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29541495/rgb-camera-based-imaging-of-cerebral-tissue-oxygen-saturation-hemoglobin-concentration-and-hemodynamic-spontaneous-low-frequency-oscillations-in-rat-brain-following-induction-of-cortical-spreading-depression
#5
Afrina Mustari, Naoki Nakamura, Satoko Kawauchi, Shunichi Sato, Manabu Sato, Izumi Nishidate
To evaluate cerebral hemodynamics and spontaneous low-frequency oscillations (SLFOs) of cerebral blood flow in rat brain, we investigated an imaging method using a digital RGB camera. In this method, the RGB values were converted into tristimulus values in the CIE (Commission Internationale de l'Eclairage) XYZ color space, which is compatible with the common RGB working spaces. Monte Carlo simulation for light transport in tissue was then used to specify the relationship among the tristimulus XYZ values and the concentrations of oxygenated hemoglobin ( C HbO ), deoxygenated hemoglobin ( C HbR ), and total hemoglobin ( C HbT ) and cerebral tissue oxygen saturation ( StO 2 )...
March 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29512224/physiology-of-static-breath-holding-in-elite-apneists
#6
REVIEW
Anthony R Bain, Ivan Drvis, Zeljko Dujic, David B MacLeod, Philip N Ainslie
NEW FINDINGS: What is the topic of this review? This review provides an up-to-date assessment of the physiology involved with extreme static dry-land breath holding in trained apneists. What advances does it highlight? We specifically highlight the recent findings involved with the cardiovascular, cerebrovascular and metabolic function during a maximal breath hold in elite apneists. ABSTRACT: Breath-hold-related activities have been performed for centuries, but only recently, within the last ∼30 years, has it emerged as an increasingly popular competitive sport...
May 1, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29511418/obstetrics-at-decisive-crossroads-regarding-pattern-recognition-of-fetal-heart-rate-decelerations-scientific-principles-and-lessons-from-memetics
#7
REVIEW
Shashikant L Sholapurkar
The survival of cardiotocography (CTG) as a tool for intrapartum fetal monitoring seems threatened somewhat unjustifiably and unwittingly despite the absence of better alternatives. Fetal heart rate (FHR) decelerations are center-stage (most important) in the interpretation of CTG with maximum impact on three-tier classification. The pattern-discrimination of FHR decelerations is inexorably linked to their nomenclature. Unscientific or flawed nomenclature of decelerations can explain the dysfunctional CTG interpretation leading to errors in detection of acidemic fetuses...
April 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29464923/effect-of-acute-hypoxemia-on-cerebral-blood-flow-velocity-control-during-lower-body-negative-pressure
#8
Noud van Helmond, Blair D Johnson, Walter W Holbein, Humphrey G Petersen-Jones, Ronée E Harvey, Sushant M Ranadive, Jill N Barnes, Timothy B Curry, Victor A Convertino, Michael J Joyner
The ability to maintain adequate cerebral blood flow and oxygenation determines tolerance to central hypovolemia. We tested the hypothesis that acute hypoxemia during simulated blood loss in humans would cause impairments in cerebral blood flow control. Ten healthy subjects (32 ± 6 years, BMI 27 ± 2 kg·m-2 ) were exposed to stepwise lower body negative pressure (LBNP, 5 min at 0, -15, -30, and -45 mmHg) during both normoxia and hypoxia (Fi O2  = 0.12-0.15 O2 titrated to an SaO2 of ~85%). Physiological responses during both protocols were expressed as absolute changes from baseline, one subject was excluded from analysis due to presyncope during the first stage of LBNP during hypoxia...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29415505/in-vivo-evaluation-of-cerebral-hemodynamics-and-tissue-morphology-in-rats-during-changing-fraction-of-inspired-oxygen-based-on-spectrocolorimetric-imaging-technique
#9
Afrina Mustari, Takuya Kanie, Satoko Kawauchi, Shunichi Sato, Manabu Sato, Yasuaki Kokubo, Izumi Nishidate
During surgical treatment for cerebrovascular diseases, cortical hemodynamics are often controlled by bypass graft surgery, temporary occlusion of arteries, and surgical removal of veins. Since the brain is vulnerable to hypoxemia and ischemia, interruption of cerebral blood flow reduces the oxygen supply to tissues and induces irreversible damage to cells and tissues. Monitoring of cerebral hemodynamics and alteration of cellular structure during neurosurgery is thus crucial. Sequential recordings of red-green-blue (RGB) images of in vivo exposed rat brains were made during hyperoxia, normoxia, hypoxia, and anoxia...
February 6, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29357969/-surgical-procedures-and-perioperative-management-for-non-small-cell-lung-cancer-complicated-with-left-atrial-tumor-thrombus
#10
Tong Bao, Fei Xiao, Deruo Liu, Yongqing Guo, Chaoyang Liang
BACKGROUND: Non-small cell lung cancer with left atrial tumor thrombus accounts for a small proportion of local advanced lung cancer. Whether surgery could bring benefits, as well as surgical options are still controversial, and have always been hot spots in surgical research. We report a single center experience of surgical treatment to non-small cell lung cancer with left atrial tumor thrombus, aim to figure out more reasonable treatment strategy. METHODS: From August 2006 to July 2017, a total of 11 cases of non-small cell lung cancer with left atrial tumor thrombus underwent surgery in Thoracic Surgery Department of China-Japan Friendship Hospital...
January 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29344963/refractory-pulmonary-edema-and-upper-body-hypoxemia-during-veno-arterial-extracorporeal-membrane-oxygenation-a-case-for-atrial-septostomy
#11
Amit Prasad, Ali Ghodsizad, Christoph Brehm, Mark Kozak, Michael Körner, Aly El Banayosy, Kai Singbartl
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi-organ failure. In patients with severely limited left ventricular ejection, peripheral VA-ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29223273/a-79-year-old-woman-with-dyspnea-and-hypoxemia-that-worsened-in-an-upright-position
#12
Tjeerd van der Veer, Johannes C C M In 't Veen, Wijnand K den Dekker, Jelle Miedema
A 79-year-old woman presented to the ED with complaints of gradually worsening exertional dyspnea, dizziness, and chest discomfort. For several weeks she had not been able to perform light household work. The patient's medical history mentioned pulmonary embolism following immobilization (2012), several fractures after trauma, an ischemic cerebral vascular accident (2014), and curative treatment for breast cancer (1995). Her current medication included esomeprazole, clopidogrel, simvastatin, calcium/vitamin D, amitriptyline, and acetaminophen...
December 2017: Chest
https://www.readbyqxmd.com/read/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#13
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
February 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29191963/competitive-apnea-and-its-effect-on-the-human-brain-focus-on-the-redox-regulation-of-blood-brain-barrier-permeability-and-neuronal-parenchymal-integrity
#14
Anthony R Bain, Philip N Ainslie, Ryan L Hoiland, Otto F Barak, Ivan Drvis, Mike Stembridge, Douglas M MacLeod, Jane McEneny, Benjamin S Stacey, Eduoard Tuaillon, Nicola Marchi, Alexis Fayd'Herbe De Maudave, Zeljko Dujic, David B MacLeod, Damian M Bailey
Static apnea provides a unique model that combines transient hypertension, hypercapnia, and severe hypoxemia. With apnea durations exceeding 5 min, the purpose of the present study was to determine how that affects cerebral free-radical formation and the corresponding implications for brain structure and function. Measurements were obtained before and following a maximal apnea in 14 divers with transcerebral exchange kinetics, measured as the product of global cerebral blood flow (duplex ultrasound) and radial arterial to internal jugular venous concentration differences ( a-vD )...
January 5, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/29158938/orthodeoxia-without-platypnea-in-hereditary-hemorrhagic-telangiectasia-in-the-presence-of-a-cerebral-abscess-and-multiple-pulmonary-arteriovenous-malformations-unusual-complications-and-transcatheter-endovascular-treatment
#15
Carlos Salazar, Jacky Bruce Blank, Veronica Palmero
Hereditary hemorrhagic telangiectasia is a rare autosomal-dominant condition affecting visceral blood vessel development. Cerebral and most commonly pulmonary arteriovenous malformations are found in the majority of symptomatic patients. The most common complications include embolic strokes and cerebral abscesses, which have been attributed to abnormal vessel communications. Platypnea orthodeoxia is a rare condition that presents dyspnea and oxygen desaturation when adopting an upright position and is relieved on decubitus...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29089437/transient-hypoxemia-chronically-disrupts-maturation-of-preterm-fetal-ovine-subplate-neuron-arborization-and-activity
#16
Evelyn McClendon, Daniel C Shaver, Kiera Degener-O'Brien, Xi Gong, Thuan Nguyen, Anna Hoerder-Suabedissen, Zoltán Molnár, Claudia Mohr, Ben D Richardson, David J Rossi, Stephen A Back
Preterm infants are at risk for a broad spectrum of neurobehavioral disabilities associated with diffuse disturbances in cortical growth and development. During brain development, subplate neurons (SPNs) are a largely transient population that serves a critical role to establish functional cortical circuits. By dynamically integrating into developing cortical circuits, they assist in consolidation of intracortical and extracortical circuits. Although SPNs reside in close proximity to cerebral white matter, which is particularly vulnerable to oxidative stress, the susceptibility of SPNs remains controversial...
December 6, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29074711/enhanced-cerebral-perfusion-during-brief-exposures-to-cyclic-intermittent-hypoxemia
#17
Xiaoli Liu, Diqun Xu, James R Hall, Sarah Ross, Shande Chen, Howe Liu, Robert T Mallet, Xiangrong Shi
Cerebral vasodilation and increased cerebral oxygen extraction help maintain cerebral oxygen uptake in the face of hypoxemia. This study examined cerebrovascular responses to intermittent hypoxemia in eight healthy men breathing 10% O2 for 5 cycles, each 6 min, interspersed with 4 min of room air breathing. Hypoxia exposures raised heart rate ( P < 0.01) without altering arterial pressure, and increased ventilation ( P < 0.01) by expanding tidal volume. Arterial oxygen saturation ([Formula: see text]) and cerebral tissue oxygenation ([Formula: see text]) fell ( P < 0...
December 1, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28987197/neuropathology-of-cerebrovascular-diseases
#18
REVIEW
Isidro Ferrer, Noemi Vidal
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#19
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
February 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28854512/cerebral-oxygenation-and-desaturations-in-preterm-infants-a-longitudinal-data-analysis
#20
Benjamin Mayer, Moritz Pohl, Helmut D Hummler, Manuel B Schmid
OBJECTIVE: Hypoxemic episodes commonly occur in very preterm infants and may be associated with several adverse effects. Cerebral tissue oxygen saturation (StO2) as measured by near infrared spectroscopy (NIRS) may be a useful measure to assess brain oxygenation. However, knowledge on variability of StO2 is limited in preterm infants at this time, so StO2 dependency on arterial oxygenation (SpO2) and heart rate (HR) was assessed in preterm infants using statistical methods of time series analysis...
2017: Journal of Neonatal-perinatal Medicine
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