Laboratory of Hyperbaric Medicine, Department of Anesthesia, Centre of Head and Orthopedics, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
J Appl Physiol (1985). 2012 Aug;113(3):426-33. doi: 10.1152/japplphysiol.00193.2012. Epub 2012 May 31.
The standard treatment of altitude decompression sickness (aDCS) caused by nitrogen bubble formation is oxygen breathing and recompression. However, micro air bubbles (containing 79% nitrogen), injected into adipose tissue, grow and stabilize at 25 kPa regardless of continued oxygen breathing and the tissue nitrogen pressure. To quantify the contribution of oxygen to bubble growth at altitude, micro oxygen bubbles (containing 0% nitrogen) were injected into the adipose tissue of rats depleted from nitrogen by means of preoxygenation (fraction of inspired oxygen = 1.0; 100%) and the bubbles studied at 101.3 kPa (sea level) or at 25 kPa altitude exposures during continued oxygen breathing. In keeping with previous observations and bubble kinetic models, we hypothesize that oxygen breathing may contribute to oxygen bubble growth at altitude. Anesthetized rats were exposed to 3 h of oxygen prebreathing at 101.3 kPa (sea level). Micro oxygen bubbles of 500-800 nl were then injected into the exposed abdominal adipose tissue. The oxygen bubbles were studied for up to 3.5 h during continued oxygen breathing at either 101.3 or 25 kPa ambient pressures. At 101.3 kPa, all bubbles shrank consistently until they disappeared from view at a net disappearance rate (0.02 mm(2) × min(-1)) significantly faster than for similar bubbles at 25 kPa altitude (0.01 mm(2) × min(-1)). At 25 kPa, most bubbles initially grew for 2-40 min, after which they shrank and disappeared. Four bubbles did not disappear while at 25 kPa. The results support bubble kinetic models based on Fick's first law of diffusion, Boyles law, and the oxygen window effect, predicting that oxygen contributes more to bubble volume and growth during hypobaric conditions. As the effect of oxygen increases, the lower the ambient pressure. The results indicate that recompression is instrumental in the treatment of aDCS.
标准的治疗方法是氮气泡形成的减压病(aDCS)吸氧和再压缩。然而,微气泡(含 79%氮气),注入脂肪组织,在 25 kPa 下生长和稳定,不管是否继续吸氧,以及组织氮压力。为了量化氧气对气泡在高海拔生长的贡献,微氧气泡(含 0%氮气)被注入氮气耗尽的大鼠脂肪组织,通过预充氧(吸入氧分数= 1.0;100%),并在 101.3 kPa(海平面)或 25 kPa 海拔暴露于继续吸氧时研究气泡。根据以前的观察和气泡动力学模型,我们假设氧气呼吸可能有助于氧气气泡在高海拔生长。麻醉大鼠暴露于 101.3 kPa(海平面)的氧气预呼吸 3 小时。然后将 500-800 nl 的微氧气泡注入暴露的腹部脂肪组织中。在 101.3 kPa 或 25 kPa 环境压力下继续吸氧时,对氧气气泡进行了长达 3.5 小时的研究。在 101.3 kPa 时,所有气泡持续收缩,直到在净消失率(0.02 mm 2 × min -1)显著快于在 25 kPa 海拔(0.01 mm 2 × min -1)时从视野中消失。在 25 kPa 时,大多数气泡最初生长 2-40 分钟,之后它们收缩并消失。四个气泡在 25 kPa 时没有消失。结果支持基于菲克第一定律扩散、波义耳定律和氧气窗口效应的气泡动力学模型,预测在低压条件下,氧气对气泡体积和生长的贡献更大。随着氧气效应的增加,环境压力越低。结果表明,再压缩在治疗减压病中是至关重要的。