De Bels D, Pierrakos C, Bruneteau A, Reul F, Crevecoeur Q, Marrone N, Vissenaeken D, Borgers G, Balestra C, Honoré P M, Theunissen S
Department of Intensive Care Medicine, Brugmann University Hospital, Brussels, Belgium.
Unit of Oxygen Study, Translational Research Laboratory, Université Libre de Bruxelles, Brussels, Belgium.
Front Physiol. 2019 Jun 26;10:806. doi: 10.3389/fphys.2019.00806. eCollection 2019.
To observe the effects of a fast-acute ascent to high altitude on brain cognitive function and transcranial doppler parameters in order to understand the physiological countermeasures of hypoxia.
17 high-altitude-naïve male subjects (mean age was 26.3 ± 8.1 years) participated in the study. We measured Critical Flicker Fusion Frequency (CFFF), blood oxygen saturation, Psychology Experiment Building (PEBL) including three tests (Modified Math Processing Task, Perceptual Vigilance Task, and Time Estimation Task), as well as Cerebral Blood Flow index (CBFi), mean cerebral artery Systolic and diastolic velocities, Cerebral Pulsatility index (CPi), and heart Rate. All were measured at sea level, at least 1 h after arrival at the hypobaric hypoxia equivalent of 3842 m and 1 h after return to sea level.
Under acute exposure to hypobaric hypoxic conditions, significant decrease in CFFF [42.1 ± 1 vs. 43.5 ± 1.7 Hz at sea level (asl), < 0.01], CBFi (611 ± 51 vs. 665 ± 71 asl, < 0.01) and blood oxygen saturation (83 ± 4% vs. 98 ± 1% asl, < 0.001) as compared to pre-ascent values were observed. Physiological countermeasures to hypoxia could be involved as there was no significant change in neuropsychometric tests, Systolic and Diastolic velocities and CPi. A significant increase in Heart Rate (81 ± 15 bpm vs. 66 ± 15 bpm asl, < 0.001) was observed. All parameters returned to their basal values 1 h after regaining sea level.
Hypoxia results in a decrease in CFFF, CBFi and oxygen saturation and in an increase in heart rate. As it decreased, Cerebral Blood Flow index does not seem to be the physiological measurement of choice to hypoxia explaining the maintenance of cognitive performance after acute exposure to hypobaric hypoxia and requires further investigation. Cerebral oxygen delivery and extraction could be one of the underlying mechanisms.
观察快速急性登高至高原对脑认知功能及经颅多普勒参数的影响,以了解缺氧的生理应对措施。
17名从未到过高海拔地区的男性受试者(平均年龄26.3±8.1岁)参与了本研究。我们测量了临界闪烁融合频率(CFFF)、血氧饱和度、心理实验套件(PEBL),其中包括三项测试(改良数学处理任务、感知警觉任务和时间估计任务),以及脑血流指数(CBFi)、大脑中动脉收缩期和舒张期速度、脑搏动指数(CPi)和心率。所有测量均在海平面、到达相当于海拔3842米的低压低氧环境后至少1小时以及返回海平面后1小时进行。
在急性暴露于低压低氧条件下,与登高前值相比,观察到CFFF显著降低[海平面(asl)时为42.1±1赫兹,而登高前为43.5±1.7赫兹,P<0.01]、CBFi(611±51 vs. 665±71 asl,P<0.01)和血氧饱和度(83±4% vs. 98±1% asl,P<0.001)。由于神经心理测试、收缩期和舒张期速度以及CPi没有显著变化,可能涉及对缺氧的生理应对措施。观察到心率显著增加(81±15次/分钟 vs. 66±15次/分钟 asl,P<0.001)。恢复到海平面1小时后,所有参数均恢复到基础值。
缺氧导致CFFF、CBFi和血氧饱和度降低,心率增加。随着脑血流指数降低,它似乎不是缺氧的首选生理测量指标,这解释了急性暴露于低压低氧环境后认知表现的维持情况,需要进一步研究。脑氧输送和提取可能是潜在机制之一。