Aviner Ben, Arieli Ran, Yalov Alexandra
The Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel.
Eliachar Research Laboratory, Western Galilee Medical Center, Nahariya, Israel.
Front Physiol. 2020 Aug 17;11:1007. doi: 10.3389/fphys.2020.01007. eCollection 2020.
Patients undergoing hyperbaric oxygen therapy and divers engaged in underwater activity are at risk of central nervous system oxygen toxicity. An algorithm for predicting CNS oxygen toxicity in active underwater diving has been published previously, but not for humans at rest. Using a procedure similar to that employed for the derivation of our active diving algorithm, we collected data for exposures at rest, in which subjects breathed hyperbaric oxygen while immersed in thermoneutral water at 33°C ( = 219) or in dry conditions ( = 507). The maximal likelihood method was employed to solve for the parameters of the power equation. For immersion, the CNS oxygen toxicity index is K = t × PO , where the calculated risk from the Standard Normal distribution is Z = [ln(K ) - 8.99)]/0.81. For dry exposures this is K = t × PO , with risk Z = [ln(K ) - 11.34)]/0.65. We propose a method for interpolating the parameters at metabolic rates between 1 and 4.4 MET. The risk of CNS oxygen toxicity at rest was found to be greater during immersion than in dry conditions. We discuss the prediction properties of the new algorithm in the clinical hyperbaric environment, and suggest it may be adopted for use in planning procedures for hyperbaric oxygen therapy and for rest periods during saturation diving.
接受高压氧治疗的患者以及从事水下活动的潜水员存在中枢神经系统氧中毒的风险。先前已发表了一种预测活跃水下潜水时中枢神经系统氧中毒的算法,但未针对静息状态下的人类。我们采用了与推导活跃潜水算法类似的程序,收集了静息状态下的暴露数据,其中受试者在33°C的热中性水中(n = 219)或干燥条件下(n = 507)呼吸高压氧。采用最大似然法求解幂方程的参数。对于浸入情况,中枢神经系统氧中毒指数为K = t×PO,其中根据标准正态分布计算的风险为Z = [ln(K) - 8.99)]/0.81。对于干燥暴露情况,这是K = t×PO,风险Z = [ln(K) - 11.34)]/0.65。我们提出了一种在1至4.4代谢当量之间的代谢率下插值参数的方法。发现静息状态下中枢神经系统氧中毒的风险在浸入时比在干燥条件下更大。我们讨论了新算法在临床高压环境中的预测特性,并建议可将其用于规划高压氧治疗程序以及饱和潜水期间的休息时间。