Khalife Maher, Ben Aziz Mohammed, Balestra Costantino, Valsamis Joseph, Sosnowski Maurice
Department of Anesthesiology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Environmental and Occupational Physiology Laboratory, Haute Ecole Bruxelles-Brabant, Brussels, Belgium.
Front Physiol. 2021 Sep 27;12:744074. doi: 10.3389/fphys.2021.744074. eCollection 2021.
The "Normobaric Oxygen Paradox" (NOP) is a physiologic mechanism that induces an increase of endogenous erythropoietin (EPO) production by creating a state of relative hypoxia in subjects previously exposed to hyperoxia, followed by a rapid return to normoxia. Oxygen exposure duration and inspired oxygen fraction required to observe a significant increase in EPO or hemoglobin are not clearly defined. Consequently, we here study the effect of one model of relative hypoxia on EPO, reticulocytes and hemoglobin stimulation in patients after surgery. Patients were prospectively randomized in two groups. The O group ( = 10) received 100% oxygen for 1 h per day for eight consecutive days, via a non-rebreathing mask. The control group ( = 12) received no oxygen variation. Serum EPO, hemoglobin and reticulocyte count were measured on admission and postoperatively on days seven and nine. Percentage EPO at day nine with respect to the baseline value was significantly elevated within the groups [O group: 323.7 (SD ± 139.0); control group: 365.6 (SD± 162.0)] but not between them. No significant difference was found between the groups in terms of reticulocytes count and hemoglobin. Our NOP model showed no difference on EPO increase between the two groups. However, both groups expressed separately significant EPO elevation.
“常压氧悖论”（NOP）是一种生理机制，通过在先前暴露于高氧环境的受试者中制造相对缺氧状态，随后迅速恢复至常压氧状态，从而诱导内源性促红细胞生成素（EPO）生成增加。观察到EPO或血红蛋白显著增加所需的氧暴露持续时间和吸入氧分数尚未明确界定。因此，我们在此研究一种相对缺氧模型对术后患者EPO、网织红细胞和血红蛋白刺激的影响。患者被前瞻性随机分为两组。O组（n = 10）通过无重复呼吸面罩连续八天每天接受1小时的100%氧气。对照组（n = 12）未进行氧变化处理。在入院时以及术后第七天和第九天测量血清EPO、血红蛋白和网织红细胞计数。两组内第九天EPO相对于基线值的百分比均显著升高[O组：323.7（标准差±139.0）；对照组：365.6（标准差±162.0）]，但两组之间无显著差异。两组在网织红细胞计数和血红蛋白方面未发现显著差异。我们的NOP模型显示两组之间EPO增加无差异。然而，两组各自均表现出显著的EPO升高。
