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经皮电刺激颏下区域对正常清醒受试者心肺反应的影响。

The effect of transcutaneous electrical stimulation of the submental area on the cardiorespiratory response in normal and awake subjects.

作者信息

Alsharifi Abdulaziz, Kaltsakas Georgios, Pengo Martino F, Parati Gianfranco, Serna-Pascual Miquel, Rafferty Gerrard, Steier Joerg

机构信息

Centre for Human and Applied Physiological Sciences (CHAPS), Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.

King's College Hospital NHS Foundation Trust, London, United Kingdom.

出版信息

Front Physiol. 2023 Mar 14;14:1089837. doi: 10.3389/fphys.2023.1089837. eCollection 2023.

Abstract

Electrical stimulation has recently been introduced to treat patients with Obstructive sleep apnoea There are, however, few data on the effects of transcutaneous submental electrical stimulation (TES) on the cardiovascular system. We studied the effect of TES on cardiorespiratory variables in healthy volunteers during head-down-tilt (HDT) induced baroreceptor loading. Cardiorespiratory parameters (blood pressure, heart rate, respiratory rate, tidal volume, airflow/minute ventilation, oxygen saturation, and end-tidal CO2/O2 concentration) were recorded seated, supine, and during head-down-tilt (50) under normoxic, hypercapnic (FiCO 5%) and poikilocapnic hypoxic (FiO 12%) conditions. Blood pressure (BP) was measured non-invasively and continuously (Finapres). Gas conditions were applied in random order. All participants were studied twice on different days, once without and once with TES. We studied 13 healthy subjects (age 29 (12) years, six female, body mass index (BMI) 23.23 (1.6) kg·m). A three-way ANOVA indicated that BP decreased significantly with TES (systolic: = 4.93E-06, diastolic: = 3.48E-09, mean: = 3.88E-08). Change in gas condition (systolic: = 0.0402, diastolic: = 0.0033, mean: = 0.0034) and different postures (systolic: 8.49E-08, diastolic: = 6.91E-04, mean: = 5.47E-05) similarly impacted on BP control. When tested for interaction, there were no significant associations between the three different factors electrical stimulation, gas condition, or posture, except for an effect on minute ventilation (gas condition/posture = 0.0369). Transcutaneous electrical stimulation has a substantial impact on the blood pressure. Similarly, postural changes and variations in inspired gas impact on blood pressure control. Finally, there was an interaction between posture and inspired gases that affects minute ventilation. These observations have implications on our understanding of integrated cardiorespiratory control, and may prove beneficial for patients with SDB who are assessed for treatment with electrical stimulation.

摘要

最近,电刺激已被用于治疗阻塞性睡眠呼吸暂停患者。然而,关于经皮颏下电刺激(TES)对心血管系统影响的数据却很少。我们研究了在头低位倾斜(HDT)诱发压力感受器负荷期间,TES对健康志愿者心肺变量的影响。记录了在常氧、高碳酸血症(FiCO₂ 5%)和异氧性低氧(FiO₂ 12%)条件下,坐位、仰卧位以及头低位倾斜(50°)时的心肺参数(血压、心率、呼吸频率、潮气量、气流/分钟通气量、氧饱和度和呼气末CO₂/O₂浓度)。血压(BP)采用无创连续测量(Finapres)。气体条件按随机顺序施加。所有参与者在不同日期接受两次研究,一次不进行TES,一次进行TES。我们研究了13名健康受试者(年龄29(12)岁,6名女性,体重指数(BMI)23.23(1.6)kg·m²)。三因素方差分析表明,TES使血压显著降低(收缩压:F = 4.93E - 06,舒张压:F = 3.48E - 09,平均压:F = 3.88E - 08)。气体条件变化(收缩压:F = 0.0402,舒张压:F = 0.0033,平均压:F = 0.0034)和不同体位(收缩压:8.49E - 08,舒张压:F = 6.91E - 04,平均压:F = 5.47E - 05)对血压控制有类似影响。在进行交互作用测试时,除了对分钟通气量有影响(气体条件/体位F = 0.0369)外,电刺激、气体条件或体位这三个不同因素之间没有显著关联。经皮电刺激对血压有显著影响。同样,体位变化和吸入气体变化对血压控制有影响。最后,体位和吸入气体之间存在影响分钟通气量的交互作用。这些观察结果对我们理解心肺综合控制有重要意义,并且可能对接受电刺激治疗评估的睡眠呼吸障碍(SDB)患者有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebe4/10043176/026852f5ff83/fphys-14-1089837-g001.jpg

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