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使用无创频域近红外光谱和漫反射相关光谱连续测量呼吸肌血流和耗氧量。

Continuous measurements of respiratory muscle blood flow and oxygen consumption using noninvasive frequency-domain near-infrared spectroscopy and diffuse correlation spectroscopy.

机构信息

Department of Critical Care, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Appl Physiol (1985). 2024 Aug 1;137(2):382-393. doi: 10.1152/japplphysiol.00871.2023. Epub 2024 Jun 13.

Abstract

Prior studies of muscle blood flow and muscle-specific oxygen consumption have required invasive injection of dye and magnetic resonance imaging, respectively. Such measures have limited utility for continuous monitoring of the respiratory muscles. Frequency-domain near-infrared spectroscopy and diffuse correlation spectroscopy (FD-NIRS & DCS) can provide continuous surrogate measures of blood flow index (BF) and metabolic rate of oxygen consumption (MRO). This study aimed to validate sternocleidomastoid FD-NIRS & DCS outcomes against electromyography (EMG) and mouth pressure (Pm) during incremental inspiratory threshold loading (ITL). Six female and six male healthy adults (means ± SD; 30 ± 7 yr, maximum inspiratory pressure 118 ± 61 cmHO) performed incremental ITL starting at low loads (8 ± 2 cmHO) followed by 50-g increments every 2 min until task failure. FD-NIRS & DCS continuously measured sternocleidomastoid oxygenated and deoxygenated hemoglobin + myoglobin (oxy/deoxy[Hb + Mb]), tissue saturation of oxygen (StO), BF, and MRO. Ventilatory parameters including inspiratory Pm were also evaluated. Pm increased during incremental ITL ( < 0.05), reaching -47[-74 to -34] cmHO (median [IQR: 25%-75%]) at task failure. Ventilatory parameters were constant throughout ITL (all > 0.05). Sternocleidomastoid BF and MRO increased from the start of the ITL (both < 0.05). Deoxy[Hb + Mb] increased close to task failure, concomitantly with a constant increase in MRO, and decreased StO. Sternocleidomastoid deoxy[Hb + Mb], BF, StO, and MRO obtained during ITL via FD-NIRS & DCS correlated with sternocleidomastoid EMG (all < 0.05). In healthy adults, FD-NIRS & DCS can provide continuous surrogate measures of respiratory BF and MRO. Increasing sternocleidomastoid oxygen consumption near task failure was associated with increased oxygen extraction and reduced tissue saturation. This study introduces a novel approach, frequency-domain near-infrared spectroscopy and diffuse correlation spectroscopy (FD-NIRS & DCS), for noninvasive continuous monitoring of respiratory muscle blood flow and metabolic rate of oxygen consumption. Unlike prior methods involving invasive dye injection and magnetic resonance imaging, FD-NIRS & DCS offers the advantage of continuous measurement without the need for invasive procedures. It holds promise for advancing muscle physiology understanding and opens avenues for real-time monitoring of respiratory muscles.

摘要

先前关于肌肉血流和肌肉特异性耗氧量的研究分别需要侵入性染料注射和磁共振成像。这些测量方法对于呼吸肌的连续监测的应用有限。频域近红外光谱和漫反射相关光谱(FD-NIRS 和 DCS)可以提供血流指数(BF)和耗氧量代谢率(MRO)的连续替代测量值。本研究旨在通过递增吸气阈负荷(ITL)期间的肌电图(EMG)和口腔压力(Pm)来验证胸锁乳突肌 FD-NIRS 和 DCS 的结果。六名女性和六名男性健康成年人(平均值±标准差;30±7 岁,最大吸气压力 118±61cmH2O)从低负荷(8±2cmH2O)开始进行递增 ITL,然后每 2 分钟增加 50g,直到任务失败。FD-NIRS 和 DCS 连续测量胸锁乳突肌氧合和去氧血红蛋白+肌红蛋白(oxy/deoxy[Hb+Mb])、氧饱和度(StO)、BF 和 MRO。还评估了包括吸气 Pm 在内的通气参数。随着递增 ITL,Pm 增加(<0.05),在任务失败时达到-47[-74 至-34]cmH2O(中位数[IQR:25%-75%])。整个 ITL 期间通气参数保持不变(均>0.05)。胸锁乳突肌 BF 和 MRO 从 ITL 开始增加(均<0.05)。去氧[Hb+Mb]在接近任务失败时增加,同时 MRO 持续增加,StO 降低。FD-NIRS 和 DCS 在 ITL 期间获得的胸锁乳突肌 deoxy[Hb+Mb]、BF、StO 和 MRO 与胸锁乳突肌 EMG 相关(均<0.05)。在健康成年人中,FD-NIRS 和 DCS 可以提供呼吸 BF 和 MRO 的连续替代测量值。在接近任务失败时,胸锁乳突肌耗氧量增加与氧提取增加和组织饱和度降低有关。本研究引入了一种新方法,频域近红外光谱和漫反射相关光谱(FD-NIRS 和 DCS),用于非侵入性连续监测呼吸肌血流和耗氧量代谢率。与涉及侵入性染料注射和磁共振成像的先前方法不同,FD-NIRS 和 DCS 具有无需侵入性程序即可进行连续测量的优势。它有望推进肌肉生理学的理解,并为呼吸肌的实时监测开辟道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36c0/11424177/43369a42402e/jappl-00871-2023r01.jpg

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