在医院环境中实施 5 天常压低氧呼吸的可行性。
Feasibility of Delivering 5-Day Normobaric Hypoxia Breathing in a Hospital Setting.
机构信息
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts.
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
出版信息
Respir Care. 2024 Oct 25;69(11):1400-1408. doi: 10.4187/respcare.11928.
BACKGROUND
Beneficial effects of breathing at [Formula: see text] < 0.21 on disease outcomes have been reported in previous preclinical and clinical studies. However, the safety and intra-hospital feasibility of breathing hypoxic gas for 5 d have not been established. In this study, we examined the physiologic effects of breathing a gas mixture with [Formula: see text] as low as 0.11 in 5 healthy volunteers.
METHODS
All 5 subjects completed the study, spending 5 consecutive days in a hypoxic tent, where the ambient oxygen level was lowered in a stepwise manner over 5 d, from [Formula: see text] of 0.16 on the first day to [Formula: see text] of 0.11 on the fifth day of the study. All the subjects returned to an environment at room air on the sixth day. The subjects' [Formula: see text], heart rate, and breathing frequency were continuously recorded, along with daily blood sampling, neurologic evaluations, transthoracic echocardiography, and mental status assessments.
RESULTS
Breathing hypoxia concentration dependently caused profound physiologic changes, including decreased [Formula: see text] and increased heart rate. At [Formula: see text] of 0.14, the mean [Formula: see text] was 92%; at [Formula: see text] of 0.13, the mean [Formula: see text] was 93%; at [Formula: see text] of 0.12, the mean [Formula: see text] was 88%; at [Formula: see text] of 0.11, the mean [Formula: see text] was 85%; and, finally, at an [Formula: see text] of 0.21, the mean [Formula: see text] was 98%. These changes were accompanied by increased erythropoietin levels and reticulocyte counts in blood. All 5 subjects concluded the study with no adverse events. No subjects exhibited signs of mental status changes or pulmonary hypertension.
CONCLUSIONS
Results of the current physiologic study suggests that, within a hospital setting, delivering [Formula: see text] as low as 0.11 is feasible and safe in healthy subjects, and provides the foundation for future studies in which therapeutic effects of hypoxia breathing are tested.
背景
先前的临床前和临床研究报告表明，在[公式：见文本] < 0.21 下呼吸有益健康，可以改善疾病预后。然而，连续 5 天吸入低氧气体的安全性和院内可行性尚未得到证实。在这项研究中，我们检查了 5 名健康志愿者连续 5 天在低氧帐篷中呼吸[公式：见文本]低至 0.11 的混合气体的生理效应。
方法
所有 5 名受试者均完成了这项研究，在低氧帐篷中连续 5 天，在 5 天内逐步降低环境中的氧气水平，第 1 天的[公式：见文本]为 0.16，第 5 天的[公式：见文本]为 0.11。所有受试者在第 6 天返回室内空气环境。连续记录受试者的[公式：见文本]、心率和呼吸频率，每日采血、神经评估、经胸超声心动图和精神状态评估。
结果
呼吸低氧浓度依赖性地引起了显著的生理变化，包括[公式：见文本]降低和心率增加。在[公式：见文本]为 0.14 时，平均[公式：见文本]为 92%；在[公式：见文本]为 0.13 时，平均[公式：见文本]为 93%；在[公式：见文本]为 0.12 时，平均[公式：见文本]为 88%；在[公式：见文本]为 0.11 时，平均[公式：见文本]为 85%；最后，在[公式：见文本]为 0.21 时，平均[公式：见文本]为 98%。这些变化伴随着血液中促红细胞生成素水平和网织红细胞计数的增加。所有 5 名受试者均完成了研究，无不良事件发生。所有受试者均未出现精神状态改变或肺动脉高压的迹象。
结论
当前生理研究的结果表明，在医院环境中，在健康受试者中提供[公式：见文本]低至 0.11 是可行且安全的，并为进一步研究低氧呼吸的治疗效果提供了基础。
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