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临床环境中通过穿墙采血法将睡眠干扰降至最低。

Through-the-Wall Blood Sampling Method to Minimize Sleep Disruption in Clinical Settings.

作者信息

Simé Mora Grissy, Lowry Catherine G, Lyon Ellen J, Biela Laurie M, Thompson David P, Hickey Matthew S, Rynders Corey A, Broussard Josiane L

机构信息

Human Performance Clinical Research Laboratory, Department of Health and Exercise Science, Colorado State University.

Human Performance Clinical Research Laboratory, Department of Health and Exercise Science, Colorado State University; Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus.

出版信息

J Vis Exp. 2025 Jun 13(220). doi: 10.3791/67530.

Abstract

Physiological rhythms, including diurnal and circadian rhythms, play a critical role in health, with disturbances increasingly linked to cardiovascular disease and type 2 diabetes. These rhythms are closely tied to sleep-wake cycles, as changes in sleep timing or duration can alter diurnal and circadian rhythms, thereby disrupting physiological homeostasis. Additional factors, such as the timing of behaviors like food intake and/or physical activity, may modulate 24-h rhythms in manners that support health or promote chronic disease risk. Despite the growing recognition of the importance of biological rhythms, obtaining serial blood samples required to elucidate patterns in circulating factors remains a significant challenge in clinical research. Routine blood draw methods can be disruptive to sleep, potentially altering sleep and biological rhythms and subsequently influencing variables of interest. This underscores the need for minimally invasive approaches that allow for the assessment of 24-h biological processes without disturbing sleep or biological rhythms. To address these challenges, many clinical and research groups employ a technique known as a "through-the-wall" blood sampling method. This approach uses extended tubing connected to an indwelling catheter, threaded through a wall or partition to a location outside the participant's room. By enabling blood collection without having to enter the room, this method minimizes disruptions, thereby preserving the integrity of the 24-h profiles of circulating variables of interest and minimally disturbing sleep. Here, we provide a detailed description of the through-the-wall blood sampling method and demonstrate its feasibility and efficacy in collecting blood samples during scheduled sleep opportunities. Representative data from a clinical study are presented, and additional considerations, including the impact of a difficult blood draw on sleep architecture, are discussed.

摘要

生理节律,包括昼夜节律和生物钟节律,对健康起着至关重要的作用,节律紊乱与心血管疾病和2型糖尿病的关联日益增加。这些节律与睡眠-觉醒周期密切相关,因为睡眠时间或时长的变化会改变昼夜节律和生物钟节律,从而破坏生理稳态。其他因素,如进食和/或体育活动等行为的时间安排,可能以支持健康或增加慢性病风险的方式调节24小时节律。尽管人们越来越认识到生物节律的重要性,但在临床研究中,获取用于阐明循环因子模式所需的系列血样仍然是一项重大挑战。常规采血方法可能会干扰睡眠,潜在地改变睡眠和生物节律,进而影响感兴趣的变量。这凸显了对微创方法的需求,这种方法能够在不干扰睡眠或生物节律的情况下评估24小时生物过程。为应对这些挑战,许多临床和研究团队采用了一种称为“穿墙式”采血法的技术。这种方法使用连接到留置导管的延长管,将其穿过墙壁或隔板到达参与者房间外的一个位置。通过无需进入房间即可进行采血,这种方法将干扰降至最低,从而保持了感兴趣的循环变量24小时曲线的完整性,并将对睡眠的干扰降至最低。在此,我们详细描述了穿墙式采血法,并展示了其在预定睡眠期间采集血样的可行性和有效性。展示了一项临床研究的代表性数据,并讨论了其他注意事项,包括采血困难对睡眠结构的影响。

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