Role of hypoxemia for the cardiovascular responses to apnea during exercise

2002 ◽  
Vol 283 (5) ◽  
pp. R1227-R1235 ◽  
Author(s):  
Peter Lindholm ◽  
Jessica Nordh ◽  
Dag Linnarsson

We sought to define the role of hypoxemia in eliciting the cardiovascular responses to apnea during exercise. Eleven men performed repeated apneas during 100-W steady-state exercise, either with normoxic gas (air) or 95% oxygen (oxygen). Beat-by-beat arterial blood pressure, arterial oxygen saturation, and heart rate (HR) were determined, and stroke volume (SV) was estimated from impedance cardiography calibrated with soluble gas rebreathing. There were large interindividual variabilities of HR, mean arterial pressure (MAP), and total peripheral resistance (TPR) at end-apnea (ea). However, for each individual, HRea, MAPea, and TPRea were highly correlated between air and oxygen ( R = 0.94, 0.78, and 0.93). HR decreased and MAP increased faster during apnea with air than with oxygen (ANOVA, P < 0.05), but MAPea was not different between conditions. Cardiac output was reduced by 33% with air and by 11% with oxygen ( P < 0.001 for air vs. oxygen). We conclude that the hypoxemia component cannot account for the wide interindividual differences of HR and TPR responses to apnea. However, hypoxemia augments the HR and TPR responses and may limit the MAP response to apnea by preventing a bradycardia-associated increase of SV.

1963 ◽  
Vol 204 (5) ◽  
pp. 895-898 ◽  
Author(s):  
James W. West ◽  
Elwood L. Foltz

In renal hypertension, protoveratrine decreased coronary blood flow, cardiac oxygen consumption, arterial and venous oxygen saturation, coronary arteriovenous oxygen difference, mean arterial blood pressure, cardiac output, cardiac work, cardiac efficiency, cardiac rate, total peripheral resistance, coronary resistance, respiratory rate, and minute volume. The decrease was significant in all functions except coronary blood flow, coronary venous oxygen saturation, and cardiac output. The results of these experiments indicate that in the renal hypertensive animal, a therapeutically beneficial effect was derived from protoveratrine on the circulation by its ability to decrease the work of the heart (lowering the elevated mean arterial pressure) and the coronary vascular resistance while maintaining coronary blood flow and cardiac output within normal levels. The less advantageous effect of protoveratrine on circulation resulted from its respiratory inhibiting effect which reduced the arterial blood oxygen saturation. Although a small decline in coronary venous oxygen saturation was noted, the coronary flow and oxygen delivery in face of the reduced arterial oxygen saturation was apparently adequate to maintain a normal cardiac activity.


1992 ◽  
Vol 262 (1) ◽  
pp. R25-R32 ◽  
Author(s):  
R. D. Russ ◽  
B. L. Brizzee ◽  
B. R. Walker

Experiments were performed in conscious chronically instrumented rats to determine the role of arginine vasopressin (AVP) in the cardiovascular adjustments to acute and chronic increases in plasma osmolality. Animals were implanted with pulsed Doppler flow probes and arterial and venous catheters for the determination of cardiac output, mean arterial blood pressure (MABP), and heart rate and for the calculation of total peripheral resistance and baroreflex sensitivity (BRS). Before and after raising plasma osmolality by either 48-h water deprivation or acute hypertonic saline infusion, specific V1- or V2-vasopressinergic receptor antagonists or vehicle were administered to the animals, and the cardiovascular responses were noted. MABP was significantly elevated in water-deprived animals. These animals also exhibited significantly increased BRS, which was further increased by administration of the V1-receptor antagonist. Animals subjected to acute hypertonic saline infusion also demonstrated increased MABP, although the infusion, unlike water deprivation, did not affect BRS. We observed no significant effects on any other variable measured. We conclude that AVP plays a relatively minor role in the cardiovascular adjustments to acute and chronic hyperosmolality.


1999 ◽  
Vol 276 (2) ◽  
pp. R340-R346 ◽  
Author(s):  
P. Stein ◽  
S. E. White ◽  
J. Homan ◽  
M. A. Hanson ◽  
A. D. Bocking

This study examines the role of the peripheral chemoreceptors in mediating fetal cardiovascular responses to prolonged hypoxia secondary to reduced uterine blood flow (RUBF). Fetal sheep were chronically instrumented for continuous heart rate (FHR), blood pressure (FBP), and carotid blood flow (CBF) measurements after bilateral sectioning of the carotid sinus and vagus nerves (denervated, n = 7) or sham denervation (intact, n = 7). Four days postoperatively, uterine blood flow was mechanically restricted, reducing fetal arterial oxygen saturation by 47.3% ( P < 0.01). An initial bradycardia was observed in intact (184.0 ± 10.7 to 160.5 ± 10.7 beats/min, not significant) but not denervated fetuses, followed by a tachycardia (180.0 ± 2.2 to 193.7 ± 2.7 beats/min, P < 0.05). FHR increased in denervated fetuses (175.5 ± 8.7 to 203.0 ± 17.9 beats/min, P < 0.05). FBP increased transiently in intact fetuses from 45.1 ± 1.0 to 55.4 ± 3.0 mmHg at 2 h ( P < 0.01), whereas denervated fetuses demonstrated a decrease in FBP from 47.1 ± 4.2 to 37.2 ± 3.7 mmHg (not significant). CBF increased ( P < 0.05) in both intact and denervated fetuses from 39.3 ± 2.8 and 29.7 ± 3.8 ml ⋅ min−1 ⋅ kg−1to 47.7 ± 0.4 and 39.1 ± 0.3 ml ⋅ min−1 ⋅ kg−1, respectively, whereas carotid vascular resistance decreased only in denervated fetuses (1.7 ± 0.1 to 1.1 ± 0.02 mmHg ⋅ ml−1 ⋅ min ⋅ kg−1, P < 0.05). We conclude that the peripheral chemoreceptors play an important role in mediating fetal cardiovascular responses to prolonged RUBF.


1989 ◽  
Vol 17 (1) ◽  
pp. 44-48 ◽  
Author(s):  
S. R. Finfer ◽  
S. I. P. MacKenzie ◽  
J. M. Saddler ◽  
T. G. L. Watkins

The cardiovascular responses to tracheal intubation using a fibreoptic bronchoscope or Macintosh laryngoscope were compared in twenty in-patients and twenty day-stay patients. Within these groups patients were randomly allocated to direct laryngoscopic or fibreoptic bronchoscopic intubation. Arterial blood pressure, heart rate and arterial oxygen saturation were recorded before induction and at one-minute intervals until four minutes after intubation. In both groups both laryngoscopic and bronchoscopic intubation resulted in a significant rise in blood pressure and heart rate. At no stage was there a significant difference in mean blood pressure in either group, or in heart rate in the day-stay patients, between the different methods of intubation. In the in-patients mean heart rate was significantly higher in those patients intubated with the bronchoscope at three and four minutes after intubation. Time taken for intubation was significantly longer in those patients intubated with the bronchoscope. In no patient did the arterial oxygen saturation fall below 98%.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinshu Katayama ◽  
Jun Shima ◽  
Ken Tonai ◽  
Kansuke Koyama ◽  
Shin Nunomiya

AbstractRecently, maintaining a certain oxygen saturation measured by pulse oximetry (SpO2) range in mechanically ventilated patients was recommended; attaching the INTELLiVENT-ASV to ventilators might be beneficial. We evaluated the SpO2 measurement accuracy of a Nihon Kohden and a Masimo monitor compared to actual arterial oxygen saturation (SaO2). SpO2 was simultaneously measured by a Nihon Kohden and Masimo monitor in patients consecutively admitted to a general intensive care unit and mechanically ventilated. Bland–Altman plots were used to compare measured SpO2 with actual SaO2. One hundred mechanically ventilated patients and 1497 arterial blood gas results were reviewed. Mean SaO2 values, Nihon Kohden SpO2 measurements, and Masimo SpO2 measurements were 95.7%, 96.4%, and 96.9%, respectively. The Nihon Kohden SpO2 measurements were less biased than Masimo measurements; their precision was not significantly different. Nihon Kohden and Masimo SpO2 measurements were not significantly different in the “SaO2 < 94%” group (P = 0.083). In the “94% ≤ SaO2 < 98%” and “SaO2 ≥ 98%” groups, there were significant differences between the Nihon Kohden and Masimo SpO2 measurements (P < 0.0001; P = 0.006; respectively). Therefore, when using automatically controlling oxygenation with INTELLiVENT-ASV in mechanically ventilated patients, the Nihon Kohden SpO2 sensor is preferable.Trial registration UMIN000027671. Registered 7 June 2017.


1944 ◽  
Vol 79 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Frank L. Engel ◽  
Helen C. Harrison ◽  
C. N. H. Long

1. In a series of rats subjected to hemorrhage and shock a high negative correlation was found between the portal and peripheral venous oxygen saturations and the arterial blood pressure on the one hand, and the blood amino nitrogen levels on the other, and a high positive correlation between the portal and the peripheral oxygen saturations and between each of these and the blood pressure. 2. In five cats subjected to hemorrhage and shock the rise in plasma amino nitrogen and the fall in peripheral and portal venous oxygen saturations were confirmed. Further it was shown that the hepatic vein oxygen saturation falls early in shock while the arterial oxygen saturation showed no alteration except terminally, when it may fall also. 3. Ligation of the hepatic artery in rats did not affect the liver's ability to deaminate amino acids. Hemorrhage in a series of hepatic artery ligated rats did not produce any greater rise in the blood amino nitrogen than a similar hemorrhage in normal rats. The hepatic artery probably cannot compensate to any degree for the decrease in portal blood flow in shock. 4. An operation was devised whereby the viscera and portal circulation of the rat were eliminated and the liver maintained only on its arterial circulation. The ability of such a liver to metabolize amino acids was found to be less than either the normal or the hepatic artery ligated liver and to have very little reserve. 5. On complete occlusion of the circulation to the rat liver this organ was found to resist anoxia up to 45 minutes. With further anoxia irreversible damage to this organ's ability to handle amino acids occurred. 6. It is concluded that the blood amino nitrogen rise during shock results from an increased breakdown of protein in the peripheral tissues, the products of which accumulate either because they do not circulate through the liver at a sufficiently rapid rate or because with continued anoxia intrinsic damage may occur to the hepatic parenchyma so that it cannot dispose of amino acids.


PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 524-528
Author(s):  
Michael S. Jennis ◽  
Joyce L. Peabody

Continuous monitoring of oxygenation in sick newborns is vitally important. However, transcutaneous Po2 measurements have a number of limiations. Therefore, we report the use of the pulse oximeter for arterial oxygen saturation (Sao2) determination in 26 infants (birth weights 725 to 4,000 g, gestational ages 24 to 40 weeks, and postnatal ages one to 49 days). Fetal hemoglobin determinations were made on all infants and were repeated following transfusion. Sao2, readings from the pulse oximeter were compared with the Sao2 measured in vitro on simultaneously obtained arterial blood samples. The linear regression equation for 177 paired measurements was: y = 0.7x + 27.2; r = .9. However, the differences between measured Sao2 and the pulse oximeter Sao2 were significantly greater in samples with &gt; 50% fetal hemoglobin when compared with samples with &lt; 25% fetal hemoglobin (P &lt; .001). The pulse oximeter was easy to use, recorded trends in oxygenation instantaneously, and was not associated with skin injury. We conclude that pulse oximetry is a reliable technique for the continuous, noninvasive monitoring of oxygenation in newborn infants.


2011 ◽  
Vol 110 (3) ◽  
pp. 670-680 ◽  
Author(s):  
Nan Liang ◽  
Tomoko Nakamoto ◽  
Seina Mochizuki ◽  
Kanji Matsukawa

To examine whether central command contributes differently to the cardiovascular responses during voluntary static exercise engaged by different muscle groups, we encouraged healthy subjects to perform voluntary and electrically evoked involuntary static exercise of ankle dorsal and plantar flexion. Each exercise was conducted with 25% of the maximum voluntary force of the right ankle dorsal and plantar flexion, respectively, for 2 min. Heart rate (HR) and mean arterial blood pressure (MAP) were recorded, and stroke volume, cardiac output (CO), and total peripheral resistance were calculated. With voluntary exercise, HR, MAP, and CO significantly increased during dorsal flexion (the maximum increase, HR: 12 ± 2.3 beats/min; MAP: 14 ± 2.0 mmHg; CO: 1 ± 0.2 l/min), whereas only MAP increased during plantar flexion (the maximum increase, 6 ± 2.0 mmHg). Stroke volume and total peripheral resistance were unchanged throughout the two kinds of voluntary static exercise. With involuntary exercise, there were no significant changes in all cardiovascular variables, irrespective of dorsal or plantar flexion. Furthermore, before the force onset of voluntary static exercise, HR and MAP started to increase without muscle contraction, whereas they had no significant changes with involuntary exercise at the moment. The present findings indicate that differential contribution of central command is responsible for the different cardiovascular responses to static exercise, depending on the strength of central control of the contracting muscle.


1964 ◽  
Vol 19 (2) ◽  
pp. 284-286 ◽  
Author(s):  
Loring B. Rowell ◽  
Henry L. Taylor ◽  
Yang Wang ◽  
Walter S. Carlson

The per cent saturation of the arterial blood with oxygen was examined in four men before and during the last 15 sec of a 3-min run of sufficient intensity to elicit a maximal oxygen intake. The measurements were repeated after a 3-month period of intensive conditioning for middle distance running and in a group of four athletes in good physical condition. The per cent saturation in the sedentary group was 95.8 at rest and 93.4 during exhausting exercise; after conditioning the similar figures were 95.4 and 91.4 and, finally, the athletes showed a per cent saturation of 85.2 during the heavy work. The arterial oxygen content during exhausting work was found to be 20.12 ml/100 ml blood in the sedentary group before training, 19.02 after conditioning, and 18.18 in the group of athletes. It is concluded that, in athletes who are well conditioned and pushing themselves close to the limit of their capacity, arterial desaturation can take place. athletic conditioning and arterial oxygen saturation; arterial desaturation in athletes; ventilation and arterial desaturation; oxygen intake and arterial oxygen saturation Submitted on August 5, 1963


2019 ◽  
pp. S97-S103
Author(s):  
A. KURZOVÁ ◽  
J. MÁLEK ◽  
L. HESS ◽  
M. JAČEK ◽  
J. SLÍVA

Remifentanil is ultrashort-acting opioid with a unique pharmacokinetic profile. It is used exclusively intravenously. While considering its rapid onset of action and other pharmacokinetic properties, we decided to assess its effects following administration via non-traditional routes. Rabbits (n=10 per each group) were randomized into six groups: remifentanil 1 μg/kg and 3 μg/kg IM, 5.0 and 10.0 μg/kg conjunctivally, and 10 μg/kg and 25.0 μg/kg intranasally. Sedating effects were assessed via a loss of the righting reflex. Secondary, mean arterial blood pressure, arterial oxygen saturation of hemoglobin, and pulse rate was monitored in all rabbits. Non-traditional routes of administration were shown to provide a rapid onset of action as well as fast recovery. Importantly, the administration of remifentanil did not result in any deterioration of cardiovascular functions.


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