Impact of hyperoxia on cardiac pathophysiology

Rodgers, Jennifer L.; Iyer, Drishya; Rodgers, Lydia E.; Vanthenapalli, Sahit; Panguluri, Siva K.

doi:10.1002/jcp.28136

Cited by 14 publications

(10 citation statements)

References 97 publications

(232 reference statements)

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“…Pulmonary fibrosis, retinopathic conditions, and renal, cardiac, and hepatic damage are some of the changes seen after longer periods of hyperoxia, even during normobaric conditions. 48,[50][51][52] Hyperoxia can give rise to vasoconstriction with increased workload on the part of the heart. Due to the risk of complications, the use of oxygen in medical emergencies and intensive care should be carefully titrated.…”

Section: Oxygen Toxicitymentioning

confidence: 99%

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Oscarsson

Müller

Rosén

et al. 2019

The Lancet Oncology

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Introduction Cancer is affecting a growing number of persons. Still, the treatment and survival of cancer is improving. Radiation therapy is used in the treatment of cancer. Late radiation-induced injuries afflict 5-15% of irradiated patients. The urinary bladder and bowel may be affected after irradiation of cancer in the pelvic region. Symptoms can be severe, with impaired health related quality of life (HRQoL). Hyperbaric oxygen therapy (HBOT) involves breathing oxygen at high ambient pressure. HBOT can reverse radiation-induced injuries, alleviate patient-perceived symptoms, and improve HRQoL. We aimed to clarify the effects of HBOT on late radiation-induced injuries in the urinary bladder and bowel, and to clarify some of the underlying mechanisms through which HBOT exerts its effects. Methods A prospective cohort study assessed effects of HBOT on patient-perceived symptoms (Paper I). A rat study assessed reversal of radiation-induced stress with HBOT (Paper II). A methodological experiment assessed reversal of HBOT on cellular death induced by radiation (Paper III). A multi-center, randomized, controlled trial assessed patient-perceived symptoms, HRQoL, and objective clinical outcomes (Paper IV). Result HBOT can alleviate patient-perceived symptoms, reduce objective findings, and improve HRQoL in patients affected by late radiation-induced injuries (Paper I, IV). Oxidative stress and downstream effects, induced by the irradiation, can be reversed by HBOT (Paper II). Paper III outlines a method for studies on urothelial cells exposed to radiation and HBOT. Conclusion HBOT can reduce radiation-induced oxidative stress and inflammatory response. HBOT can reverse injuries induced by radiation therapy to the pelvic region, alleviate patient-perceived symptoms and lead to improved HRQoL.

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Section: Oxygen Toxicitymentioning

confidence: 99%

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Oscarsson

Müller

Rosén

et al. 2019

The Lancet Oncology

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“…Ventilation with high levels of supplemental oxygen presents another potential risk for elderly patients. Supplemental oxygen is frequently implemented for the treatment of hypoxia, in order to improve arterial oxygen levels in critically ill patients [39]. However, high oxygen exposure (hyperoxia) has been also been shown to induce oxidative stress due to increased production of ROS, which results in significant lung injury [40,41,42].…”

Section: The Prevalence Of Aging Adults Admitted To Critical Carementioning

confidence: 99%

Cardiovascular Risks Associated with Gender and Aging

Rodgers

Jones

Bolleddu

et al. 2019

JCDD

Self Cite

581

370

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The aging and elderly population are particularly susceptible to cardiovascular disease. Age is an independent risk factor for cardiovascular disease (CVD) in adults, but these risks are compounded by additional factors, including frailty, obesity, and diabetes. These factors are known to complicate and enhance cardiac risk factors that are associated with the onset of advanced age. Sex is another potential risk factor in aging adults, given that older females are reported to be at a greater risk for CVD than age-matched men. However, in both men and women, the risks associated with CVD increase with age, and these correspond to an overall decline in sex hormones, primarily of estrogen and testosterone. Despite this, hormone replacement therapies are largely shown to not improve outcomes in older patients and may also increase the risks of cardiac events in older adults. This review discusses current findings regarding the impacts of age and gender on heart disease.

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“…Thus, optimal oxygen targets are required to minimize and balance the competing risks of hypoxaemia and hyperoxaemia in APE patients. From a physiological standpoint, it is necessary to avoid hypoxaemia to maintain su cient oxygen delivery to important tissues, while avoiding hyperoxaemia is also necessary to avoid the formation and toxic effects of reactive oxygen species (ROS) [5,41]. Since our study included all APE patients, the results were applicable to APE patients with or without oxygen therapy.…”

Section: Discussionmentioning

confidence: 99%

Admission Oxygen Saturation and Mortality in Acute Pulmonary Embolism Patients: Observational Data From Large ICU Databases

Peng

Shen

et al. 2021

Preprint

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Background The relationship between blood oxygenation and clinical outcomes of acute pulmonary embolism (APE) patients in intensive care unit (ICU) is unclear, which could be nonlinear. The study aimed to determine the association between admission pulse oximetry-derived oxygen saturation (SpO2) levels and mortality, and to determine the optimal range with real-world data. Methods Patients diagnosed with APE on admission and staying in ICU for at least 24 hours in the Medical Information Mart for Intensive Care III (MIMIC-III) database and the eICU Collaborative Research Database (eICU-CRD) were included. Logistic regression and restricted cubic spline (RCS) models were applied to determine the nonlinear relationship between mean SpO2 levels within the first 24 hours after ICU admission and in-hospital mortality, from which we derived an optimal range of SpO2. Subgroup analyses were based on demographics, treatment information, scoring system and comorbidities. Results We included 1109 patients who fulfilled inclusion criteria, among whom 129 (12%) died during hospitalization and 80 (7.2%) died in ICU. The RCS showed that the relationship between admission SpO2 levels and in-hospital mortality of APE patients was nonlinear and U-shaped. The optimal range of SpO2 with the lowest mortality was 95–98%. Multivariate stepwise logistic regression analysis with backward elimination confirmed that the admission SpO2 levels of 95%-98% was associated with decreased hospital mortality compared to the group with SpO2 < 95% (Odds ratio [OR] = 2.321; 95% confidence interval [CI]: 1.405–3.786; P < 0.001) and 100% (OR = 2.853; 95% CI: 1.294–5.936; P = 0.007), but there was no significant difference compared with 99% SpO2 (OR = 0.670, 95% CI: 0.326–1.287; P > 0.05). This association was consistent across subgroup analyses. Conclusions The relationship between admission SpO2 levels and in-hospital mortality followed a U-shaped curve among patients with APE. The optimal range of SpO2 for APE patients was 95–98%.

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Impact of hyperoxia on cardiac pathophysiology

Cited by 14 publications

References 97 publications

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2–3 trial

Cardiovascular Risks Associated with Gender and Aging

Admission Oxygen Saturation and Mortality in Acute Pulmonary Embolism Patients: Observational Data From Large ICU Databases

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