Sublingual microvascular perfusion is altered during normobaric and hyperbaric hyperoxia

Milstein, Dan M.J.; Helmers, Renée; Hackmann, Sanne; Belterman, Charly; Hulst, Rob A. van; Lange, Jan de

doi:10.1016/j.mvr.2016.02.001

Cited by 29 publications

(22 citation statements)

References 39 publications

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“…The hypothesis that oxygen exposure influences the adaptation of the microcirculation is supported in four ways: First, studies found a higher VEGF concentration in newborns suffering from intrauterine growth restriction, a condition where the fetus is exposed to a greater hypoxic condition [27,36]. Second, and consistent with our results, when exposed to normo-and hyperbaric hyperoxia (FiO 2 Á100%), vessel density decreased in healthy volunteers and in a recent animal study [7,21]. Furthermore, subgroup analysis in SGA newborns in our own study showed significantly higher TVD values directly after birth.…”

Section: Discussionsupporting

confidence: 90%

Adaptation of the Cutaneous Microcirculation in Preterm Neonates

et al. 2016

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Section: Discussionsupporting

confidence: 90%

Adaptation of the Cutaneous Microcirculation in Preterm Neonates

et al. 2016

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“…Following changes in environment, increased shear stress during blood shifts, NO synthesis can be stimulated to provide a mechanism for the local regulation of vascular tone and blood flow [41, 42]. Observation showing the absence of microvascular vasoconstriction during hyperbaric hyperoxic conditions also supports our interpretation [43]. …”

Section: Discussionsupporting

confidence: 75%

Acute Biochemical, Cardiovascular, and Autonomic Response to Hyperbaric (4 atm) Exposure in Healthy Subjects

Kozakiewicz

Słomko

Buszko

et al. 2018

Evidence-Based Complementary and Alternative Medicine

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The aim of this study was to explore the effect of a hyperbaric environment alone on the cardiovascular system by ensuring elimination of factors that may mask the effect on hyperbaria. The research was performed in a hyperbaric chamber to eliminate the effect of physical activity and the temperature of the aquatic environment. Biochemical analysis and examination with the Task Force Monitor device were performed before and immediately after exposure. TFM was used for noninvasive examination of the cardiovascular system and the functional evaluation of the autonomic nervous system. Natriuretic peptides were measured as biochemical markers which were involved in the regulation of haemodynamic circulation vasoconstriction (urotensin II). L-arginine acted as a precursor of the level of the nitric oxide whereas angiotensin II and angiotensin (1–7) were involved in cardiac remodeling. The study group is comprised of 18 volunteers who were professional divers of similar age and experience. The results shown in our biochemical studies do not exceed reference ranges but a statistically significant increase indicates the hyperbaric environment is not without impact upon the human body. A decrease in HR, an increase in mBP, dBP, and TPR, and increase in parasympathetic heart nerves activity suggest an increase in heart afterload with a decrease in heart activity within almost one hour after hyperbaric exposure. Results confirm that exposure to a hyperbaric environment has significant impact on the cardiovascular system. This is confirmed both by changes in peptides associated with poorer cardiovascular outcomes, where a significant increase in the studied parameters was observed, and by noninvasive examination.

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“…Our results suggest that the vasoconstrictor response was more pronounced during an acute increase in arterial PaO 2 rather than after a more sustained exposure. Of note, continuous monitoring of the microcirculation in the same region of sublingual mucosa is likely to be more sensitive in detecting even minute variations in vessel density compared to intermittent measurements, as it excludes any variability related to the random selection of different areas, albeit averaged over three samples [31, 32]. …”

Section: Discussionmentioning

confidence: 99%

Effects of short-term hyperoxia on erythropoietin levels and microcirculation in critically Ill patients: a prospective observational pilot study

et al. 2017

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BackgroundThe normobaric oxygen paradox states that a short exposure to normobaric hyperoxia followed by rapid return to normoxia creates a condition of ‘relative hypoxia’ which stimulates erythropoietin (EPO) production. Alterations in glutathione and reactive oxygen species (ROS) may be involved in this process. We tested the effects of short-term hyperoxia on EPO levels and the microcirculation in critically ill patients.MethodsIn this prospective, observational study, 20 hemodynamically stable, mechanically ventilated patients with inspired oxygen concentration (FiO2) ≤0.5 and PaO2/FiO2 ≥ 200 mmHg underwent a 2-hour exposure to hyperoxia (FiO2 1.0). A further 20 patients acted as controls. Serum EPO was measured at baseline, 24 h and 48 h. Serum glutathione (antioxidant) and ROS levels were assessed at baseline (t0), after 2 h of hyperoxia (t1) and 2 h after returning to their baseline FiO2 (t2). The microvascular response to hyperoxia was assessed using sublingual sidestream dark field videomicroscopy and thenar near-infrared spectroscopy with a vascular occlusion test.ResultsEPO increased within 48 h in patients exposed to hyperoxia from 16.1 [7.4–20.2] to 22.9 [14.1–37.2] IU/L (p = 0.022). Serum ROS transiently increased at t1, and glutathione increased at t2. Early reductions in microvascular density and perfusion were seen during hyperoxia (perfused small vessel density: 85% [95% confidence interval 79–90] of baseline). The response after 2 h of hyperoxia exposure was heterogeneous. Microvascular perfusion/density normalized upon returning to baseline FiO2.ConclusionsA two-hour exposure to hyperoxia in critically ill patients was associated with a slight increase in EPO levels within 48 h. Adequately controlled studies are needed to confirm the effect of short-term hyperoxia on erythropoiesis.Trial registrationClinicalTrials.gov (www.clinicaltrials.gov), NCT02481843, registered 15th June 2015, retrospectively registered

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Sublingual microvascular perfusion is altered during normobaric and hyperbaric hyperoxia

Cited by 29 publications

References 39 publications

Adaptation of the Cutaneous Microcirculation in Preterm Neonates

Adaptation of the Cutaneous Microcirculation in Preterm Neonates

Acute Biochemical, Cardiovascular, and Autonomic Response to Hyperbaric (4 atm) Exposure in Healthy Subjects

Effects of short-term hyperoxia on erythropoietin levels and microcirculation in critically Ill patients: a prospective observational pilot study

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