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Influence of exertional hypoxemia on cerebral oxygenation in fibrotic interstitial lung disease
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2020-12-15 , DOI: 10.1016/j.resp.2020.103601
Mathieu Marillier 1 , Anne-Catherine Bernard 1 , Samuel Verges 2 , Onofre Moran-Mendoza 3 , Denis E O'Donnell 3 , J Alberto Neder 3
Affiliation  

It is unknown whether hypoxemia, a hallmark of fibrotic interstitial lung disease (f-ILD), may impair cerebral oxygenation during exercise in these patients.

Twenty-seven patients [23 males, 72 ± 8 years, lung diffusing capacity for carbon monoxide (DLCO) = 44 ± 11 % predicted] and 12 controls performed an incremental bicycle test. Prefrontal oxygenation [tissue saturation index (TSI)] was assessed by near-infrared spectroscopy.

Patients showed lower arterial O2 saturation (SpO2) and larger fall in cerebral TSI during exercise vs controls (p < 0.05). However, changes (Δ) from rest to peak-exercise in SpO2 (-2.2 % to -26.9 %) and TSI (1.4 % to -16.6 %) varied substantially among patients. In the 16 patients showing significant cerebral deoxygenation (Δ TSI ≥ 4% based on controls), SpO2 decreased more (-12.6 ± 6.7 % vs -5.7 ± 2.8 %, p = 0.001) and peak O2 uptake was lower (68.3 ± 19.2 % vs 87.8 ± 24.8 % predicted, p = 0.03) vs their 11 counterparts. In association with DLCO and forced vital capacity, Δ cerebral TSI independently predicted peak O2 uptake on multivariable regression analysis (R2 = 0.54).

Exertional hypoxemia impairs cerebral oxygenation in a dose-dependent fashion in f-ILD. Future studies are warranted to investigate whether this potentially reversible abnormality play a contributory role in limiting exercise tolerance in these patients.



中文翻译:

劳力性低氧血症对纤维化间质性肺病脑氧合的影响

尚不清楚低氧血症(纤维化间质性肺病 ( f- ILD)的标志)是否会损害这些患者在运动过程中的脑氧合。

27 名患者 [23 名男性,72 ± 8 岁,肺一氧化碳扩散能力 (DL CO ) = 44 ± 11 % 预测值] 和 12 名对照者进行了增量自行车测试。前额氧合 [组织饱和度指数 (TSI)] 通过近红外光谱法进行评估。

对照组相比,患者在运动期间显示出较低的动脉 O 2饱和度 (SpO 2 ) 和更大的脑 TSI 下降( p  < 0.05)。然而,SpO 2(-2.2 % 至 -26.9 %)和 TSI(1.4 % 至 -16.6 %)从休息到峰值运动的变化 (Δ) 因患者而异。在表现出显着脑缺氧(Δ TSI ≥ 4%,基于对照)的 16 名患者中,SpO 2降低更多(-12.6 ± 6.7 % vs -5.7 ± 2.8 %,p  = 0.001)并且峰值 O 2摄取较低(68.3 ± 19.2 % vs 87.8 ± 24.8 % 预测,p  = 0.03) vs他们的 11 个同行。与 DL CO和用力肺活量相关,Δ 大脑 TSI 独立预测了多变量回归分析中的峰值 O 2吸收(R 2  = 0.54)。

f - ILD 中,劳力性低氧血症以剂量依赖性方式损害脑氧合。未来的研究有必要调查这种潜在的可逆异常是否在限制这些患者的运动耐力方面发挥了促进作用。

更新日期:2020-12-24
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