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Cognitive Functions in Scuba, Technical and Saturation Diving. BIOLOGY 2023; 12:biology12020229. [PMID: 36829505 PMCID: PMC9953147 DOI: 10.3390/biology12020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/20/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
Scuba diving as a recreational activity is becoming increasingly popular. However, the safety of this activity, especially in the out-of-comfort zone, has been discussed worldwide. The latest publications bring conclusions regarding negative effects on cognitive functions. We compare the acute and chronic effects of diving on cognitive functioning depending on the type of dive performed, including recreational, technical and saturation diving. However, the results of research show that acute and chronic effects on cognitive functions can be negative. While acute effects are reversible after the ascent, chronic effects include white matter lesions in magnetic resonance imaging scans. We believe that more investigations should be performed to determine the chronic effects that could be observed after a few months of observations in a group of regular, intense divers. In addition, publications referring to technical divers are very limited, which is disquieting, as this particular group of divers seems to be neglected in research concerning the effects of diving on cognitive functions.
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Ryan BJ, Seeley AD, Pitsas DM, Mayer TA, Caldwell AR, Ceaser TG, Luippold AJ, Charkoudian N, Salgado RM. Influence of graded hypercapnia on endurance exercise performance in healthy humans. Am J Physiol Regul Integr Comp Physiol 2022; 323:R638-R647. [PMID: 36094451 PMCID: PMC9602925 DOI: 10.1152/ajpregu.00132.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022]
Abstract
Military and/or emergency services personnel may be required to perform high-intensity physical activity during exposure to elevated inspired carbon dioxide (CO2). Although many of the physiological consequences of hypercapnia are well characterized, the effects of graded increases in inspired CO2 on self-paced endurance performance have not been determined. The aim of this study was to compare the effects of 0%, 2%, and 4% inspired CO2 on 2-mile run performance, as well as physiological and perceptual responses during time trial exercise. Twelve physically active volunteers (peak oxygen uptake = 49 ± 5 mL·kg-1·min-1; 3 women) performed three experimental trials in a randomized, single-blind, crossover manner, breathing 21% oxygen with either 0%, 2%, or 4% CO2. During each trial, participants completed 10 min of walking at ∼40% peak oxygen uptake followed by a self-paced 2-mile treadmill time trial. One participant was unable to complete the 4% CO2 trial due to lightheadedness during the run. Compared with the 0% CO2 trial, run performance was 5 ± 3% and 7 ± 3% slower in the 2% and 4% CO2 trials, respectively (both P < 0.001). Run performance was significantly slower with 4% versus 2% CO2 (P = 0.046). The dose-dependent performance impairments were accompanied by stepwise increases in mean ventilation, despite significant reductions in running speed. Dyspnea and headache were significantly elevated during the 4% CO2 trial compared with both the 0% and 2% trials. Overall, our findings show that graded increases in inspired CO2 impair endurance performance in a stepwise manner in healthy humans.
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Affiliation(s)
- Benjamin J Ryan
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Afton D Seeley
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Dina M Pitsas
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Thomas A Mayer
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Aaron R Caldwell
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Tyrone G Ceaser
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Adam J Luippold
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Roy M Salgado
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
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van der Schrier R, van Velzen M, Roozekrans M, Sarton E, Olofsen E, Niesters M, Smulders C, Dahan A. Carbon dioxide tolerability and toxicity in rat and man: A translational study. FRONTIERS IN TOXICOLOGY 2022; 4:1001709. [PMID: 36310693 PMCID: PMC9606673 DOI: 10.3389/ftox.2022.1001709] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Due the increasing need for storage of carbon dioxide (CO2) more individuals are prone to be exposed to high concentrations of CO2 accidentally released into atmosphere, with deleterious consequences. Methods: We tested the effect of increasing CO2 concentrations in humans (6–12%) and rats (10–50%) at varying inhalation times (10–60 min). In humans, a continuous positive airway pressure helmet was used to deliver the gas mixture to the participants. Unrestrained rats were exposed to CO2 in a transparent chamber. In both species regular arterial blood gas samples were obtained. After the studies, the lungs of the animals were examined for macroscopic and microscopic abnormalities. Results: In humans, CO2 concentrations of 9% inhaled for >10 min, and higher concentrations inhaled for <10 min were poorly or not tolerated due to exhaustion, anxiety, dissociation or acidosis (pH < 7.2), despite intact oxygenation. In rats, concentrations of 30% and higher were associated with CO2 narcosis, epilepsy, poor oxygenation and, at 50% CO2, spontaneous death. Lung hemorrhage and edema were observed in the rats at inhaled concentrations of 30% and higher. Conclusion: This study provides essential insight into the occurrence of physiological changes in humans and fatalities in rats after acute exposure to high levels of CO2. Humans tolerate 9% CO2 and retain their ability to function coherently for up to 10 min. These data support reconsideration of the current CO2 levels (<7.5%) that pose a risk to exposed individuals (<7.5%) as determined by governmental agencies to ≤9%.
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Affiliation(s)
| | - Monique van Velzen
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
| | - Margot Roozekrans
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands,Department of Anesthesiology, Noordwest Ziekenhuisgroep, Alkmaar, Netherlands
| | - Elise Sarton
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
| | - Erik Olofsen
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
| | - Marieke Niesters
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Albert Dahan
- Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands,*Correspondence: Albert Dahan,
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Boillat MA, Hauser PC. CO 2-measuring dongle. HARDWAREX 2022; 12:e00338. [PMID: 35873734 PMCID: PMC9301570 DOI: 10.1016/j.ohx.2022.e00338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/04/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
The compact pocketable CO2-measuring device is built on a small printed circuit board (PCB) with the dimensions of ca. 8.5 × 3 cm. It is plugged into the universal serial bus (USB) port of a personal computer (PC) which serves to provide power and for downloading the measurements. The measurements can be viewed on the computer display where they also can be plotted as a graph to recognize trends. As the level of CO2 rises indoors when people are present and the air is not exchanged adequately the device can be employed as a personal device for monitoring indoor air quality. This is of particular interest when airborne pathogens might be present such as during the COVID-19 pandemic. The device utilizes a novel compact CO2 sensor which has only become available commercially recently, and is based on the photoacoustic measuring principle. A graphical user interface on the PC programmed in Python allows easy interaction with the user. A MSP430FR2433 microcontroller on the board controls the sensor and establishes the communication to the software application on the computer. This was facilitated by the choice of Forth as the programming framework for the microcontroller.
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Alvarez Villela M, Dunworth SA, Kraft BD, Harlan NP, Natoli MJ, Suliman HB, Moon RE. Effects of high-intensity interval training with hyperbaric oxygen. Front Physiol 2022; 13:963799. [PMID: 36060678 PMCID: PMC9437248 DOI: 10.3389/fphys.2022.963799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022] Open
Abstract
Hyperbaric Oxygen (HBO2) has been proposed as a pre-conditioning method to enhance exercise performance. Most prior studies testing this effect have been limited by inadequate methodologies. Its potential efficacy and mechanism of action remain unknown. We hypothesized that HBO2 could enhance aerobic capacity by inducing mitochondrial biogenesis via redox signaling in skeletal muscle. HBO2 was administered in combination with high-intensity interval training (HIIT), a potent redox stimulus known to induce mitochondrial biogenesis. Aerobic capacity was tested during acute hypobaric hypoxia seeking to shift the limiting site of whole body V̇O2 from convection to diffusion, more closely isolating any effect of improved oxidative capacity. Healthy volunteers were screened with sea-level (SL) V̇O2peak testing. Seventeen subjects were enrolled (10 men, 7 women, ages 26.5±1.3 years, BMI 24.6±0.6 kg m−2, V̇O2peak SL = 43.4±2.1). Each completed 6 HIIT sessions over 2 weeks randomized to breathing normobaric air, “HIIT+Air” (PiO2 = 0.21 ATM) or HBO2 (PiO2 = 1.4 ATM) during training, “HIIT+HBO2” group. Training workloads were individualized based on V̇O2peak SL test. Vastus Lateralis (VL) muscle biopsies were performed before and after HIIT in both groups. Baseline and post-training V̇O2peak tests were conducted in a hypobaric chamber at PiO2 = 0.12 ATM. HIIT significantly increased V̇O2peak in both groups: HIIT+HBO2 31.4±1.5 to 35.2±1.2 ml kg−1·min−1 and HIIT+Air 29.0±3.1 to 33.2±2.5 ml kg−1·min−1 (p = 0.005) without an additional effect of HBO2 (p = 0.9 for interaction of HIIT x HBO2). Subjects randomized to HIIT+HBO2 displayed higher skeletal muscle mRNA levels of PPARGC1A, a regulator of mitochondrial biogenesis, and HK2 and SLC2A4, regulators of glucose utilization and storage. All other tested markers of mitochondrial biogenesis showed no additional effect of HBO2 to HIIT. When combined with HIIT, short-term modest HBO2 (1.4 ATA) has does not increase whole-body V̇O2peak during acute hypobaric hypoxia. (ClinicalTrials.gov Identifier: NCT02356900; https://clinicaltrials.gov/ct2/show/NCT02356900).
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Affiliation(s)
- Miguel Alvarez Villela
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
| | - Sophia A. Dunworth
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
| | - Bryan D. Kraft
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Durham, NC, United States
| | - Nicole P. Harlan
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Durham, NC, United States
| | - Michael J. Natoli
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
| | - Hagir B. Suliman
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
| | - Richard E. Moon
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Durham, NC, United States
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Durham, NC, United States
- *Correspondence: Richard E. Moon,
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Vrijdag XCE, van Waart H, Sames C, Mitchell SJ, Sleigh JW. Does hyperbaric oxygen cause narcosis or hyperexcitability? A quantitative EEG analysis. Physiol Rep 2022; 10:e15386. [PMID: 35859332 PMCID: PMC9300958 DOI: 10.14814/phy2.15386] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022] Open
Abstract
Divers breathe higher partial pressures of oxygen at depth than at the surface. The literature and diving community are divided on whether or not oxygen is narcotic. Conversely, hyperbaric oxygen may induce dose‐dependent cerebral hyperexcitability. This study evaluated whether hyperbaric oxygen causes similar narcotic effects to nitrogen, and investigated oxygen's hyperexcitability effect. Twelve human participants breathed “normobaric” air and 100% oxygen, and “hyperbaric” 100% oxygen at 142 and 284 kPa, while psychometric performance, electroencephalography (EEG), and task load perception were measured. EEG was analyzed with functional connectivity and temporal complexity algorithms. The spatial functional connectivity, estimated using mutual information, was summarized with the global efficiency network measure. Temporal complexity was calculated with a “default‐mode‐network (DMN) complexity” algorithm. Hyperbaric oxygen‐breathing caused no change in EEG global efficiency or in the psychometric test. However, oxygen caused a significant reduction of DMN complexity and a reduction in task load perception. Hyperbaric oxygen did not cause the same changes in EEG global efficiency seen with hyperbaric air, which likely related to a narcotic effect of nitrogen. Hyperbaric oxygen seemed to disturb the time evolution of EEG patterns that could be taken as evidence of early oxygen‐induced cortical hyperexcitability. These findings suggest that hyperbaric oxygen is not narcotic and will help inform divers' decisions on suitable gas mixtures.
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Affiliation(s)
- Xavier C E Vrijdag
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Hanna van Waart
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Chris Sames
- Slark Hyperbaric Unit, Waitemata District Health Board, Auckland, New Zealand
| | - Simon J Mitchell
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.,Slark Hyperbaric Unit, Waitemata District Health Board, Auckland, New Zealand.,Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
| | - Jamie W Sleigh
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.,Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand
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Ghitea TC, Aleya L, Tit DM, Behl T, Stoicescu M, Sava C, Iovan C, El-Kharoubi A, Uivarosan D, Pallag A, Bungau S. Influence of diet and sport on the risk of sleep apnea in patients with metabolic syndrome associated with hypothyroidism - a 4-year survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:23158-23168. [PMID: 34802081 DOI: 10.1007/s11356-021-17589-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/13/2021] [Indexed: 06/13/2023]
Abstract
Apnea is a common problem observed among obese individuals, affecting the quality of sleep and increasing cardiovascular risk and mortality. The current study monitored the risk of obstructive sleep apnea (OSA) following diet therapy and sports-associated diet therapy in patients with metabolic syndrome (MS) and hypothyroidism. The subjects included in the study were divided into 3 groups: control group (CG) (n=36), diet therapy group (DG) (including patients following a personalized diet therapy program) (n=76), and diet therapy and sports group (DSG) (which considered patients doing sports in addition to following a personalized diet therapy program) (n=80). The evaluation methods included body analysis (body mass index, fat mass, and visceral fat), paraclinical analysis (homeostasis model assessment of insulin resistance), assessment of difficulty in breathing, stress monitoring, hypothyroidism, and risk of OSA. The OSA index was assessed using the Berlin Questionnaire of Sleep Apnea and Epworth Sleepiness Scale. The correlation between OSA with body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR) index, fat mass, and visceral fat showed a statistically significant positive ratio (p<0.05; F=3.871). The obtained results indicated that diet therapy and physical activity reduced the OSA risk by 78.72%.
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Affiliation(s)
- Timea Claudia Ghitea
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania
| | - Lotfi Aleya
- Laboratoire Chrono-environment, CNRS 6249, Université de Franche-Comté, Besançon, France.
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410073, Oradea, Romania
| | - Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India
| | - Manuela Stoicescu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania
| | - Cristian Sava
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania
| | - Ciprian Iovan
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410068, Oradea, Romania
| | - Amina El-Kharoubi
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073, Oradea, Romania
| | - Diana Uivarosan
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410068, Oradea, Romania
| | - Annamaria Pallag
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410073, Oradea, Romania
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028, Oradea, Romania.
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410073, Oradea, Romania.
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Elbl C, Brunner JX, Schier D, Junge A, Junge H. Protective face masks add significant dead space. Eur Respir J 2021; 58:13993003.01131-2021. [PMID: 33926971 DOI: 10.1183/13993003.01131-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/21/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Christoph Elbl
- Grisons Institute for Patient Safety and Simulation (GRIPS), Cantonal Hospital Graubünden, Chur, Switzerland
| | | | - Dominic Schier
- Grisons Institute for Patient Safety and Simulation (GRIPS), Cantonal Hospital Graubünden, Chur, Switzerland
| | - Adrian Junge
- Grisons Institute for Patient Safety and Simulation (GRIPS), Cantonal Hospital Graubünden, Chur, Switzerland
| | - Helge Junge
- Grisons Institute for Patient Safety and Simulation (GRIPS), Cantonal Hospital Graubünden, Chur, Switzerland
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9
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Vrijdag XC, van Waart H, Sleigh JW, Balestra C, Mitchell SJ. Investigating critical flicker fusion frequency for monitoring gas narcosis in divers. Diving Hyperb Med 2020; 50:377-385. [PMID: 33325019 PMCID: PMC7872789 DOI: 10.28920/dhm50.4.377-385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/28/2020] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Critical flicker fusion frequency (CFFF) has been used in various studies to measure the cognitive effects of gas mixtures at depth, sometimes with conflicting or apparently paradoxical results. This study aimed to evaluate a novel automatic CFFF method and investigate whether CFFF can be used to monitor gas-induced narcosis in divers. METHODS Three hyperbaric chamber experiments were performed: 1) Automated and manual CFFF measurements during air breathing at 608 kPa (n = 16 subjects); 2) Manual CFFF measurements during air and heliox breathing at sea level (101.3 kPa) and 608 kPa (n = 12); 3) Manual CFFF measurements during oxygen breathing at sea level, 142 and 284 kPa (n = 10). All results were compared to breathing air at sea level. RESULTS Only breathing oxygen at sea level, and at 284 kPa, caused a significant decrease in CFFF (2.5% and 2.6% respectively compared to breathing air at sea level. None of the other conditions showed a difference with sea level air breathing. CONCLUSIONS CFFF did not significantly change in our experiments when breathing air at 608 kPa compared to air breathing at sea level pressure using both devices. Based on our results CFFF does not seem to be a sensitive tool for measuring gas narcosis in divers in our laboratory setting.
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Affiliation(s)
- Xavier Ce Vrijdag
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
- Deep Dive Dubai, Dubai, United Arab Emirates
- Corresponding author: Xavier Vrijdag, Department of Anaesthesiology, School of Medicine, University of Auckland, Private bag 92019, Auckland 1142, New Zealand,
| | - Hanna van Waart
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Jamie W Sleigh
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
- Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand
| | - Costantino Balestra
- Environmental, Occupational and Ageing (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium
| | - Simon J Mitchell
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
- Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
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El-Betany AMM, Behiry EM, Gumbleton M, Harding KG. Humidified Warmed CO 2 Treatment Therapy Strategies Can Save Lives With Mitigation and Suppression of SARS-CoV-2 Infection: An Evidence Review. Front Med (Lausanne) 2020; 7:594295. [PMID: 33425942 PMCID: PMC7793941 DOI: 10.3389/fmed.2020.594295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/25/2020] [Indexed: 01/17/2023] Open
Abstract
The coronavirus disease (COVID-19) outbreak has presented enormous challenges for healthcare, societal, and economic systems worldwide. There is an urgent global need for a universal vaccine to cover all SARS-CoV-2 mutant strains to stop the current COVID-19 pandemic and the threat of an inevitable second wave of coronavirus. Carbon dioxide is safe and superior antimicrobial, which suggests it should be effective against coronaviruses and mutants thereof. Depending on the therapeutic regime, CO2 could also ameliorate other COVID-19 symptoms as it has also been reported to have antioxidant, anti-inflammation, anti-cytokine effects, and to stimulate the human immune system. Moreover, CO2 has beneficial effects on respiratory physiology, cardiovascular health, and human nervous systems. This article reviews the rationale of early treatment by inhaling safe doses of warmed humidified CO2 gas, either alone or as a carrier gas to deliver other inhaled drugs may help save lives by suppressing SARS-CoV-2 infections and excessive inflammatory responses. We suggest testing this somewhat counter-intuitive, but low tech and safe intervention for its suitability as a preventive measure and treatment against COVID-19. Overall, development and evaluation of this therapy now may provide a safe and economical tool for use not only during the current pandemic but also for any future outbreaks of respiratory diseases and related conditions.
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Affiliation(s)
- Alaa M. M. El-Betany
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
| | - Enas M. Behiry
- School of Medicine, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
| | - Mark Gumbleton
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
| | - Keith G. Harding
- Wound Healing Research Unit, Welsh Wound Innovation Centre, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Atangana E, Atangana A. Facemasks simple but powerful weapons to protect against COVID-19 spread: Can they have sides effects? RESULTS IN PHYSICS 2020; 19:103425. [PMID: 33014697 PMCID: PMC7525365 DOI: 10.1016/j.rinp.2020.103425] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 05/18/2023]
Abstract
In the last few months, the spread of COVID-19 among humans has caused serious damages around the globe letting many countries economically unstable. Results obtained from conducted research by epidemiologists and virologists showed that, COVID-19 is mainly spread from symptomatic individuals to others who are in close contact via respiratory droplets, mouth and nose, which are the primary mode of transmission. World health organization regulations to help stop the spread of this deadly virus, indicated that, it is compulsory to utilize respiratory protective devices such as facemasks in the public. Indeed, the use of these facemasks around the globe has helped reduce the spread of COVID-19. The primary aim of facemasks, is to avoid inhaling air that could contain droplets with COVID-19. We should note that, respiration process is the movement of oxygen from external atmosphere to the cells within tissue and the transport of carbon dioxide outside. However, the rebreathing of carbon dioxide using a facemask has not been taken into consideration. The hypercapnia (excess inhaled content of CO2) has been recognized to be related to symptoms of fatigue, discomfort, muscular weakness, headaches as well as drowsiness. Rebreathing of CO2 has been a key to concern regarding the use of a facemask. Rebreathing usually occur when an expired air that is rich in CO2 stays long than normal in the breathing space of the respirator after a breath. The increase of the arterial CO2 concentration leads to symptoms that are aforementioned. Studies have been conducted on facemask shortages and on the appropriate facemask required to reduce the spread of COVID-19; however no study has been conducted to assess the possible relationship between CO2 inhalation due to facemask, to determine and recommend which mask is appropriate in the reduction of the spread of the coronavirus while simultaneously avoid CO2 inhalation by the facemask users. In the current paper, we provided a literature review on the use of facemasks with the aim to determine which facemasks could be used to avoid re-inhaling rejected CO2. Additionally, we presented mathematical models depicting the transport of COVID-19 spread through wind with high speed. We considered first mathematical models for which the effect air-heterogeneity is neglected, such that air flow follows Markovian process with a retardation factor, these models considered two different scenarios, the speed of wind is constant and time-space dependent. Secondly, we assumed that the wind movement could follow different processes, including the power law process, fading memory process and a two-stage processes, these lead us to use differential operators with power law, exponential decay and the generalized Mittag-Leffler function with the aim to capture these processes. A numerical technique based on the Lagrange polynomial interpolation was used to solve some of these models numerically. The numerical solutions were coded in MATLAB software for simulations. The results obtained from the mathematical simulation showed that a wind with speed of 100 km/h could transport droplets as far as 300 m. The results obtained from these simulations together with those presented by other researchers lead us to conclude that, the wind could have helped spread COVID-19 in some places around the world, especially in coastal areas. Therefore, appropriate facemasks that could help avoid re-inhaling enough CO2 should be used every time one is in open air even when alone especially in windy environment.
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Affiliation(s)
- Ernestine Atangana
- Centre for Environmental Management, Faculty of Natural and Agricultural Science, University of the Free State Bloemfontein, 9301, South Africa
| | - Abdon Atangana
- Institute for Groundwater Studies, Faculty of Natural and Agricultural Sciences, University of the Free State, 9301 Bloemfontein, South Africa
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Moon RE. Central nervous system oxygen toxicity during 100% oxygen breathing at normobaric pressure. Diving Hyperb Med 2020; 50:306. [PMID: 32957137 DOI: 10.28920/dhm50.3.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Richard E Moon
- Duke University Medical Center, Durham, North Carolina, USA.,Address for correspondence: Duke University Medical Center, Durham, North Carolina, USA,
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13
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Eynan M. Central nervous system oxygen toxicity during 100% oxygen breathing at normobaric pressure: Reply. Diving Hyperb Med 2020; 50:306-307. [PMID: 32957138 DOI: 10.28920/dhm50.3.306-307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/05/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Mirit Eynan
- Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel.,Address for correspondence: Israel Naval Medical Institute, Israel Defense Forces Medical Corps, Haifa, Israel,
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14
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Boussana A, Galy O, Le Gallais D, Hue O. The effect of an Olympic distance triathlon on the respiratory muscle strength and endurance in triathletes. J Exerc Rehabil 2020; 16:356-362. [PMID: 32913841 PMCID: PMC7463066 DOI: 10.12965/jer.2040518.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022] Open
Abstract
High-intensity exercise, marathons, and long distances triathlons have been shown to induce the fatigue of respiratory muscles (RMs). Never-theless, fatigue and the recovery period have not been studied in re-sponse of an Olympic distance triathlon (1.5-km swim, 40-km bike, 10-km run: short-distance triathlon). The aim of this study was to evaluate the RM fatigue induced by an Olympic distance triathlon. Nine male triath-letes (24±1.1 years) underwent spirometric testing and the assessment of RM performance. Respiratory function tests were conducted in sit-ting position. Spirometric parameters, maximal inspiratory and expirato-ry pressures, and RM endurance assessed by measuring the time limit were evaluated before (pre-T), after (post-T), and the day following the triathlon (post-T-24 hr). Residual volume increased: pre-T vs. post-T (P<0.002), maximal inspiratory pressure significantly decreased from 127.4±17.2 (pre-T) to 121.6±18.5 cmH2O (post-T) (P<0.001) and returned to the pre-T value 24 hr after the race (125.0±18.6). RM endurance sig-nificantly decreased from 4:51±0:8 (pre-T) to 3:13±0:7 min (post-T, P< 0.001) and then remained decreased for 24 hr after the race from 4:51± 0:8 (pre-T) to 3:39±0:4 min 24 hr after (P<0.002). Both, strength and en-durance of inspiratory muscles decrease after Olympic distance triath-lon. Furthermore, the impaired of inspiratory muscle endurance 24 hr after the race suggested a slow recovery and persistence of inspiratory muscle fatigue.
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Affiliation(s)
- Alain Boussana
- Department Higher Institute of Physical and Sports Education, University Marien Ngouabi, Brazzaville, Congo.,Department Sciences and Techniques of Physical and Sports Activities, University Antilles Guyane, Pointe à Pitre Cedex, France
| | - Olivier Galy
- Department Higher School of Professorship and Education, University of New-Caledonia, Noumea CEDEX, New-Caledonia, France
| | - Daniel Le Gallais
- Department Sciences and Techniques of Physical and Sports Activities, University of Montpellier, Montpellier, France
| | - Olivier Hue
- Department Sciences and Techniques of Physical and Sports Activities, University Antilles Guyane, Pointe à Pitre Cedex, France
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15
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Carfora A, Campobasso CP, Cassandro P, La Sala F, Maiellaro A, Perna A, Petrella R, Borriello R. Fatal inhalation of volcanic gases in three tourists of a geothermal area. Forensic Sci Int 2019; 297:e1-e7. [DOI: 10.1016/j.forsciint.2019.01.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 11/28/2022]
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16
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Wu Z, Zhang M, Zhang Z, Dong W, Wang Q, Ren J. Ratio of β-amyloid protein (Aβ) and Tau predicts the postoperative cognitive dysfunction on patients undergoing total hip/knee replacement surgery. Exp Ther Med 2017; 15:878-884. [PMID: 29399093 PMCID: PMC5772777 DOI: 10.3892/etm.2017.5480] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 09/22/2017] [Indexed: 12/11/2022] Open
Abstract
β-amyloid (Aβ) and Tau proteins are biomarkers of Alzheimer's disease neuropathogenesis. We hypothesized that they are also potential biomarkers for postoperative cognitive dysfunction (POCD). The present study was designed to evaluate the use of the Aβ-42/Tau ratio for the diagnosis of POCD in patients undergoing hip/knee replacement surgery. A total of 80 patients who underwent total hip/knee replacement surgery were grouped into POCD or non-POCD patients at 7 days, 1 and 3 months after surgery, according to a z-score recommended by the international study of POCD. Cerebrospinal fluid samples were collected prior to surgery and the concentration of Aβ-42 and Tau protein were detected. The ratio of Aβ-42/Tau was compared between the two groups at different time points. The patients completed the whole battery of neuropsychological tests following surgery. The POCD occurrence rates at 7 days, 1 and 3 months were 40, 25 and 15%, respectively. The Aβ-42/Tau ratios were much lower in the POCD group than those in the non-POCD group at 7 days (1.7±0.4 vs. 2.6±0.3), 1 month (1.6±0.5 vs. 2.4±0.4), and 3 months (1.6±0.4 vs. 2.5±0.4). The sensitivity and specificity for diagnosis of POCD as indicated by the ratios, at the three time points, were 91.7 vs. 81.2%, 86.7 vs. 70%, and 88 vs. 75.5%, respectively. The results show the incidence of POCD of patients aged at least 65 years who have undergone hip or knee fracture surgery gradually decrease as more patients recover. However, the Aβ-42/Tau ratio can be used in forecasting the occurrence of POCD elderly patients.
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Affiliation(s)
- Zhipeng Wu
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
| | - Mei Zhang
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
| | - Zhenhong Zhang
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
| | - Wei Dong
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
| | - Qingben Wang
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
| | - Juan Ren
- Department of Anesthesiology, People's Hospital of Shouguang, Shouguang, Weifang, Shandong 262700, P.R. China
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17
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Sheng M, Liu P, Mao D, Ge Y, Lu H. The impact of hyperoxia on brain activity: A resting-state and task-evoked electroencephalography (EEG) study. PLoS One 2017; 12:e0176610. [PMID: 28464001 PMCID: PMC5412995 DOI: 10.1371/journal.pone.0176610] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 04/13/2017] [Indexed: 12/17/2022] Open
Abstract
A better understanding of the effect of oxygen on brain electrophysiological activity may provide a more mechanistic insight into clinical studies that use oxygen treatment in pathological conditions, as well as in studies that use oxygen to calibrate functional magnetic resonance imaging (fMRI) signals. This study applied electroencephalography (EEG) in healthy subjects and investigated how high a concentration of oxygen in inhaled air (i.e., normobaric hyperoxia) alters brain activity under resting-state and task-evoked conditions. Study 1 investigated its impact on resting EEG and revealed that hyperoxia suppressed α (8-13Hz) and β (14-35Hz) band power (by 15.6±2.3% and 14.1±3.1%, respectively), but did not change the δ (1-3Hz), θ (4-7Hz), and γ (36-75Hz) bands. Sham control experiments did not result in such changes. Study 2 reproduced these findings, and, furthermore, examined the effect of hyperoxia on visual stimulation event-related potentials (ERP). It was found that the main peaks of visual ERP, specifically N1 and P2, were both delayed during hyperoxia compared to normoxia (P = 0.04 and 0.02, respectively). In contrast, the amplitude of the peaks did not show a change. Our results suggest that hyperoxia has a pronounced effect on brain neural activity, for both resting-state and task-evoked potentials.
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Affiliation(s)
- Min Sheng
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Peiying Liu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Deng Mao
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Yulin Ge
- Department of Radiology, New York University Langone Medical Center, New York, New York, United States of America
| | - Hanzhang Lu
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail:
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18
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Carbon dioxide poisoning: a literature review of an often forgotten cause of intoxication in the emergency department. Int J Emerg Med 2017; 10:14. [PMID: 28378268 PMCID: PMC5380556 DOI: 10.1186/s12245-017-0142-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 03/29/2017] [Indexed: 11/10/2022] Open
Abstract
The goal of this article was to provide an overview of the literature available on carbon dioxide intoxication. Articles were included based on their focus on medical or physiological effects of carbon dioxide. Studies related to decompression sickness were excluded. Mechanisms of carbon dioxide poising (both as an asphyxiant and as a toxicant) were described. Our review suggested that precautions are needed when handling dry ice or while working in confined spaces. Pre-hospital responders also need to pay attention for the possible diagnosis of CO2 intoxication for their own safety. When confronted with a victim, he/she should be removed from the dangerous area as fast as possible and oxygen should be administered. Without adequate treatment, victims may show acute reduced cognitive performance, respiratory failure, and circulatory arrest. Therefore, carbon dioxide poisoning is a rare but not to miss diagnosis in the emergency department.
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Freiberger JJ, Derrick BJ, Natoli MJ, Akushevich I, Schinazi EA, Parker C, Stolp BW, Bennett PB, Vann RD, Dunworth SAS, Moon RE. Assessment of the interaction of hyperbaric N2, CO2, and O2 on psychomotor performance in divers. J Appl Physiol (1985) 2016; 121:953-964. [PMID: 27633739 DOI: 10.1152/japplphysiol.00534.2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 09/02/2016] [Indexed: 11/22/2022] Open
Abstract
Diving narcosis results from the complex interaction of gases, activities, and environmental conditions. We hypothesized that these interactions could be separated into their component parts. Where previous studies have tested single cognitive tasks sequentially, we varied inspired partial pressures of CO2, N2, and O2 in immersed, exercising subjects while assessing multitasking performance with the Multi-Attribute Task Battery II (MATB-II) flight simulator. Cognitive performance was tested under 20 conditions of gas partial pressure and exercise in 42 male subjects meeting U.S. Navy age and fitness profiles. Inspired nitrogen (N2) and oxygen (O2) partial pressures were 0, 4.5, and 5.6 ATA and 0.21, 1.0, and 1.22 ATA, respectively, at rest and during 100-W immersed exercise with and without 0.075-ATA CO2 Linear regression modeled the association of gas partial pressure with task performance while controlling for exercise, hypercapnic ventilatory response, dive training, video game frequency, and age. Subjects served as their own controls. Impairment of memory, attention, and planning, but not motor tasks, was associated with N2 partial pressures >4.5 ATA. Sea level O2 at 0.925 ATA partially rescued motor and memory reaction time impaired by 0.075-ATA CO2; however, at hyperbaric pressures an unexpectedly strong interaction between CO2, N2, and exercise caused incapacitating narcosis with amnesia, which was augmented by O2 Perception of narcosis was not correlated with actual scores. The relative contributions of factors associated with diving narcosis will be useful to predict the effects of gas mixtures and exercise conditions on the cognitive performance of divers. The O2 effects are consistent with O2 narcosis or enhanced O2 toxicity.
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Affiliation(s)
- J J Freiberger
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - B J Derrick
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - M J Natoli
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - I Akushevich
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - E A Schinazi
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - C Parker
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - B W Stolp
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - P B Bennett
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - R D Vann
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - S A S Dunworth
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - R E Moon
- Duke Center for Hyperbaric Medicine and Environmental Physiology and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
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Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study. Crit Care Res Pract 2015; 2015:491780. [PMID: 25945257 PMCID: PMC4402173 DOI: 10.1155/2015/491780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 03/19/2015] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
Aim. Delirium is common among mechanically ventilated patients in the intensive care unit (ICU). There are little data regarding delirium among mechanically ventilated patients in Africa. We sought to determine the burden of delirium and associated factors in Uganda. Methods. We conducted a multicenter prospective study among mechanically ventilated patients in Uganda. Eligible patients were screened daily for delirium using the confusional assessment method (CAM-ICU). Comparisons were made using t-test, chi-squares, and Fisher's exact test. Predictors were assessed using logistic regression. The level of statistical significance was set at P < 0.05. Results. Of 160 patients, 81 (51%) had delirium. Median time to onset of delirium was 3.7 days. At bivariate analysis, history of mental illness, sedation, multiorgan dysfunction, neurosurgery, tachypnea, low mean arterial pressure, oliguria, fevers, metabolic acidosis, respiratory acidosis, anaemia, physical restraints, marital status, and endotracheal tube use were significant predictors. At multivariable analysis, having a history of mental illness, sedation, respiratory acidosis, higher PEEP, endotracheal tubes, and anaemia predicted delirium. Conclusion. The prevalence of delirium in a young African population is lower than expected considering the high mortality. A history of mental illness, anaemia, sedation, endotracheal tube use, and respiratory acidosis were factors associated with delirium.
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