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Biomedical subjects

A M Hanniquet

Publications and source records attributed to A M Hanniquet.

15 recordsLinked to original sources

Positive end expiratory pressure (PEEP) slightly modifies ventilatory response during incremental exercise.

To clarify the ventilatory effects of a 5-cm H2O positive end expiratory pressure (PEEP) in healthy men during incremental exercise in normoxic conditions, 22 subjects were subjected to a constant workload (0 W, 50 W, 100 W, 150 W and 200 W) on a cycle ergometer for periods of 8 min each, both with and without 5-cm H2O PEEP. Results show that PEEP increases inspiratory (TI) and expiratory (TE) duration and tidal volume (VT) and decreases breathing frequency (fB) at rest (p < 0.05). During exercise, TI is higher at 50 W and 100 W (p < 0.05), but not at 150 and 200 W. TE only increases at 50 W (p < 0.05). An increased VT (p < 0.05 at 50, 100 and 150 W) and a decreased fB (p < 0.05 throughout the experiment) were observed. However, mean inspiratory flow (VT/T1) and duty cycle (TI/TT) were unaffected by PEEP. In conclusion, this study shows that a 5-cm H2O PEEP slightly modifies the ventilatory parameters in healthy subjects during incremental exercise in normoxic conditions.

Adult↗

Short hypobaric hypoxia and breathing pattern: effect of positive end expiratory pressure.

The ventilatory effects of a 5-cm H2O positive end expiratory pressure (PEEP) and its influence on the breathing pattern during short hypoxic exposure both at rest and during physical exercise were studied. There were 22 healthy subjects who were submitted to normoxia and to 4-h of hypoxia in a hypobaric chamber (4500 m, PB = 589 hPa) both at rest and during an 8-min cycle ergometer exercise (100 W) without and with a 5 cm H2O PEEP. The results show that hypoxia compared with normoxia induces increases in tidal volume (VT) (+28.5%, p < 0.05 at rest; and +19.4%, p < 0.01 at 100 W) and in respiratory frequency (f) at 100 W (p < 0.05), and significant decreases in inspiratory (tI) (p < 0.05 at rest and at 100 W), and expiratory (tE) durations (p < 0.05 at 100 W). However, the breathing pattern expressed as duty cycle (tI/tt) is unchanged, whereas an increased mean inspiratory flow (VT/tI) is observed (p < 0.01 at rest and at 100 W). This study also demonstrates that PEEP during a 4-h hypobaric hypoxia significantly increases VT (+22.2% p < 0.01 at rest, +8.9% p < 0.05 at 100 W), tI, and tE at rest (p < 0.05), but not during exercise and tends to decrease f (p = 0.06 at rest and at 100 W). However, PEEP does not alter the breathing pattern in hypoxia since VT/tI and tI/tt are unchanged. Heart rate and arterial O2 saturation are also unaffected by PEEP. In conclusion, this study shows that a 4-h hypoxia modifies ventilatory parameters and mean inspiratory flow (VT/tI) at rest and during exercise (100 W), whereas a 5-cm H2O PEEP does not alter the breathing pattern despite changes in ventilatory parameters are observed.

Adult↗

Positive end expiratory pressure as a method for preventing acute mountain sickness.

In order to study the use of positive end expiratory pressure (PEEP) to prevent acute mountain sickness (AMS), 22 subjects were exposed randomly to 8-h hypobaric hypoxia in a hypobaric chamber (4500 m, 589 hPa, 22 degrees C) once being administered 5-cm H2O PEEP and once without. The prevention of AMS by PEEP was evaluated by scoring AMS according to the Lake Louise system (self-report questionnaire and clinical assessment) throughout the experiment with O2 saturation (SO2) and heart rate measurements being made. Arterial blood analyses (partial pressures of arterial O2 and CO2, PaO2, PaCO2, and pH) were made at the end of the exposure. Results showed decreased AMS scores with PEEP at the end of the 8-h hypoxia [1.50 (SEM 1.32) vs 3.23 (SEM 2.07), P < 0.01 for self-report plus clinical assessment scores] with a lower prevalence (23% vs 55%, P < 0.01). The SO2, PaO2, PaCO2 and HCO3- did not change significantly. However, a smaller increase in arterial pH [7.47 (SEM 0.02) vs 7.50 (SEM 0.02), P < 0.05] was observed with PEEP, attesting a lesser alkalosis. Moreover, heart rate increased with PEEP (P < 0.05). In conclusion, this study would suggest that a 5-cm H2O PEEP may help decrease AMS scores at the end of an 8-h exposure to hypoxia in a hypobaric chamber. Such a method could be used to prevent AMS in such experimental conditions without adverse effects.

Adult↗

General and local cold responses in humans after 2 weeks at high altitude.

To investigate the effects of a short-term high altitude residence (2 weeks between 4150 m and 6885 m in the Andes) on the general and local cold responses after descent, 11 subjects were submitted both to a whole body standard cold air test (SCAT, dry bulb temperature = 1 degree C, 2 h, nude, at rest) and to a local cold water test of the right upper limb (CWT, 5 degrees C, 5 min) both before and after the expedition. Compared to before the expedition, a lower systolic blood pressure was observed after the high altitude residence [130.00 (SEM 3.35) mm Hg vs 140.40 (SEM 4.74) mm Hg at the end of CWT, P < 0.05] whereas no significant change either in diastolic blood pressure or in heart rate was found. All skin temperatures of the right upper limb were lowered (P < 0.05). During SCAT, body temperatures were unchanged (rectal and mean skin temperature, Tsk) but metabolic heat production was slightly but significantly diminished [110 (SEM 4) W.m-2 vs 125 (SEM 3) W.m-2, P < 0.05] and heat debt increased [11.37 (SEM 1.11) kJ.kg-1 vs 9.30 (SEM 2.30) kJ.kg-1, P < 0.05]. Moreover, the time of onset of continuous shivering (d) was shortened [8.20 (SEM 1.90) min vs 17.30 (SEM 3.60) min, P < 0.05] and the level of Tsk observed at (d) was higher [25.70 (SEM 0.80) degrees C vs 23.57 (SEM 0.78) degrees C, P < 0.05] suggesting an increase in the sensitivity of the thermoregulatory system despite the slight decreased shivering activity observed. It was concluded that general and local cold tolerance were modified by a short-term residence at altitude and that the changes observed were not in accordance with general or (and) local cold adaptation. In contrast, high altitude sojourn could be a risk factor for frostbite of the extremities.

Altitude↗

Pre-adaptation, adaptation and de-adaptation to high altitude in humans: cardio-ventilatory and haematological changes.

The aim of this study was first to investigate cardio-ventilatory and haematological responses induced by intermittent acclimation and second to study de-adaptation from high altitude observed after descent. To achieve these objectives nine subjects were submitted to intermittent acclimation in a low barometric chamber (8 h daily for 5 days, day 1 at 4500 m, day 5 at 8500 m) before an expedition to the Himalayas. Cardio-ventilatory changes were measured during a hypobaric poikilocapnic hypoxic test (4500 m, barometric pressure = 589 hPa) and haematological changes were studied at sea level. These measurements were performed before and after acclimation, after return to sea level, but also 1 and 2 months after the expedition. In addition, partial pressures of oxygen and carbon dioxide in arterial blood (PaO2, PaCO2) and arterial erythropoietin concentration [EPO] were measured at rest during the hypoxic test. Results suggested the pre-adaptation protocol was efficient since an increased PaO2 (+12%, P < 0.05), a smaller difference in alveolo-arterial PO2 ( -63%, P < 0.05) and a lower PaCO2 ( -11%, P < 0.05), subsequent to ventilatory changes, were observed after acclimation with a significant increase in reticulocytes and in sea level [EPO] (+44% and +62% respectively, P < 0.05). De-adaptation was characterized by a loss of these cardio-ventilatory changes 1 month after descent, whereas the haematological changes (increased red blood cells and packed cell volume, P < 0.05) persisted for 1 month before disappearing 2 months after descent. This study would also suggest that acute hypoxia performed after a sojourn at high altitude could induce significantly depressed EPO responses (P < 0.05).

Adaptation, Physiological↗

Evaluation of the Lake Louise acute mountain sickness scoring system in a hypobaric chamber.

This study evaluated the relevance of the Lake Louise acute mountain sickness (AMS) scoring system in comparison with other AMS scoring systems. To achieve this objective nine subjects were submitted to a 9-hr exposure to hypoxia in a hypobaric chamber (altitude 4500-5500 m) that led to the development of AMS. AMS was scored at the end of this exposure period both by questionnaires (Hackett AMS questionnaire, Lake Louise AMS self-report questionnaire, Environmental Symptoms Questionnaire ESQ II and ESQ IV) and by a clinical investigation following the Lake Louise AMS clinical and functional AMS assessment. The AMS scores were between 0 and 9 for the Hackett AMS score, 0 and 38 for the ESQ II AMS score, 0 and 13.7 for the ESQ IV AMS score, 0 and 10 for the Lake Louise AMS self-report, 0 and 2 for the Lake Louise AMS clinical assessment score, and between 0 and 2 for the Lake Louise functional score. All the AMS questionnaire scores were related to the clinical AMS assessment score (p < 0.05) without significant differences between them. The Lake Louise AMS self-report score appeared highly correlated to other AMS scoring systems (Hackett, ESQ II and ESQ IV) (p < 0.05). Suggestions were proposed to improve the sensitivity and the specificity of the Lake Louise AMS scoring questionnaire but also the Lake Louise AMS clinical assessment. In conclusion, this study suggests the relevance of the Lake Louise AMS self-report questionnaire to assess and score AMS with simplicity and rapidity.

Adult↗

Physiological changes induced by pre-adaptation to high altitude.

To study the physiological effects of pre-adaptation to high altitude, seven subjects were submitted to acclimatization at 4350 m followed by intermittent acclimation in a low barometric pressure chamber (5000 m to 8500 m). The subjects then spent 25 days in the Himalayas. Ventilatory and cardiac responses were studied during a hypobaric poikilocapnic hypoxic test performed both at rest and during exercise (100 W) in normoxia and in hypoxia (barometric pressure: 589 hPa, altitude: 4500 m). Haemoglobin, erythrocytes, reticulocytes, packed cell volume, 2,3-diphosphoglycerate (2,3-DPG) and erythropoietin (EPO) were measured. All variables were studied before pre-adaptation to high altitude (A), after the acclimatization period (B), after the acclimation period (C) and after the expedition (D). The ventilatory and cardiac responses were characterized by an increased tidal volume in hypoxia (+33% during exercise in B, P < 0.05; +100% at rest and +33% during exercise in C, P < 0.05) without any change in respiratory frequency, whereas an increased systolic blood pressure was only observed in C during exercise in hypoxia [+23 mmHg (3.07 kPa), P < 0.01]. Arterial O2 saturation was higher in hypoxia in C and D, both at rest (+8.2% and +4.7%, P < 0.01, respectively), and during exercise (+6.3% and +6.3%, P < 0.01, respectively). Erythrocytes, haemoglobin and packed cell volume did not vary significantly. The number of reticulocytes was higher in B (+172%, P < 0.05) and in C (+249%, P < 0.05). EPO and 2,3-DPG increased only in C (+770%, P < 0.01 and +23%, P < 0.05, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Acclimatization↗

How should body heat storage be determined in humans: by thermometry or calorimetry?

The aim of this study was to determine whether in humans there are differences in the heat storage calculated by partitional calorimetry (S, the balance of heat gains and heat losses) compared to the heat storage obtained by conventional methods (thermometry) via either core temperature or mean body temperatures (Tb = 0.8Tc + 0.2Tsk, where Tc is core temperature and Tsk is mean skin temperature) when two different sites are used as an index of Tc [rectal (T(re)) and auditory canal (T(ac)) temperatures]. Since women respond to the heat differently than men, both sexes were studied. After a stabilisation period at thermal neutrality, six men and seven women were exposed to a globe temperature of 50 degrees C, relative humidity of 17% and wind speed of 0.8-1.0 m.s-1 for 90 min semi-nude at rest, where T(re), T(ac), Tsk, metabolic rate, dry (radiant + convective heat exchange) and evaporative heat losses, S, heat storage by Tc (STc) and heat storage by Tb (STb) were assessed every minute. In the mean, S was equal to 350.8(SEM 49.6) kJ whereas STc amounted to only 114.6(SEM 16.2) and 196.7(SEM 32.3) kJ for T(re) and T(ac), respectively (P less than 0.05). Final STb(re) underestimated S by 49% [177.7(SEM 23.0) kJ; P less than 0.05] whereas STb(ac) was not significantly different than S [255.7(SEM 37.9) kJ]. In the women, S corresponded to a total of 294.3(SEM 23.2) kJ, a value that was very similar to the STb(ac) [262.6(SEM 31.0) kJ], whereas STb(re) under-predicated S by 35% [190.4(SEM 26.3) kJ; P less than 0.05].(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Thermal exchanges during sleep in anhidrotic ectodermal dysplasia.

Anhidrotic ectodermal dysplasia is a congenital syndrome characterized by the absence of sweat glands. A sweating test was performed on such a patient and proved his inability to sweat. Thermal exchanges during night sleep were then measured in this patient and compared with data obtained from a healthy control subject. Ambient conditions were as follows: dry bulb temperature 32.2 degrees C, relative humidity 30%-40%, wind speed 0.7 m.s-1. Polysomnographic recordings showed normal sleep patterns in both subjects, but a "first night effect" in the patient. Rectal (Tre) and mean skin (Tsk) temperatures and loss of mass were monitored continuously throughout the 8-h sleep recording. Loss of mass averaged 34.1 g.h-1 in the patient vs 78.1 g.h-1 in the control subject. No relationship with sleep stages was observed in the patient, in contrast to the control subject who experienced a decrease in evaporation during rapid eye movement sleep. Body temperatures varied little in the patient, but decreased until the 6th h of sleep in the control subject. On two occasions there was a 0.3 degrees C fall in the Tre of the patient during two slow wave sleep (SWS) phases, while Tsk and loss of mass did not change. As thermolytic processes had not varied on these two occasions, it was concluded that the fall in Tre indicated a concomitant decrease in metabolic heat production, in agreement with the assumption that SWS represented a state of energy conservation.

Adolescent↗

Thermal changes observed before and after J.-L. Etienne's journey to the North Pole. Is central nervous system temperature preserved in hypothermia?

The thermoregulatory responses of a French doctor, Jean-Louis Etienne, were examined in a standard cold test before and after his journey to the North Pole, to investigate whether general and/or local cold adaptation had occurred. The two tests were carried out in a climatic chamber for 2 h at rest (dry bulb temperature, 1 degree C; relative humidity, 40%; wind speed, 0.8 m.s-1). After his journey, Etienne showed a general hypothermic-hypometabolic adaptation, i.e. a decrease in rectal temperature (Tre) and metabolic heat production (M), and an increased local skin temperature of the extremities. Between the two tests, a change occurred in the relationship between tympanic temperature (Tty) and M. During the post-journey cold test, Tty [as representative of the central nervous system (CNS) temperature] increased while the decrease in Tre was accelerated, probably due to a redistribution of blood volume towards the CNS. Such a mechanism would protect the central core with special reference to the CNS.

Acclimatization↗

Seasonal changes in circadian rhythms of body temperatures in humans living in a dry tropical climate.

Seven volunteers (3 females and 4 males; 3 Caucasians and 4 Africans) participated in two 24 h sessions during the cool dry (CD) and the hot dry (HD) seasons of the sahelian tropical climate. Body temperatures were taken on portable cassette recorders for 24 h. Rectal (Tre) and mean skin (Tsk) temperatures decreased in the HD compared to the CD conditions, meeting one of the criteria for adaptation to heat. No ethnic differences in thermal responses were found. Males and females differed in their body temperature rhythms and in their reactions to heat. Body temperatures were higher in females than in males. Males reacted to heat with a decrease in Tre, without change in the Tre-Tsk gradient. Females showed a decrease in both Tre and Tsk, more marked for Tsk, with an increase in the Tre-Tsk gradient. It was concluded that males showed seasonal acclimatization to heat via a decrease in metabolism confirmed by a decrease in plasma levels of thyroid stimulating hormone (TSH) in the HD condition. Females showed a mixed metabolic and thermolytic type of acclimatization, with an absence of variation in plasma TSH levels. In conclusion, the steady rise in temperature between the CD and HD conditions was sufficient to trigger an acclimatization to heat similar in Caucasian and African subjects, although exposure to the external climate differed widely.

Acclimatization↗

Physical fitness and thermoregulatory reactions in a cold environment in men.

The relationship between the physical fitness level (maximal O2 consumption, VO2max) and thermoregulatory reactions was studied in 17 adult males submitted to an acute cold exposure. Standard cold tests were performed in nude subjects, lying for 2 h in a climatic chamber at three ambient air temperatures (10, 5, and 1 degrees C). The level of physical fitness conditioned the intensity of thermoregulatory reactions to cold. For all subjects, there was a direct relationship between physical fitness and 1) metabolic heat production, 2) level of mean skin temperature (Tsk), 3) level of skin conductance, and 4) level of Tsk at the onset of shivering. The predominance of thermogenic or insulative reactions depended on the intensity of the cold stress: insulative reactions were preferential at 10 degrees C, or even at 5 degrees C, whereas colder ambient temperature (1 degree C) triggered metabolic heat production abilities, which were closely related to the subject's physical fitness level. Fit subjects have more efficient thermoregulatory abilities against cold stress than unfit subjects, certainly because of an improved sensitivity of the thermoregulatory system.

Adipose Tissue↗