Biomedical subjects

E C Parker

Publications and source records attributed to E C Parker.

8 recordsLinked to original sources

PubMed1998

Probabilistic models of the role of oxygen in human decompression sickness.

Probabilistic models of human decompression sickness (DCS) have been successful in describing DCS risk observed across a wide variety of N2-O2 dives but have failed to account for the observed DCS incidence in dives with high PO2 during decompression. Our most successful previous model, calibrated with 3,322 N2-O2 dives, predicts only 40% of the observed incidence in dives with 100% O2 breathing during decompression. We added 1,013 O2 decompression dives to the calibration data. Fitting the prior model to this expanded data set resulted in only a modest improvement in DCS prediction of O2 data. Therefore, two O2-specific modifications were proposed: PO2-based alteration of inert gas kinetics (model 1) and PO2 contribution to total inert gas (model 2). Both modifications statistically significantly improved the fit, and each predicts 90% of the observed DCS incidence in O2 dives. The success of models 1 and 2 in improving prediction of DCS occurrence suggests that elevated PO2 levels contribute to DCS risk, although less than the equivalent amount of N2. Both models allow rational optimization of O2 use in accelerating decompression procedures.

Air Pressure↗

PubMed1998

Relationship between T-wave amplitude and oxygen pulse in guinea pigs in hyperbaric helium and hydrogen.

Diving is known to induce a change in the amplitude of the T wave (ATw) of electrocardiograms, but it is unknown whether this is linked to a change in cardiovascular performance. We analyzed ATw in guinea pigs at 10-60 atm and 25-36 degreesC, breathing 2% O2 in either helium (heliox; n = 10) or hydrogen (hydrox; n = 9) for 1 h at each pressure. Core temperature and electrocardiograms were detected by using implanted radiotelemeters. O2 consumption rate was measured by using gas chromatography. In a previous study (S. R. Kayar and E. C. Parker. J. Appl. Physiol. 82: 988-997, 1997), we analyzed the O2 pulse, i.e., the O2 consumption rate per heart beat, in the same animals. By multivariate regression analysis, we identified variables that were significant to O2 pulse: body surface area, chamber temperature, core temperature, and pressure. In this study, inclusion of ATw made a significantly better model with fewer variables. After normalizing for chamber temperature and pressure, the O2 pulse increased with increasing ATw in heliox (P = 0.001) but with decreasing ATw in hydrox (P < 0.001). Thus ATw is associated with the differences in O2 pulse for animals breathing heliox vs. hydrox.

Air Pressure↗

PubMed1998

Evaluation of oxygen and pressure in treatment of decompression sickness in guinea pigs.

These experiments examined whether increasing the partial pressure of oxygen (PO2), hydrostatic pressure, or both were responsible for the improvement in effectiveness of recompression treatment previously observed in guinea pigs with increasing depths of air. Unanesthetized male guinea pigs (600-700 g) were subjected to 8.6 atm abs (871 kPa) air dives for 60 min and then decompressed at 1.82 atm (184 kPa)/min to the surface. Subsequently, animals usually displayed hypotension, cardiac arrhythmia, and tachypnea, indicative of a fatal bout (> 95% death rate) of decompression sickness (DCS). Animals that developed DCS were treated by recompressing to depths ranging from 2.5 to 11.6 atm abs (253-1175 kPa), with 14, 28, 42, or 100% O2/balance N2. This design produced PO2's at treatment depth ranging from 0.4 to 3.6 atm abs (41-365 kPa). Upon recompression, recovery of blood pressure, heart rate, and breathing rate generally occurred. The area under the breathing rate vs. time curve was used to examine the effectiveness of treatment over a period of 60 min. A dramatic improvement in recovery over time was observed with increasing recompression depth for all gas mixtures. Analysis indicated that the positive response to depth was related to increasing hydrostatic pressure, increasing PO2 had no statistically significant beneficial effect.

Animals↗

PubMed1997

Decompression comparison of helium and hydrogen in rats.

The hypothesis that there are differences in decompression risk between He and H2 was examined in 1,607 unanesthetized male albino rats subjected to dives on 2% O2-balance He or 2% O2-balance H2 (depths < or = 50 ATA, bottom times < or = 60 min). The animals were decompressed to 10.8 ATA with profiles varying from rapid to slow, with up to four decompression stops of up to 60 min each. Maximum likelihood analysis was used to estimate the relative decompression risk on a per unit pressure basis (termed "potency") and the rate of gas uptake and elimination, both factors affecting the decompression sickness risk, from a specific dive profile. H2 potency for causing decompression sickness was found to be up to 35% greater than that for He. Uptake rates were unresolvable between the two gases with the time constant (TC) estimated at approximately 2-3 min, leading to saturation in both cases in < 15 min. Washout of both gases was significantly slower than uptake, with He washout (TC approximately 1.5-3 h) substantially slower than H2 washout (TC approximately 0.5 h). It is unknown whether the decompression advantage of the faster washout of H2 or the disadvantage of its increased potency, observed in the rat, would be important for human diving.

Animals↗

PubMed1997

Oxygen pulse in guinea pigs in hyperbaric helium and hydrogen.

We analyzed O2 pulse, the total volume of O2 consumed per heart beat, in guinea pigs at pressures from 10 to 60 atmospheres. Animals were placed in a hyperbaric chamber and breathed 2% O2 in either helium (heliox) or hydrogen (hydrox). Oxygen consumption rate (VO2) was measured by gas chromatographic analysis. Core temperature and heart rate were measured by using surgically implanted radiotelemeters. The VO2 was modulated over a fourfold range by varying chamber temperature from 25 to 36 degrees C. There was a direct correlation between VO2 and heart rate, which was significantly different for animals in heliox vs. hydrox (P = 0.003). By using multivariate regression analysis, we identified variables that were significant to O2 pulse: body surface area, chamber temperature, core temperature, and pressure. After normalizing for all nonpressure variables, the residual O2 pulse was found to decrease significantly (P = 0.02) with pressure for animals in heliox but did not decrease significantly (P = 0.38) with pressure for animals in hydrox over the range of pressures studied. This amounted to a roughly 25% lower O2 pulse for normothermic animals in 60 atmospheres heliox vs. hydrox. These results suggest that reduction of cardiovascular efficiency in a hyperbaric environment can be mitigated by the choice of breathing gas.

Animals↗

PubMed1997

The Chiari II malformation: a surgical series.

Thirty patients between the ages of 7 months and 24 years were treated surgically for symptomatic Chiari II malformation at the Arkansas Children's Hospital. All patients underwent at least bony decompression of the malformation. Assessments of the patients' conditions were made at 6 weeks and 1 year after surgery, and complications of surgery were noted. For a majority of the patients, the presenting symptoms were resolved following treatment (74% at 6 weeks and 80% at 1 year). Partial resolution occurred in several of the patients (17% at 6 weeks and 14% at 1 year). A small number remained the same at 6 weeks (6%) and at 1 year (3%), while 1 patient was worse after surgery. Ten of the patients with complete resolution in the short term required repeat surgery an average of 49 months after their original operation, after which they again attained complete resolution of their symptoms. Scales for clinical, radiographic and operative grading of the patients' conditions as mild, moderate or severe were devised, and these were employed to characterize the condition of each patient. Patients in each grading category had good results, with rates of complete symptomatic resolution ranging from 67 to 100%. Severity in each category was found to be well correlated with eventual recurrence of symptoms and need for reoperation.

Adolescent↗

PubMed1997

Improved probabilistic decompression model risk predictions using linear-exponential kinetics.

Using a data base of 2,383 air and nitrogen-oxygen dives resulting in 131 cases of decompression sickness (DCS), risk functions were developed for a set of probabilistic decompression models according to survival analysis techniques. Parameters were optimized using the method of maximum likelihood Gas kinetics were either traditional exponential uptake and elimination, or an exponential uptake followed by linear elimination (LE kinetics) when calculated supersaturation was excessive. Risk functions either used the calculated relative gas supersaturation directly, or a delayed risk using a time integral of prior supersaturation. The most successful model (considering both incidence and time of onset of DCS) used supersaturation risk, and LE kinetics (in only 1 of 3 parallel compartments). Several methods of explicitly incorporating metabolic gases in physiologically plausible functions were usually found in lumped threshold terms and did not explicitly affect the overall data fit. The role of physiologic fidelity vs. empirical data fitting ability in accounting for model success is discussed.

Decompression Sickness↗

PubMed1993

Contribution of tissue lipid to long xenon residence times in muscle.

Experiments demonstrate that the mean residence time of an inert gas in tissue is longer than that predicted by a single-compartment model of gas exchange. Also the relative dispersion (RD, the standard deviation of residence times divided by the mean) is 1 according to this model, but RDs in real tissues are closer to 2, suggesting that a multiple-compartment model might be more accurate. The residence time of a gas is proportional to its solubility in the tissue. Although the noble gases in particular are 10 times more soluble in lipid than in nonlipid tissues, models of gas exchange generally do not incorporate measurements of the lipid in tissue, which may lead to error in the predicted gas residence times. Could a multiple-compartment model that accounts for the lipid in tissue more accurately predict the mean and RD of gas residence times? In this study, we determined the mean and RD of Xe residence times in intact and surgically isolated muscles in a canine model. We then determined the lipid content and the perfusion heterogeneity in each tissue, and we used these measurements with a multiple-compartment model of gas exchange to predict the longest physiologically plausible Xe residence times. Even so, we found the observed Xe mean residence times to be twice as long as those predicted by the model. However, the predicted RDs were considerably larger than the observed RDs. We conclude that lipid alone cannot account for the residence times of Xe in tissue and that a multiple-compartment model is not an accurate representation of inert gas exchange in tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗