BIOLOGICAL VARIATIONS OF REACTIVE HYPEREMIA IN CRITICALLY ILL PATIENTS

危重患者反应性高血症的生物学变异

• 批准号: 7604916
• 负责人: KEVIN C DOERSCHUG
• 金额: $ 0.14万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2007-09-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7604916
• 关键词: Anatomy; Beds; Biological; Blood; Blood capillaries; Blood flow; Catheters; Computer Retrieval of Information on Scientific Projects Database; Critical Illness; Distal; Endothelial Cells; Forearm; Funding; Grant; Hemoglobin; Institution; Invasive; Ischemia; Left; Leg; Literature; Location; Measurement; Mediating; Monitor; Nitric Oxide; Oxygen; Patients; Pilot Projects; Radial; Rate; Research; Research Personnel; Resources; Source; Spectrum Analysis; Tissues; United States National Institutes of Health; Variant; Venous; Work; capillary; falls; reactive hyperemia; response; tissue oxygenation

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Reactive hyperemia (RH) refers to arterial dilation in response to temporary stagnant ischemia, and is mediated in part through release of nitric oxide from endothelial cells. Near Infra-Red Spectroscopy (NIRS) can detect capillary hemoglobin concentration as well as capillary hemoglobin oxygen saturation. Tissue oxygen saturation falls during stagnant ischemia, and rises when flow returns; the rate of increase in tissue oxygen saturation represents reactive hyperemia. Our initial work has shown tht microvascular responses to reactive hyperemia are impaired in some critically ill patients. What is not known is the anatomic variation of these findings, and whether invasive catheters alter the blood flow response distal to the catheter. Furthermore, literature suggests that locally released soluble factors may be responsible for the microvascular responses in reactive hyperemia. We propose a pilot study to examine the anatomic and iatrogenic associated variation of microvascular reactive hyperemia in critically ill patients that have clinically indicated radial arterial catheters. Subjects will have NIRS measurements of reactive hyperemia in three locations, including one leg and both left and right forearms. Blood will be collected (ICU subjects only) before and during reactive hyperemia, simultaneously from arterial and venous catheters that demarcate the monitored tissue bed, and analyzed for candidate soluble factors purported to be associated with reactive hyperemia.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 反应性充血（RH）是指响应暂时停滞缺血而出现的动脉扩张，部分是通过内皮细胞释放一氧化氮介导的。 近红外光谱 (NIRS) 可以检测毛细血管血红蛋白浓度以及毛细血管血红蛋白氧饱和度。 组织氧饱和度在停滞性缺血期间下降，在血流恢复时上升；组织氧饱和度的增加率代表反应性充血。 我们的初步工作表明，一些危重患者的微血管对反应性充血的反应受损。 目前尚不清楚的是这些发现的解剖学变化，以及侵入性导管是否会改变导管远端的血流反应。 此外，文献表明局部释放的可溶性因子可能是反应性充血中微血管反应的原因。 我们提出了一项初步研究，以检查临床上需要桡动脉导管的危重患者微血管反应性充血的解剖学和医源性相关变化。 受试者将在三个位置（包括一条腿以及左右前臂）进行反应性充血的 NIRS 测量。 在反应性充血之前和期间，将同时从划分监测组织床的动脉和静脉导管收集血液（仅限 ICU 受试者），并分析据称与反应性充血相关的候选可溶性因子。