The Young Everest Study: preliminary report of changes in sleep and cerebral blood flow velocity during slow ascent to altitude in unacclimatised children
| Autor: | Romola S. Bucks, Fenella J. Kirkham, Christopher H.E. Imray, Aidan Laverty, Emma Fettes, Samatha Sonnappa, Janine Cooper, Johanna Gavlak, Michael P.W. Grocott, Janet Stocks, Denny Z. H. Levett, Daniel Martin |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Adolescent Ultrasonography Doppler Transcranial Acclimatization Hemodynamics Hypocapnia Nepal Preliminary report Medicine Humans Oximetry Child Travel business.industry hypoxia Altitude Transcranial Doppler Cardiorespiratory fitness Hypoxia (medical) Carbon Dioxide medicine.disease Oxygen Cerebral blood flow Anesthesia Periodic breathing Cerebrovascular Circulation Pediatrics Perinatology and Child Health acute mountain sickness RC0321 Original Article Female medicine.symptom business Sleep Blood Flow Velocity |
| Zdroj: | Archives of Disease in Childhood |
| ISSN: | 1468-2044 0003-9888 |
| Popis: | Background:\ud Cerebral blood flow velocity (CBFV) and sleep physiology in healthy children exposed to hypoxia and hypocarbia are under-researched.\ud Aim: To investigate associations between sleep variables, daytime end-tidal carbon dioxide (EtCO2) and CBFV in children during high-altitude ascent.\ud Methods: Vital signs, overnight cardiorespiratory sleep studies and transcranial Doppler were undertaken in nine children (aged 6–13 years) at low altitude (130 m), and then at moderate (1300 m) and high (3500 m) altitude during a 5-day ascent.\ud Results: Daytime (130 m: 98%; 3500 m: 90%, p=0.004) and mean (130 m: 97%, 1300 m: 94%, 3500: 87%, p=0.0005) and minimum (130 m: 92%, 1300 m: 84%, 3500 m: 79%, p=0.0005) overnight pulse oximetry oxyhaemoglobin saturation decreased, and the number of central apnoeas increased at altitude (130 m: 0.2/h, 1300 m: 1.2/h, 3500 m: 3.5/h, p=0.2), correlating inversely with EtCO2 (R2 130 m: 0.78; 3500 m: 0.45). Periodic breathing occurred for median (IQR) 0.0 (0; 0.3)% (130 m) and 0.2 (0; 1.2)% (3500 m) of total sleep time. At 3500 m compared with 130 m, there were increases in middle (MCA) (mean (SD) left 29.2 (42.3)%, p=0.053; right 9.9 (12)%, p=0.037) and anterior cerebral (ACA) (left 65.2 (69)%, p=0.024; right 109 (179)%; p=0.025) but not posterior or basilar CBFV. The right MCA CBFV increase at 3500 m was predicted by baseline CBFV and change in daytime SpO2 and EtCO2 at 3500 m (R2 0.92); these associations were not seen on the left.\ud Conclusions: This preliminary report suggests that sleep physiology is disturbed in children even with slow ascent to altitude. The regional variations in CBFV and their association with hypoxia and hypocapnia require further investigation. |
| Databáze: | OpenAIRE |
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