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The Elusive Path of Brain Tissue Oxygenation and Cerebral Perfusion in Harness Hang Syncope in Mountain Climbers
- Source :
- High altitude medicinebiology. 18(4)
- Publication Year :
- 2017
-
Abstract
- Lanfranconi, Francesca, Luca Pollastri, Giovanni Corna, Manuela Bartesaghi, Massimiliano Novarina, Alessandra Ferri, and Giuseppe Andrea Miserocchi. The elusive path of brain tissue oxygenation and cerebral perfusion in harness hang syncope in mountain climbers. High Alt Med Biol. 18:363-371, 2017. Aim: Harness hang syncope (HHS) is a risk that specifically affects wide ranges of situations requiring safety harnesses in mountains. An irreversible orthostatic stasis could lead to death if a prompt rescue is not performed. We aimed at evaluating the risk of developing HHS and at identifying the characteristics related to the pathogenesis of HHS. Results: Forty adults (aged 39.1 [8.2] years) were enrolled in a suspension test lasting about 28.7 (11.4) minutes. We measured cardiovascular parameters, and near infrared spectroscopy (NIRS) was used to assess cerebral hypoxia by changes in the concentration of oxyhemoglobin (Δ[HbO2]) and de-oxyhemoglobin (Δ[HHb]). In the four participants who developed HHS: (1) systolic and diastolic blood pressure showed ample oscillations with a final abrupt drop (∼30 mmHg); (2) Δ[HbO2] increased after 8-12 minutes of suspension and reached a plateau before HHS; and (3) Δ[HHb] decreased with a final abrupt increase before syncope. Conclusions: Participants who developed HHS failed to activate cardiovascular reflexes that usually safeguard O2 availability to match the metabolic needs of the brain tissue. Since cerebral hypoxia was detected as an early phenomenon by Δ[HbO2] and Δ[HHb] changes, NIRS measurement appears to be the most important parameter to monitor the onset of HHS.
- Subjects :
- Adult
Male
Physiology
media_common.quotation_subject
harness hang syncope
Blood Pressure
Brain tissue
Syncope
03 medical and health sciences
Hemoglobins
0302 clinical medicine
medicine
Humans
Cerebral perfusion pressure
Hypoxia
media_common
Spectroscopy, Near-Infrared
Public Health, Environmental and Occupational Health
Cerebral hypoxia
Brain
030229 sport sciences
General Medicine
Anatomy
Art
Oxygenation
Middle Aged
medicine.disease
cardiovascular reflex
microgravity
Cerebrovascular Circulation
cerebral hypoxia
Mountaineering
Oxygen
Cardiovascular reflexes
NIRS
Anesthesia
Oxyhemoglobins
Female
030217 neurology & neurosurgery
suspension trauma
Subjects
Details
- ISSN :
- 15578682
- Volume :
- 18
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- High altitude medicinebiology
- Accession number :
- edsair.doi.dedup.....1017a5ab63ef3644a8915b6a573937fb