title: Cerebral oxygenation at high altitude and the response to carbon dioxide, hyperventilation and oxygen. The Birmingham Medical Research Expeditionary Society.
abstract: Cerebral oxygenation is likely to be of critical importance in determining function at high altitude. The present study has used the technique of near-IR spectroscopy to monitor changes in cerebral regional oxygenation in response to inhaled carbon dioxide, hyperventilation and supplementary oxygen on ascent to 4680 m over 3 days. At sea level, inhaled CO(2) resulted in a significant rise in cerebral regional oxygenation [from mean 69.6% (S.D. 2.4% to 71. 1+/-2.3%; means+/-S.D.; P<0.001). At 4680 m, CO(2) increased regional cerebral oxygenation (63.8+/-2.5% to 65.9+/-2.2%; P<0.001) and also increased peripheral oxygen saturation (75.1+/-6.1% to 83. 6+/-4.0%; P<0.001). Voluntary hyperventilation resulted in improved peripheral oxygen saturation at 2770 m, 3650 m and 4680 m, whereas cerebral regional oxygenation was reduced at sea level and at 2770 m, unchanged at 3650 m and increased at 4680 m. Supplementary oxygen (6 1itres/min) at 4680 m resulted in greater improvements in peripheral oxygen saturation (76.7+/-7.9% to 98.1+/-1.5%; P<0.001) and cerebral regional oxygenation (64.6+/-3.3% to 70.6+/-2.9%; P<0. 001) than were found with CO(2) or hyperventilation. We conclude that attempts to increase CO(2) inhalation or ventilation at high altitude are likely to be beneficial for cerebral oxygenation in the short term.
authors.affiliation: The Immunodiagnostic Research Laboratory, The Medical School, University of Birmingham, Edgbaston, Birmingham B15 2TT, U.K. chrisimray@aol.com
authors.forename: C H
authors.initials: CH
authors.lastname: Imray
authors.forename: S
authors.initials: S
authors.lastname: Brearey
authors.forename: T
authors.initials: T
authors.lastname: Clarke
authors.forename: D
authors.initials: D
authors.lastname: Hale
authors.forename: J
authors.initials: J
authors.lastname: Morgan
authors.forename: S
authors.initials: S
authors.lastname: Walsh
authors.forename: A D
authors.initials: AD
authors.lastname: Wright
mesh_terms: D000328:Adult; D000531:Altitude; D001921:Brain / Q000378:metabolism*; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000502:physiology*; D005260:Female; D006441:Hemoglobin A / Q000378:metabolism; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage / Q000378:metabolism*; D010313:Partial Pressure
chemical_list: D002245:Carbon Dioxide; D006441:Hemoglobin A; D010100:Oxygen