Posts tagged oxygen
Articles and news from the latest research reports.
Anaesthetic technique important to prevent damage to brain
Researchers at the University of Adelaide have discovered that a commonly used anaesthetic technique to reduce the blood pressure of patients undergoing surgery could increase the risk of starving the brain of oxygen.
Reducing blood pressure is important in a wide range of surgeries - such as sinus, shoulder, back and brain operations - and is especially useful for improving visibility for surgeons, by helping to remove excess blood from the site being operated on.
There are many different techniques used to lower patients’ blood pressure for surgery - one of them is known as hypotensive anaesthesia, which slows the arterial blood pressure by up to 40%.
Professor PJ Wormald, a sinus, head and neck surgeon from the University’s Discipline of Surgery, based at the Queen Elizabeth Hospital, led a world-first study looking at both the effectiveness of hypotensive anaesthesia from the surgeon’s point of view and its impact on the patients.
The study followed 32 patients who underwent endoscopic sinus surgery. The results have now been published online in the journal The Laryngoscope.
"There is an important balance in anaesthesia where the blood pressure is lowered so that the surgeon has good visibility and is able to perform surgery safely. There are numerous sensitive areas in sinus surgery - the brain, the eye and large vessels such as the carotid. However, if the blood pressure is lowered too far this may cause damage to the brain and other organs," says Professor Wormald.
"We know from previous research that a person’s brain undergoing anaesthesia has lower metabolic requirements than the awake brain, and therefore it can withstand greater reductions in blood flow.
"There is also a widely accepted concept that the brain has the ability to autoregulate - to adapt and maintain a constant blood flow as needed, despite a wide range of blood pressure conditions. Our studies challenge this; they show that the brain can only autoregulate up to a point, and cannot completely adapt to such low blood pressures.
"This drop in blood pressure poses a risk of starving the brain of much-needed oxygen and nutrients, which could result in injury. There have been cases, for example, where patients have reported memory loss following surgery.
"Given that hypotensive anaesthesia is a widely used technique, not just in sinus surgery but in many different types of surgery, we’ve made recommendations in our paper that suggest a safer approach to this technique. This would reduce risk to the patient while enabling the surgeon to carry out their work effectively," Professor Wormald says.
(Image: Shutterstock)
MR Spectroscopy Shows Differences in Brains of Preterm Infants
Premature birth appears to trigger developmental processes in the white matter of the brain that could put children at higher risk of problems later in life, according to a study being presented next week at the annual meeting of the Radiological Society of North America (RSNA).
Preterm infants—generally those born 23 to 36 weeks after conception, as opposed to the normal 37- to 42-week gestation—face an increased risk of behavioral problems, ranging from impulsiveness and distractibility to more serious conditions like autism and attention deficit hyperactivity disorder (ADHD).
"In the United States, we have approximately 500,000 preterm births a year," said Stefan Blüml, Ph.D., director of the New Imaging Technology Lab at Children’s Hospital Los Angeles and associate professor of research radiology at the University of Southern California in Los Angeles. "About 60,000 of these babies are at high risk for significant long-term problems, which means that this is a significant problem with enormous costs."
Dr. Blüml and colleagues have been studying preterm infants to learn more about how premature birth might cause changes in brain structure that may be associated with clinical problems observed later in life. Much of the focus has been on the brain’s white matter, which transmits signals and enables communication between different parts of the brain. While some white matter damage is readily apparent on structural magnetic resonance imaging (MRI), Dr. Blüml’s group has been using magnetic resonance spectroscopy (MRS) to look at differences on a microscopic level.
In this study, the researchers compared the concentrations of certain chemicals associated with mature white matter and gray matter in 51 full-term and 30 preterm infants. The study group had normal structural MRI findings, but MRS results showed significant differences in the biochemical maturation of white matter between the term and preterm infants, suggesting a disruption in the timing and synchronization of white and gray matter maturation. Gray matter is the part of the brain that processes and sends out signals.
"The road map of brain development is disturbed in these premature kids," Dr. Blüml said. "White matter development had an early start and was ‘out of sync’ with gray matter development."
This false start in white matter development is triggered by events after birth, according to Dr. Blüml.
"This timeline of events might be disturbed in premature kids because there are significant physiological switches at birth, as well as stimulatory events, that happen irrespective of gestational maturity of the newborn," he said. "The most apparent change is the amount of oxygen that is carried by the blood."
Dr. Blüml said that the amount of oxygen delivered to the fetus’s developing brain in utero is quite low, and our brains have evolved to optimize development in that low oxygen environment. However, when infants are born, they are quickly exposed to a much more oxygen-rich environment.
"This change may be something premature brains are not ready for," he said.
While this change may cause irregularities in white matter development, Dr. Blüml noted that the newborn brain has a remarkable capacity to adapt or even “re-wire” itself—a concept known as plasticity. Plasticity not only allows the brain to govern new skills over the course of development, like learning to walk and read, but could also make the brains of preterm infants and young children more responsive to therapeutic interventions, particularly if any abnormalities are identified early.
"Our research points to the need to better understand the impact of prematurity on the timing of critical maturational processes and to develop therapies aimed at regulating brain development," Dr. Blüml said.
(Source: www2.rsna.org)
Oxygen Chamber Can Boost Brain Repair
Stroke, traumatic injury, and metabolic disorder are major causes of brain damage and permanent disabilities, including motor dysfunction, psychological disorders, memory loss, and more. Current therapy and rehab programs aim to help patients heal, but they often have limited success.
Now Dr. Shai Efrati of Tel Aviv University’s Sackler Faculty of Medicine has found a way to restore a significant amount of neurological function in brain tissue thought to be chronically damaged — even years after initial injury. Theorizing that high levels of oxygen could reinvigorate dormant neurons, Dr. Efrati and his fellow researchers, including Prof. Eshel Ben-Jacob of TAU’s School of Physics and Astronomy and the Sagol School of Neuroscience, recruited post-stroke patients for hyperbaric oxygen therapy (HBOT) — sessions in high pressure chambers that contain oxygen-rich air — which increases oxygen levels in the body tenfold.
Analysis of brain imaging showed significantly increased neuronal activity after a two-month period of HBOT treatment compared to control periods of non-treatment, reported Dr. Efrati in PLoS ONE. Patients experienced improvements such as a reversal of paralysis, increased sensation, and renewed use of language. These changes can make a world of difference in daily life, helping patients recover their independence and complete tasks such as bathing, cooking, climbing stairs, or reading a book.
The most common form of strokes are caused by a sudden reduction in blood flow to the brain (ischemia) that leads to an inadequate supply of oxygen and nutrients. These so-called ischemic strokes are one of the leading causes of death and disability in industrialized nations. If they are not immediately remedied by medical intervention, areas of the brain may die off. In the journal Angewandte Chemie, Korean researchers have now proposed a new approach for supplemental treatment: Ceria nanoparticles could trap the reactive oxygen compounds that result from ischemia and cause cells to die.