The Effection Of Pressure Support On Plateau Hypoxia

Objective: To discuss the effects of repeatedly coming and going to the 4776m altitude from 2880m on the serum enzymes (AST, ALT, ALP, TBIL, DBIL, CK, CK-MB and HBDH) and blood cells (Hb, RBC, MCV, WBC and PLT).Methods: 80 healthy male were observed who were divided into control group(40) and experimental group(40) at random. The control group continued to live and work at 2880m altitude whose serum was collecting at the beginning. The experimental group repeatedly coming and going to the 4776m altitude from 2880m ,the wey is working at 4776 m four weeks→return to 2880m and work eight weeks→reentering to 4776m Four weeks. The labor intensity of two groups in 2880m altitude is quite,but higher than 4776m.The serum of experimental group was collecting at the eighth week in 2880m, at the first week and the fouth week when reentering to 4776m.Results: (1) Compared with the control group AST, ALT, ALP, TBIL, CK-MB and HBDH increased significantly when returned to 4776m 1week (P <0.05),comparing with the first week CK,CK-MB,HBDH,ALP,TBIL and DBIL decreased sign- Ificantly (P <0.05). (2) Compared with the control group, AST, ALT, ALP, TBIL, DBIL and HBDH had no significant difference (P> 0.05)when return to 2880 m 8 weeks from 4776 m . (3) Compared with the control group WBC, RBC, PLT, Hb and MCV had no significant change at the first week in 4776 m, but WBC, RBC, Hb and MCV increased significantly (P <0.05) and PLT decreased significantly (P <0.05 ) at the fourth week. (4) Compared with the control group WBC, RBC, PLT, Hb and MCV had no difference at the eighth week in 2880 m (P> 0.05). Conclusion: Although the plateau migrants who repeatedly coming and going to 4776m altitude form 2880m repeatedly. But their liver function and myocardial tissue will still suffering from greater damage when they returning to 4776m altitude form 2880m again.When they lived 4776 m four weeks their Enzyme decreased to the level of these who had lived 2880m two years.Part two The effection of pressure support on plateau hypoxiaObjective: To observe and compare the effects of different interventions on alleviating plateau hypoxia at high altitude.Methods: 45 healthy male were observed at two altitudes( 2880m and 3996m)who were divided into oxygen inhalation group, Single-soldier oxygen increasing respirator(SOIR)group and BIPAP group at random. Oxygen inhalation group was treated with oxygen inhalation via nasal by 2 L / min. SOIR was used to assist gas exchange in SOIR group. BIPAP group were treated with bi-level of non-invasive positive pressure ventilation, with pressure support level at IPAP 10cmH2O, EPAP 4cmH2O. Arterial oxygen partial pressure(PaO2),carbon dioxide partial pressure(PaCO2),oxygen saturation(SpO2)and heart rate (HR) were measured before and 30 minutes after treatment.Results: (1) Inhaling oxygen and non-invasive positive pressure ventilation can improve PaO2 and SpO2 significantly at 2880m altitude, but Single-soldier oxygen increasing respirator ( SOIR ) had no effection.(2) Inhaling oxygen and non-invasive positive pressure ventilation can improve PaO2 and SpO2 significantly at 3996m altitude, but SOIR had no effection.Conclusion: BIPAP can improve PaO2 and SpO2 of human on the plateau at 2880m and 3992m altitude,but SOIR can not.Part three Developing, testing and preliminary applicating the hyperbaric cabinObjective: To develope a kind of hyperbaric cabin and test the effects of the hyperbaric cabin of the oxygenation on plains.Methods: (1) Testing the performance of hyperbaric cabin: Entered hyperbaric cabin and recorded the noise, pressure and temperature before pressurization. Recorded the corresponding time, noise and temperature when the Pressure increased every 0.01MPa untill the pressure reached balance. Opened the door between the main cabin and the transitive cabin when the pressure of the main cabin finished. Recorded the time when the pressure reached balance then closed the door between the main cabin and the transitive cabin. Opened the cabin's door and recorded the decompression time of hyperbaric cabin. (2) 16 healthy rabbits were divided into control group and experimental group at random,which were all implemented with endotracheal intubation and carotid arteries indwelling catheter at anesthesia. The arterial blood gas of the control group and experimental group were observed at 0 min, 30min and 60min when they were Placed at room and hyperbaric cabin after operation. Respiratory rate (RR) and blood pressure (BP) were also monitored in both groups when arterial blood gas was measured. After experiment the animals were killed and the serum and lung tissue were collecting. (3) 8 healthy volunteers whose arterial oxygen partial pressur(ePaO2),oxygen saturation(SpO2),carbon dioxide partial pressure(PaCO2)and pH (PH) values were measured before and 60 minutes after entering hyperbaric cabin (cabin pressure differential of 0.03 Mpa)were observed. Meanwhile,blood pressure (BP), heart rate (HR) and respiratory rate (RR) were also measured before and 30 minutes, 60 minutes after entering hyperbaric cabin.Results: (1) The maximum pressure of hyperbaric cabin was 0.03 Mpa, the intensity of noise fluctuated between 66 and 69 dB. The difference of temperature was about 1.50C before and after compression.The time was about 170 seconds when the pressure reached balance between the main cabin and the transitive cabin. The decompression time of hyperbaric cabin is about 120 seconds.(2) PaO2 was rised from 68.63±3.89mmHg to 120.63±8.42mmHg at 30 minutes in experimental group. (3) PaO2 was rised from 65.88±7.30mmHg to 79.88±6.40mmHg in control group,meanwhile PaO2 did not change significantly at 60 minutes than 30 minutes in Both groups (P>0.05). (4)PaCO2,BP and RR did not change significantly also in the testing process in Both groups(P>0.05).(5) PaO2 was rised from 96.38±9.80 mmHg to 150.14±17.48 mmHg at 60 minutes after entering hyperbaric, however PaCO2, BP, RR and HR did not change significantly.Conclusion: (1)The pressure of hyperbaric cabin can reach 0.03 MPa in a short time, while the safety and comfort are good. (2)Hyperbaric cabin could improve PaO2 of rabbits remarkedly and had no effects on PaCO2, BP and RR under Increasing the pressure of 0.03 MPa. (3)Hyperbaric cabin could improve PaO2 of healthy volunteers remarkedly and had no effection on PaCO2, BP, RR and HR under Increasing the pressure of 0.03 MPa.