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Hypoxicator | |
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Specialty | pulmonology |
A hypoxicator is a medical device intended to provide a stimulus for the adaptation of an individual's cardiovascular system by means of breathing reduced oxygen hypoxic air and triggering mechanisms of compensation. The aim of intermittent hypoxic training or hypoxic therapy conducted with such a device is to obtain benefits in physical performance and wellbeing through improved oxygen metabolism.
There are several commercial systems available. Most of these systems have not been cleared for medical applications by the FDA and are used by athletes for altitude training.
Advanced hypoxicators have a built-in pulse oximeter used to monitor and in some cases control the temporary reduction of arterial oxygen saturation that results in physiological responses evident at both systemic and cellular levels even after only a few minutes of hypoxia. [1] Hypoxic Training Index (HTi) can be used to measure the delivered therapeutic dosage over the training session.
The underlying mechanisms of adaptation to mild, non-damaging, short-term (minutes) hypoxic stress (also called - intermittent hypoxic training) are complex and diverse, [2] but are part of normal physiology and are opposite to patho-physiological effects of severe sleep apnea hypoxia.[ clarification needed ][ citation needed ]
There are a number of types of hypoxicators that can be distinguished by the method of producing hypoxic air and its delivery to the user's respiratory system. Commonly used are air separation systems employing semi-permeable membrane technology or pressure swing adsorption or (PSAS). There are also non-powered hand-held devices – rebreathers-hypoxicators.[ citation needed ]
The term hypoxicator was suggested by Russian scientists in 1985 to describe a new class of devices for Intermittent hypoxic training (IHT) –an emerging drug-free treatment for a wide range of degenerative disorders and for simulated altitude training used to achieve greater endurance performance [3] as well as offering pre-acclimatisation for mountaineers –minimising the risk of succumbing to acute mountain sickness on a subsequent ascent.
The hypoxia challenge of IHT is normally delivered in an intermittent manner: 3-7 min of hypoxic air breathing alternated with 1-5 min of normoxic or hyperoxic air. The hypoxicator allows automated and pre-programmed delivery of the required hypoxic and hyperoxic or normoxic air and safety monitoring. The therapeutic range of arterial oxygen desaturation for IHT is SpO2 = 75% - 88% and must be selected based upon the recommendation of a medical specialist.[ citation needed ]
Studies have also shown that hypoxic air treatment may increase the recovery speed and endurance of spinal cord injuries. [4]
There are no reported adverse effects associated with this kind of treatment. However, symptoms of over-training may appear as a result of abusing basic training protocols supplied by manufacturers. Products that do not offer effective and instant monitoring and control over the treatment sessions must be avoided.[ citation needed ] Pulse oximeters should be used to monitor the level of arterial oxygen saturation that is the basic measure of hypoxic training dosage. Good brands have pulse oximeters integrated into the system and the best hypoxicators are equipped with automated biofeedback hypoxic training control mechanisms.[ citation needed ]
This type of equipment has been validated as a cost-effective and safe method of assessing respiratory patients' response to the reduced levels of oxygen onboard commercial passenger flights. [5]
Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise..
Trimix is a breathing gas consisting of oxygen, helium and nitrogen and is used in deep commercial diving, during the deep phase of dives carried out using technical diving techniques, and in advanced recreational diving.
Altitude sickness, the mildest form being acute mountain sickness (AMS), is the harmful effect of high altitude, caused by rapid exposure to low amounts of oxygen at high elevation. People can respond to high altitude in different ways. Symptoms may include headaches, vomiting, tiredness, confusion, trouble sleeping, and dizziness. Acute mountain sickness can progress to high-altitude pulmonary edema (HAPE) with associated shortness of breath or high-altitude cerebral edema (HACE) with associated confusion. Chronic mountain sickness may occur after long-term exposure to high altitude.
A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas, but other mixtures of gases, or pure oxygen, are also used in breathing equipment and enclosed habitats such as scuba equipment, surface supplied diving equipment, recompression chambers, high-altitude mountaineering, high-flying aircraft, submarines, space suits, spacecraft, medical life support and first aid equipment, and anaesthetic machines.
Oxygen therapy, also known as supplemental oxygen, is the use of oxygen as medical treatment. Acute indications for therapy include hypoxemia, carbon monoxide toxicity and cluster headache. It may also be prophylactically given to maintain blood oxygen levels during the induction of anesthesia. Oxygen therapy is often useful in chronic hypoxemia caused by conditions such as severe COPD or cystic fibrosis. Oxygen can be delivered via nasal cannula or face mask, or via high pressure conditions such as in endotracheal intubation or hyperbaric chamber. It can also be given through bypassing the airway, such as in ECMO therapy.
Polycythemia is a laboratory finding in which the hematocrit and/or hemoglobin concentration are increased in the blood. Polycythemia is sometimes called erythrocytosis, and there is significant overlap in the two findings, but the terms are not the same: polycythemia describes any increase in hematocrit and/or hemoglobin, while erythrocytosis describes an increase specifically in the number of red blood cells in the blood.
Pulse oximetry is a noninvasive method for monitoring a person's oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy of the more accurate reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis. But the two are correlated well enough that the safe, convenient, noninvasive, inexpensive pulse oximetry method is valuable for measuring oxygen saturation in clinical use.
Generalized hypoxia is a medical condition in which the tissues of the body are deprived of the necessary levels of oxygen due to an insufficient supply of oxygen, which may be due to the composition or pressure of the breathing gas, decreased lung ventilation, or respiratory disease, any of which may cause a lower than normal oxygen content in the arterial blood, and consequently a reduced supply of oxygen to all tissues perfused by the arterial blood. This usage is in contradistinction to localized hypoxia, in which only an associated group of tissues, usually with a common blood supply, are affected, usually due to an insufficient or reduced blood supply to those tissues. Genralized hypoxia is also used as a synonym for hypoxic hypoxia This is not to be confused with hypoxemia, which refers to low levels of oxygen in the blood, although the two conditions often occur simultaneously, since a decrease in blood oxygen typically corresponds to a decrease in oxygen in the surrounding tissue. However, hypoxia may be present without hypoxemia, and vice versa, as in the case of infarction. Several other classes of medical hypoxia exist.
Altitude training is the practice by some endurance athletes of training for several weeks at high altitude, preferably over 2,400 metres (8,000 ft) above sea level, though more commonly at intermediate altitudes due to the shortage of suitable high-altitude locations. At intermediate altitudes, the air still contains approximately 20.9% oxygen, but the barometric pressure and thus the partial pressure of oxygen is reduced.
An altitude tent is a sealed tent used to simulate a higher altitude with reduced oxygen. Living or training at altitude causes the body to adapt to the lower oxygen content by producing more oxygen-carrying red blood cells and hemoglobin, thus causing the body to adapt to the higher altitude and enhancing performance when returning to a lower altitude. Mountain climbers can use them to avoid altitude sickness, and athletes can use them to enhance performance at lower altitudes.
Hypoxemia is an abnormally low level of oxygen in the blood. More specifically, it is oxygen deficiency in arterial blood. Hypoxemia has many causes, and often causes hypoxia as the blood is not supplying enough oxygen to the tissues of the body.
A CO-oximeter is a device that measures the oxygen carrying state of hemoglobin in a blood specimen, including oxygen-carrying hemoglobin (O2Hb), non-oxygen-carrying but normal hemoglobin (HHb), as well as the dyshemoglobins such as carboxyhemoglobin (COHb) and methemoglobin (MetHb). The use of 'CO' rather than 'Co' or 'co' is more appropriate since this designation represents a device that measures carbon monoxide (CO) bound to hemoglobin, as distinguished from simple oximetry which measures hemoglobin bound to molecular oxygen—O2Hb—or hemoglobin capable of binding to molecular oxygen—HHb. Simpler oximeters may report oxygen saturation alone, i.e. the ratio of oxyhemoglobin to total 'bindable' hemoglobin. CO-oximetry is useful in defining the causes for hypoxemia, or hypoxia,.
Freediving blackout, breath-hold blackout or apnea blackout is a class of hypoxic blackout, a loss of consciousness caused by cerebral hypoxia towards the end of a breath-hold dive, when the swimmer does not necessarily experience an urgent need to breathe and has no other obvious medical condition that might have caused it. It can be provoked by hyperventilating just before a dive, or as a consequence of the pressure reduction on ascent, or a combination of these. Victims are often established practitioners of breath-hold diving, are fit, strong swimmers and have not experienced problems before. Blackout may also be referred to as a syncope or fainting.
Masimo Corporation is a global medical technology company that develops, manufactures, and markets a variety of noninvasive patient monitoring technologies, hospital automation solutions, home monitoring devices, ventilation solutions, and consumer products. Masimo is based in Irvine, California. The company's core measurement technologies are pulse oximetry, alongside advanced Pulse CO-Oximetry measurements, brain function monitoring, regional oximetry, acoustic respiration rate monitoring, capnography, nasal high-flow respiratory support therapy, patient position and activity tracking, and neuromodulation technology for the reduction of symptoms associated with opioid withdrawal. Masimo was founded in 1989 by electrical engineer Joe Kiani, who was later joined by fellow engineer Mohamed Diab.
The Hypoxic Training index (HTi) provides an objective measure of the hypoxic stress delivered during the Intermittent Hypoxic Training (IHT) session, compared to simple recording the inhaled fraction of oxygen (FiO2). HTi provides a figure (index) of dosage received by the individual at the end of the session. Knowledge of HTi can therefore be used to alter the training regime for different individuals, compensating for individual variability, and can be used in scientific studies to ensure that subject exposure was correctly controlled.
Intermittent hypoxic training (IHT), also known as intermittent hypoxic therapy, is a technique aimed at improving human performance by way of adaptation to reduced oxygen.
Oxygen saturation is the fraction of oxygen-saturated hemoglobin relative to total hemoglobin in the blood. The human body requires and regulates a very precise and specific balance of oxygen in the blood. Normal arterial blood oxygen saturation levels in humans are 97–100 percent. If the level is below 90 percent, it is considered low and called hypoxemia. Arterial blood oxygen levels below 80 percent may compromise organ function, such as the brain and heart, and should be promptly addressed. Continued low oxygen levels may lead to respiratory or cardiac arrest. Oxygen therapy may be used to assist in raising blood oxygen levels. Oxygenation occurs when oxygen molecules enter the tissues of the body. For example, blood is oxygenated in the lungs, where oxygen molecules travel from the air and into the blood. Oxygenation is commonly used to refer to medical oxygen saturation.
Intermittent hypoxia (also known as episodic hypoxia) is an intervention in which a person or animal undergoes alternating periods of normoxia and hypoxia. Normoxia is defined as exposure to oxygen levels normally found in earth's atmosphere (~21% O2) and hypoxia as any oxygen levels lower than those of normoxia. Normally, exposure to hypoxia is negatively associated to physiological changes to the body, such as altitude sickness. However, when used in moderation, intermittent hypoxia may be used clinically as a means to alleviate various pathological conditions.
Respiratory compromise describes a deterioration in respiratory function with a high likelihood of rapid progression to respiratory failure and death. Respiratory failure occurs when inadequate gas exchange by the respiratory system occurs, with a low oxygen level or a high carbon dioxide level.
Silent hypoxia is generalised hypoxia that does not coincide with shortness of breath. This presentation is known to be a complication of COVID-19, and is also known in walking pneumonia, altitude sickness, and rebreather diving.