Dalgıçlarda apneye bağlı vazomotor reaksiyonun transkranyal Doppler ile değerlendirilmesi
Küçük Resim Yok
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dalmanın, disbarik osteonekrozdan dekompresyon hastalığı sonrası oluşan kalıcı nörolojik defisite kadar uzun dönem zararlı etkileri olmaktadır. Soluk tutma ile oluşan hiperkapni, serebral kan akım hızlarında değişikliğe neden olmakta ve hiperkapnik serebrovasküler reaktivite, tekrarlayan apnelerin sonucu olarak obstrüktif uyku apnesi ve konjestif kalp hastalığında azalmaktadır. Dalgıçlarda da istemli nefes tutma sonucu tekrarlayan apne periyotlarına benzer ataklar olmakta ve hiperkapniye sekonder serebrovasküler reaktivite azalmaktadır.Bu amaçla apnelerin, hiperkapniye karşı gelişen serebrovasküler reaktiviteyi azalttığı hipotezini, nefes tutan dalgıçlar ile dalgıç olmayanların hiperkapniye verdiği solunumsal cevaptaki değişimlerin, orta serebral arter hızındaki değişimleri değerlendirmek için bu çalışmayı gerçekleştirdik.Çalışmamız, Mayıs 2010 ve Ağustos 2010 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı'nda gerçekleştirildi. Çalışmaya, 20 denek ve 20 kontrol grubu olarak toplam 40 olgu alındı. Deneklerin yaş ortalaması 30.9±6.11 yıl (24-49), kontrol grubunun yaş ortalaması 30.8±6.10 yıl (22-40) olarak hesaplandı. Deneklerin orta serebral arter ortalama akım hızı değerlerinde dalış öncesi ve sonrasında fark olmadığı; orta serebral arter sistolik ve diastolik akım hız değerlerinin değişmediği; dalış öncesi ve sonrası arteryel tansiyon ve nabız değerlerinin değişmediği; dalış öncesi ve sonrası nefes tutmalı indeks değerlerinin etkilenmediği; orta serebral arter pulsatil indeks değerlerinin değişmediği tespit edildi. Dalış öncesi denek grubunda orta serebral arter nefes tutmalı indeks değerlerinin kontrol grubuna kıyasla daha yüksek hesaplandı.Sonuçta; dalgıçlarda dalış öncesi ve sonrasında orta serebral arter ortalama, sistolik ve diastolik akım hızlarının, arteryel kan basıncı ve nabzın, orta serebral arter nefes tutmalı indeks ve pulsatil indeks değerlerinin değişmediği, kontrol grubu olgularına göre denek grubunda dalış öncesi orta serebral arter nefes tutmalı indeks değerinin belirgin derecede yüksek çıktığı tespit edildi.Anahtar kelimeler: Dalgıç, serebral vazomotor reaktivite, transkranial doppler, nefes tutmalı indeks.
Diving has several long-term detrimental impacts from dysbaric osteonecrosis to the permanent neurological deficit that developed after decompression disease. Hypercapnia as a result of breath-holding causes differences in cerebral perfusion velocity gradient and hypercapnic cerebrovascular reactivity that ensues from repeating apneas, decreases in obstructive sleep apnea and congestive heart disease. Attacks that are similar to repeating apnea periods, as a result of volunteer breath holding also occur and cerebrovascular reactivity that developed secondarily to the hypercapnia decreases in divers.The aim of this study is to assess the changes in velocity of middle cerebral artery that caused by changes in respiratory response to the hypercapnic environment which develops in divers or non-divers who hold their breath and to evaluate the hypotesis of apneas decrease the cerebrovascular reactivity which reacts against hypercapnia.Our study was conducted in Department of Neurology of Trakya University School of Medicine Faculty between May, 2010 and August, 2010. A total of 40 individuals, 20 subjects and 20 control group are received to the research. Mean age was 30.9±6.11 years (24 to 49) in subject group and 30.8±6.10 years in control group (22 to 40). It is found that there was no significant difference with respect to mean flow velocity gradient in middle cerebral artery before and after diving, systolic and diastolic middle cerebral artery velocity values did not change, arterial tension and arterial pulsation values did not change before and after diving, breath holding index values were not affected before and after diving, middle cerebral artery pulsatile index values did not change in subject group. It was calculated that middle cerebral artery breath holding index values in subject group was higher than control group before diving.In conclusion, we explored that mean systolic and diastolic values of middle cerebral artery velocity, arterial blood pressure and pulsation, breath holding index and pulsatile index values of middle cerebral artery did not change before and after diving in divers, but breath holding index value of middle cerebral artery was significantly higher in subject group than control group.Key words: Diver, cerebral vasomotor reactivity, transcranial doppler, breath holding index.
Diving has several long-term detrimental impacts from dysbaric osteonecrosis to the permanent neurological deficit that developed after decompression disease. Hypercapnia as a result of breath-holding causes differences in cerebral perfusion velocity gradient and hypercapnic cerebrovascular reactivity that ensues from repeating apneas, decreases in obstructive sleep apnea and congestive heart disease. Attacks that are similar to repeating apnea periods, as a result of volunteer breath holding also occur and cerebrovascular reactivity that developed secondarily to the hypercapnia decreases in divers.The aim of this study is to assess the changes in velocity of middle cerebral artery that caused by changes in respiratory response to the hypercapnic environment which develops in divers or non-divers who hold their breath and to evaluate the hypotesis of apneas decrease the cerebrovascular reactivity which reacts against hypercapnia.Our study was conducted in Department of Neurology of Trakya University School of Medicine Faculty between May, 2010 and August, 2010. A total of 40 individuals, 20 subjects and 20 control group are received to the research. Mean age was 30.9±6.11 years (24 to 49) in subject group and 30.8±6.10 years in control group (22 to 40). It is found that there was no significant difference with respect to mean flow velocity gradient in middle cerebral artery before and after diving, systolic and diastolic middle cerebral artery velocity values did not change, arterial tension and arterial pulsation values did not change before and after diving, breath holding index values were not affected before and after diving, middle cerebral artery pulsatile index values did not change in subject group. It was calculated that middle cerebral artery breath holding index values in subject group was higher than control group before diving.In conclusion, we explored that mean systolic and diastolic values of middle cerebral artery velocity, arterial blood pressure and pulsation, breath holding index and pulsatile index values of middle cerebral artery did not change before and after diving in divers, but breath holding index value of middle cerebral artery was significantly higher in subject group than control group.Key words: Diver, cerebral vasomotor reactivity, transcranial doppler, breath holding index.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Nöroloji, Neurology ; Radyoloji ve Nükleer Tıp
