Effect of Hypercapnia Treatment on Respiratory Recovery after Spinal Cord Injury

高碳酸血症治疗对脊髓损伤后呼吸恢复的影响

• 批准号: 10589975
• 负责人: Abdulghani Sankari
• 金额: --
• 依托单位: JOHN D DINGELL VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10589975
• 关键词: Acute; Address; Adherence; Affect; Alveolar; Animals; Breathing; Carbon Dioxide; Cardiovascular system; Caring; Cause of Death; Cervical; Cervical spinal cord injury; Chemical Stimulation; Chronic; Clinical; Clinical Trials; Cognition; Disease; Dropout; Educational Intervention; Enrollment; Exercise; Feasibility Studies; Future; General Population; Health; Heart Diseases; High Prevalence; Human; Hypercapnia; Hypertension; Hypoxia; Impairment; Individual; Injury; Innovative Therapy; Institutional Review Boards; Integrated Health Care Systems; Intervention; Knowledge; Life; Link; Measures; Mechanics; Minority Groups; Mission; Morbidity - disease rate; Motor; Multiple Sclerosis; Muscle; Nerve; Neuromuscular Diseases; Outcome; Paresis; Patients; Personal Satisfaction; Persons; Pilot Projects; Placebos; Polysomnography; Population; Quality of life; Recovery; Reporting; Research; Research Project Grants; Resources; Respiration Disorders; Respiratory Diaphragm; Respiratory Muscles; Respiratory Paralysis; Respiratory Signs and Symptoms; Respiratory physiology; Role; Sample Size; Severities; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Social Functioning; Spinal cord injury; Spinal cord injury patients; Stroke; Structure; Symptoms; Techniques; Testing; Therapeutic Intervention; Thoracic Injuries; Tissues; Training; United States; Ventilator; Veterans; Wakefulness; Withdrawal; acceptability and feasibility; arm; base; cardiovascular effects; exercise rehabilitation; feasibility testing; follow-up; functional improvement; improved; improvement on sleep; innovation; interest; mechanical device; mortality; motor recovery; muscle strength; novel; novel strategies; novel therapeutic intervention; novel therapeutics; pressure; prevent; programs; psychologic; randomized controlled design; recruit; respiratory; ventilation

Project Summary Abstract Title: Effect of Hypercapnia Treatment on Respiratory Recovery after Spinal Cord Injury. Respiratory and cardiovascular complications are the most common causes of death in the first year post-injury. Nearly 80% of patients with SCI, including Veterans, suffer from breathing and sleep disorders after six months of injury. However, most patients with SCI do not tolerate standard mechanical treatment leading to a lack of adherence. Therefore, identifying other therapies is important for this common condition linked to poor outcomes in the general population (heart disease, stroke, hypertension, and poor cognition). In individuals with SCI, it has been reported that chemical stimulation using acute intermittent hypoxia techniques improves ventilatory and motor recovery. The effect of intermittent hypoxia is dependent on the level of alveolar Carbon Dioxide (CO2) and may pose undesirable cardiovascular effects. However, the effect of hypercapnia alone on respiratory recovery during wakefulness and sleep in patients with SCI is unknown. The purpose of this application is to identify new therapeutic interventions for respiratory and sleep disorders in Veterans with SCI. This application proposes a pilot study to enroll 30 Veterans with SCI to receive two weeks of daily acute intermittent hypercapnia (dAIHc) treatment. There will be three specific aims to address the following hypotheses: Specific Aim (1): Measure the recruitment rate and feasibility of a pilot intervention using dAIHc in individuals with SCI. Specific Aim (2): Test the hypothesis that dAIHc will increase minute ventilation and respiratory muscle forces in individuals with SCI. Specific Aim (3): Test the hypothesis that dAIHc will improve sleep parameters in individuals with SCI.

项目摘要摘要 高碳酸血症治疗对脊髓损伤后呼吸功能恢复的影响 受伤。 呼吸道和心血管并发症是#年最常见的死亡原因。 受伤后的第一年。包括退伍军人在内的近80%的脊髓损伤患者患有 受伤六个月后出现呼吸和睡眠障碍。然而，大多数患有 SCI不能耐受标准的机械治疗，导致缺乏依从性。 因此，确定其他治疗方法对于这种与 一般人群的不良结局(心脏病、中风、高血压和贫困 认知)。据报道，在患有脊髓损伤的个体中，化学刺激使用 急性间歇性低氧技术可改善呼吸和运动恢复。这个 间歇性低氧的影响取决于肺泡二氧化碳(CO2)的水平 并可能造成不良的心血管影响。然而，高碳酸血症的影响 在脊髓损伤患者清醒和睡眠期间单独进行呼吸恢复是 未知。 这项应用的目的是确定新的呼吸道治疗干预措施。 以及患有脊髓损伤的退伍军人的睡眠障碍。这项申请提出了一项试点研究，以 招募30名患有脊髓损伤的退伍军人接受两周的每日急性间歇性高碳酸血症 (DAIHc)治疗。将有三个具体目标来解决以下假设： 具体目标(1)：衡量招聘率和试点干预的可行性 在脊髓损伤患者中使用dAIHc。 具体目标(2)：检验dAIHc将增加每分钟通气量和 脊髓损伤患者的呼吸肌力量。 具体目标(3)：测试dAIHc将改善睡眠参数的假设 患有脊髓损伤的个体。