2023-11-30 アイルランド・リムリック大学(UL)
◆8人の被験者が通常の酸素濃度と低酸素濃度で1週間ずつ過ごす実験で、高地療法がヘモグロビンの増加を引き起こす一方で、有酸素フィットネスには大きな変化がなかったと報告されました。これは手術前の高地療法が高齢者にとって有益であり、今後の研究でその有効性が検証される可能性があります。
<関連情報>
- https://www.ul.ie/research/news/ul-research-high-altitude-training-shows-promise-for-patients-ahead-of-surgery
- https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.16158
プレリハビリテーションとしての高地トレーニングの可能性:生理学的研究 Potential for using simulated altitude as a means of prehabilitation: a physiology study
L. A. Brown, J. A. Griffiths, P. Santer, P. M. Jakeman, T. G. Smith
Anaesthesia Published: 25 October 2023
DOI:https://doi.org/10.1111/anae.16158
Summary
The current pandemic of surgical complications necessitates urgent and pragmatic innovation to reduce postoperative morbidity and mortality, which are associated with poor pre-operative fitness and anaemia. Exercise prehabilitation is a compelling strategy, but it has proven difficult to establish that it improves outcomes either in isolation or as part of a multimodal approach. Simulated altitude exposure improves performance in athletes and offers a novel potential means of improving cardiorespiratory and metabolic fitness and alleviating anaemia within the prehabilitation window. We aimed to provide an initial physiological foundation for ‘altitude prehabilitation’ by determining the physiological effects of one week of simulated altitude (FIO2 15%, equivalent to approximately 2438 m (8000 ft)) in older sedentary volunteers. The study used a randomised, double-blind, sham-controlled crossover design. Eight participants spent counterbalanced normoxic and hypoxic weeks in a residential hypoxia facility and underwent repeated cardiopulmonary exercise tests. Mean (SD) age of participants was 64 (7) y and they were unfit, with mean (SD) baseline anaerobic threshold 12 (2) ml.kg-1.min-1 and mean (SD) peak V̇O2 15 (3) ml.kg-1.min-1. Hypoxia was mild (mean (SD) SpO2 93 (2) %, p < 0.001) and well-tolerated. Despite some indication of greater peak exercise capacity following hypoxia, overall there was no effect of simulated altitude on anaerobic threshold or peak V̇O2. However, hypoxia induced a substantial increase in mean (SD) haemoglobin of 1.5 (2.7) g.dl-1 (13% increase, p = 0.028). This study has established the concept and feasibility of ‘altitude prehabilitation’ and demonstrated specific potential for improving haematological fitness. Physiologically, there is value in exploring a possible role for simulated altitude in pre-operative optimisation.
