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It has been shown in in vitro and animal models that hypoxia can have pro-inflammatory effects and hyperoxia can have anti-inflammatory effects. The pro-inflammatory effect could be the result of activation of Hypoxia Inducible Factor, a transcription factor that is known to activate many cell systems aimed at cell survival, including the inflammatory response. The anti-inflammatory effects of hyperoxia could be the annihilation of Hypoxia Inducible Factor, but also a decrease in inflammation due to oxygen toxicity resulting in a decrease in clearance of pathogens. These effects have been sparsely studied in humans. Therefore, we hypothesize that hypoxia results in an increase in Hypoxia Inducible Factor in circulating leukocytes and increases inflammatory reactions, whereas hyperoxia decreases these reactions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hypoxia | Experimental | Subjects will be breathing an individualized mix of nitrogen and room air titrated to an oxygen saturation of 80-85%. |
|
| Hyperoxia | Experimental | Subjects will be breathing 100% of oxygen |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypoxia | Other | Subjects will be breathing an individualized mix of nitrogen and room air titrated to an oxygen saturation of 80-85%. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Hypoxia Inducible Factor 1 alpha in circulating leukocytes | Hypoxia Inducible Factor 1 alpha in circulating neutrophils, lymphocytes and monocytes as measured with flow cytometry | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Hypoxia Inducible Factor mRNA and anti Hypoxia Inducible Factor mRNA in circulating leukocytes | 24 hours | |
| Reactive Oxygen Species in circulating leukocytes | ROS in circulating leukocytes, subclassified in neutrophils and monocytes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dorien Kiers, MD | Intensive Care Medicine, Radboud University Nijmegen Medical Centre | Principal Investigator |
| Peter Pickkers, MD,PhD | Intensive Care Medicine, Radboud University Nijmegen Medical Centre | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Intensive Care Medicine, Radboud University Nijmegen Medical Centre | Nijmegen | Nijmegen, Gelderland | 6500 HB | Netherlands |
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| ID | Term |
|---|---|
| D000860 | Hypoxia |
| D018496 | Hyperoxia |
| D007249 | Inflammation |
| ID | Term |
|---|---|
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010335 | Pathologic Processes |
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| Hyperoxia | Other | Subjects will be breathing 100% oxygen |
|
| 24 hours |
| Phagocytic function of circulating leukocytes | 24 hours |
| cytokine production after ex vivo stimulation of leukocytes | 24 hours |
| circulating cytokines (including but not limited to IL-6, IL-10, IL-1RA) | 24 hours |
| Hemodynamic parameters | Blood pressure, heart frequency, cardiac output measurement | 24 hours |
| ventilatory response | Measures of ventilation: respiratory rate, blood gas changes | 24 hours |
| adenosine metabolism | urine and plasma adenosine,adenosine receptor mRNA, purines | 24 hours |
| alkaline phosphatase | 24 hours |
| cognitive function | neuropsychologic assessment of cognitive function | 24 hours |
| Hepcidin and iron parameters | 24 hours |
| catecholamines | adrenaline, noradrenaline and dopamine | 24 hours |
| Neutrophil function | 24 hours |
| body temperature | 24 hours |
| oxygen saturation and PaO2 | 24 hours |
| subjective symptoms | 24 hours |
| high sensitive troponin | 24 hours |
| iFABP | 24 hours |
| Brain specific proteins | 24 hours |
| endocan | 24 hours |
| adrenomedullin | 24 hours |
| EPO | 24 hours |
| VEGF | 24 hours |
| Heart rate variability | 24 hours |