Browsing by Author "Caulier Cisterna, Raúl"

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    Monitoring Changes in Oxygen Muscle during Exercise with High-Flow Nasal Cannula Using Wearable NIRS Biosensors
    (2023) Contreras Briceño, Felipe; Espinosa Ramírez, Maximiliano; Rivera Greene, Augusta; Guerra Venegas, Camila Isidora; Lungenstrass Poulsen, Antonia Isabel; Villagra Reyes, Victoria Paz; Caulier Cisterna, Raúl; Araneda, Oscar F.; Viscor, Ginés
    Exercise increases the cost of breathing (COB) due to increased lung ventilation (V˙ E), inducing respiratory muscles deoxygenation (∇ SmO2), while the increase in workload implies ∇ SmO2 in locomotor muscles. This phenomenon has been proposed as a leading cause of exercise intolerance, especially in clinical contexts. The use of high-flow nasal cannula (HFNC) during exercise routines in rehabilitation programs has gained significant interest because it is proposed as a therapeutic intervention for reducing symptoms associated with exercise intolerance, such as fatigue and dyspnea, assuming that HFNC could reduce exercise-induced ∇ SmO2. SmO2 can be detected using optical wearable devices provided by near-infrared spectroscopy (NIRS) technology, which measures the changes in the amount of oxygen bound to chromophores (e.g., hemoglobin, myoglobin, cytochrome oxidase) at the target tissue level. We tested in a study with a cross-over design whether the muscular desaturation of m.vastus lateralis and m.intercostales during a high-intensity constant-load exercise can be reduced when it was supported with HFNC in non-physically active adults. Eighteen participants (nine women; age: 22 ± 2 years, weight: 65.1 ± 11.2 kg, height: 173.0 ± 5.8 cm, BMI: 21.6 ± 2.8 kg·m−2) were evaluated in a cycle ergometer (15 min, 70% maximum watts achieved in ergospirometry (V˙ O2-peak)) breathing spontaneously (control, CTRL) or with HFNC support (HFNC; 50 L·min−1, fiO2: 21%, 30 °C), separated by seven days in randomized order. Two-way ANOVA tests analyzed the ∇ SmO2 (m.intercostales and m.vastus lateralis), and changes in V˙ E and ∇ SmO2·V˙ E−1. Dyspnea, leg fatigue, and effort level (RPE) were compared between trials by the Wilcoxon matched-paired signed rank test. We found that the interaction of factors (trial × exercise-time) was significant in ∇ SmO2-m.intercostales, V˙ E, and (∇ SmO2-m.intercostales)/V˙ E (p < 0.05, all) but not in ∇ SmO2-m.vastus lateralis. ∇ SmO2-m.intercostales was more pronounced in CTRL during exercise since 5′ (p < 0.05). Hyperventilation was higher in CTRL since 10′ (p < 0.05). The ∇ SmO2·V˙ E−1 decreased during exercise, being lowest in CTRL since 5′. Lower dyspnea was reported in HFNC, with no differences in leg fatigue and RPE. We concluded that wearable optical biosensors documented the beneficial effect of HFNC in COB due to lower respiratory ∇ SmO2 induced by exercise. We suggest incorporating NIRS devices in rehabilitation programs to monitor physiological changes that can support the clinical impact of the therapeutic intervention implemented.
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    Neonatal anthropometry outcomes comparing two gestational weight gain standards
    (2025) Mardones Santander, Francisco José; Rosso Rosso, Pedro Pablo; Farías Jofré, Marcelo Enrique; Ulloa, Sofía; Villarroel, Luis; Caulier Cisterna, Raúl; Miranda Hurtado, Martín Alexis; Erazo, Álvaro; Lanyon Alarcón, Glenn
    Objectives: The gestational weight gain chart published by Rosso and Mardones (RM) was used by the Ministry of Health in Argentina from the 1990s until 2009, when it was replaced by the Calvo et al. chart (CEA). This study compared the diagnostic capability of the RM and CEA charts for identifying mothers at risk of delivering babies with signs of intrauterine growth impairment (Birth length<50 cm, Birth weight <2500 g, Birth weight <3000 g and Birth weight >4000 g).Methods: Data from pregnant women and neonates studied in Santiago, Chile (n = 27,600), as well as a sub-sample of 11,465 term healthy singleton cases were utilized. Frequency distributions of women and their 95% confidence intervals were calculated for both charts at the first and third trimester of pregnancy. Sensitivity, specificity, positive and negative predictive values of undesirable outcomes of the RM and CEA charts were compared.Results: The CEA chart classified as either underweight or obese a smaller number of women than the RM chart. The proportion of neonates with signs of intrauterine growth impairment was similar in both charts, however the number of affected neonates was higher in the women considered to be either underweight or obese by the RM chart. Higher sensitivity values for undesirable outcomes were displayed by the RM chart. The sum of sensitivity and specificity was also higher for the RM chart, meaning a greater diagnostic accuracy; this sum was comparable only for birth weight <2500 g. The RM chart was found to have higher positive and negative predictive values for undesirable outcomes than the CEA chart.Conclusion: The RM chart has a better diagnostic capability than the CEA chart to identify mothers at risk of delivering babies with signs of intrauterine growth impairment.
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    Non-invasive near-infrared spectroscopy assessment of the spinal neurovascular response in a patient with transverse myelitis: a case report
    (2022) Oyarzún Isamitt, Juan Esteban; Caulier Cisterna, Raúl; González Appelgren, Juan Pablo; Gonzalez, Leticia; Trujillo, Oscar; Eblen-Zajjur, Antonio; Uribe Arancibia, Sergio A.
    Background: Transverse myelitis (TM) is characterized by acute development of motor, sensory and autonomic dysfunctions due to horizontally diffused inflammation in one or more segments of the spinal cord in the absence of a compressive lesion. The not well-known inflammation process induces demyelination resulting in neurological dysfunction. Case presentation: In this case report we used a functional Near-Infrared Spectroscopy (fNIRS) technique to evaluate changes in the peri-spinal vascular response induced by a peripheral median nerve electrical stimulation in a patient with chronic transverse myelitis (TM). fNIRS showed drastically reduced signal amplitude in the peri-spinal vascular response, compared to that obtained from a healthy control group throughout most of the C7-T1 and T10-L2 spinal cord segments. Conclusion: The potential use of this relatively non-invasive fNIRS technology support the potential clinical application of this method for functional test of the spinal cord through the assessment of the spinal neurovascular response.