Study of acute hypoxia markers in healthy subjects: Utility in post-crash investigation

Publication date: Available online 19 June 2017
Source:Medical Journal Armed Forces India
Author(s): S.R. Santhosh, S. Sampath, P. Sannigrahi, A. Gupta, D.K. Khukhar
BackgroundLactic acid is being routinely used as a marker of hypoxia in aircrash investigation. Since lactic acid estimation as a marker of hypoxia in postmortem samples for aircrash investigation is prone to many interfering factors, like the postmortem production and hemolysis. A study was carried out to evaluate other hypoxia markers other than lactic acid which could be later added as markers of hypoxia in postmortem investigations of aircraft accidents.Methods25 healthy males of age 20–40 yrs volunteered participants were subjected to an simulated altitude of 15,000ft for 30min and the mean plasma concentration of Hypoxia Inducing Factor 1α (HIF 1α), Erythropoietin (EPO), Vascular Endothelial Growth Factor (VEGF) and lactic acid (LA) were analyzed from their venous blood sample collected at 4 intervals viz. Ground level pre exposure, 15,000ft at 15min, 15,000ft at 30min and Ground level 3h post exposure.ResultsStatistical analysis revealed significant increase in mean plasma concentration of lactic acid, HIF-1α and EPO on exposure for duration of 15min and 30min at an altitude of 15,000ft.ConclusionOur study reveals that HIF-1α and EPO are sensitive to hypoxia exposure as compared to lactic acid and can be used in association with LA as hypoxia markers. However stability of these proteins in postmortem conditions needs to be studied and the potential for estimation of mRNA transcripts of HIF-1α and EPO, which would be stable in postmortem conditions, can be explored.



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