Acute intermittent hypoxia will be provided to the subject by delivering 15 brief exposures (~60 seconds) of hypoxic air alternated with 15 brief exposures (~60 seconds) of room air. The amount of oxygen delivered during hypoxic exposures may range from 15%-9% fraction of inspired oxygen, compared to 21% oxygen in normal atmospheric air. This is followed by a 30 minute rest period and then 60 minutes of computerized cognitive training.

A sham protocol will be administered in which 21% fraction of inspired oxygen will be delivered by the hypoxicator during hypoxic intervals, and room air will be delivered through the four-way valve during room air intervals. This is followed by a 30 minute rest period and then 60 minutes of computerized cognitive training (Posit; Brain HQ).

Aging

Acute intermittent hypoxia is a safe, non-invasive technique. All sessions will be monitored by research study staff trained in delivering acute intermittent hypoxia. Hypoxic intervals will be delivered with a commercially available sports performance hypoxicator. A unit capable of delivering a fraction of inspired oxygen ranging from 21%-9% will be used. Air will be delivered into a mask that will be secured comfortably over the subject's nose and mouth. Intervention sessions will occur for 10 days over a 2 week period.

Acute Intermittent Hypoxia

60 minutes of Double Decision cognitive training for 10 days over a 2 week period.

Computerized Cognitive Training

UF Health at the University of Florida

Enhancing Cognition in Older Adults With Intermittent Hypoxia and Cognitive Training

Enhancing Cognition in Older Adults With Intermittent Hypoxia and Cognitive Training: The EXCITE Study

Determine whether training performance improves when cognitive training (CT) is coupled with intermittent hypoxia (IH). Posit Science Double Decision is designed to improve the speed and accuracy with which the brain can process visual information, both at the center of gaze and on the periphery, known as "useful field of view" (UFOV). Scored in milliseconds, where lower scores indicate better processing speeds. CT will involve up to 10 hours of training over 2-weeks (10 days) and employs a PositScience BrainHQ suite via its researcher portal

University of Florida

Anesthesia will be induced intravenously with midazolam (0.015-0.03 mg/kg), sufentanil, propofol and rocuronium.
Sevoflurane will be administered by inhalation for anesthesia maintenance. The concentration of inhaled sevoflurane will be adjusted to maintain the bispectral index (BIS) value between 40 and 60, with or without 50% nitrous oxide. Analgesia will be supplemented with remifentanil (administered by continuous infusion), sufentanil (administered by intermittent injection/continuous infusion), or fentanyl (administered by intermittent injection).
Towards the end of surgery, sevoflurane inhalational concentration will be decreased and fentanyl/sufentanil will be administered when necessary. Sevoflurane inhalation will be stopped at the end of surgery.

Anesthesia will be induced intravenously with midazolam (0.015-0.03 mg/kg), sufentanil, propofol and rocuronium.
Propofol will be administered by intravenous infusion for anesthesia maintenance. The infusion rate of propofol will be adjusted to maintain the BIS value between 40 and 60, with or without 50% nitrous oxide. Analgesia will be supplemented with remifentanil (administered by continuous infusion), sufentanil (administered by intermittent injection/continuous infusion), or fentanyl (administered by intermittent injection).
Towards the end of surgery, propofol infusion rate will be decreased and fentanyl/sufentanil will be administered when necessary. Propofol infusion will be stopped at the end of surgery.

Long-term Effects Secondary to Cancer Therapy in Adults

Sevoflurane will be administered by inhalation for anesthesia maintenance. The concentration of inhaled sevoflurane will be adjusted to maintain the BIS value between 40 and 60, with or without 50% nitrous oxide. Sevoflurane inhalational concentration will be decreased towards the end of surgery. Sevoflurane inhalation will be stopped at the end of surgery.

Sevoflurane

Propofol will be administered by intravenous infusion for anesthesia maintenance. The infusion rate of propofol will be adjusted to maintain the BIS value between 40 and 60, with or without 50% nitrous oxide. Propofol infusion rate will be decreased towards the end of surgery. Propofol infusion will be stopped at the end of surgery.

Propofol

Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital

Beijing Shijitan Hospital

Peking University Cancer Hospital

University School and Hospital of Stomatology

Cancer Hospital of Guangxi Medical University

Shenzhen Second People's Hospital

Guizhou Provincial People's Hospital

Hebei Medical University Forth Hospital

The First Affiliated Hospital of Zhengzhou University

The Third Xiangya Hospital of Central South University

Zhongda Hospital

Ningxia People's Hospital

Affiliated Hospital of Qinghai University

Tang-Du Hospital

Shaanxi Provincial People's Hospital

Shanxi Province Cancer Hospital

Tianjin Nankai Hospital

Impact of Anesthesia Maintenance Methods on Long-term Survival Rate

Impact of Inhalational Versus Intravenous Anesthesia Maintenance Methods on Long-term Survival Rate in Elderly Patients After Cancer Surgery: an Open-label, Randomized Controlled Trial

Duration of survival within 3 years after surgery

Survival rates at different timepoints after surgery

Duration of recurrence-free survival within 3 years after surgery

Recurrence-free survival rates at different timepoints after surgery

Quality of life is assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

Cognitive function is assessed with the Telephone Interview for Cognitive Status-Modified (TICS-m)

Dong-Xin Wang

Professor and Chairman, Department of Anesthesiology and Critical Care Medicine

Peking University First Hospital

Hebei Medical University Fourth Hospital

The People's Hospital of Ningxia

Peking University Hospital of Stomatology

Beijing Cancer Hospital

children aged 0-5 years who received general anesthesia and developed perioperative desaturation

children aged 0-5 years who received general anesthesia and did not developed perioperative desaturation

Low IQ

Disorder of Growth and Development

children aged 0-5 years old who receive general anesthesia and developed perioperative desaturation

perioperative desaturation

children aged 0-5 years who did not developed perioperative desaturation under general anesthesia

no perioperative desaturation

Prince of Songkla University

Growth and Intelligence Outcome in Children Who Developed Perioperative Desaturation

Possible Effect of Peri-operative Desaturation on Growth and Intelligence Outcome in Children Undergone General Anesthesia at a Tertiary Care Hospital in Southern Thailand

gaba/hypoxia

Enhancing Cognition in Older Adults With Intermittent Hypoxia and Cognitive Training

Impact of Anesthesia Maintenance Methods on Long-term Survival Rate

Growth and Intelligence Outcome in Children Who Developed Perioperative Desaturation

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