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Hypercapnia

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https://www.readbyqxmd.com/read/29159869/acute-intermittent-hypoxia-with-concurrent-hypercapnia-evokes-p2x-and-trpv1-receptor-dependent-sensory-long-term-facilitation-in-na%C3%A3-ve-carotid-bodies
#1
Arijit Roy, Melissa M J Farnham, Fatemeh Derakhshan, Paul M Pilowsky, Richard J A Wilson
Apneas constitute an acute existential threat to neonates and adults. In large part, this threat is detected by the carotid bodies, the primary peripheral chemoreceptors, and combatted by arousal and acute cardiorespiratory responses, including increased sympathetic output. Similar responses occur with repeated apneas but they continue beyond the last apnea and can persist for hours (i.e. ventilatory and sympathetic LTF). These long-term effects may be adaptive during acute episodic apnea, but may prolong hypertension causing chronic cardiovascular impairment...
November 21, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29158356/cerebrovascular-reactivity-and-vascular-activation-in-postmenopausal-women-with-histories-of-preeclampsia
#2
Jill N Barnes, Ronée E Harvey, Kathleen B Miller, Muthuvel Jayachandran, Katherine R Malterer, Brian D Lahr, Kent R Bailey, Michael J Joyner, Virginia M Miller
Cerebrovascular reactivity (CVR) is reduced in patients with cognitive decline. Women with a history of preeclampsia are at increased risk for cognitive decline. This study examined an association between pregnancy history and CVR using a subgroup of 40 age- and parity-matched pairs of women having histories of preeclampsia (n=27) or normotensive pregnancy (n=29) and the association of activated blood elements with CVR. Middle cerebral artery velocity was measured by Doppler ultrasound before and during hypercapnia to assess CVR...
November 20, 2017: Hypertension
https://www.readbyqxmd.com/read/29156413/anterior-posterior-gradient-differences-in-lobar-and-cingulate-cortex-cerebral-blood-flow-in-late-life-depression
#3
Margarita Abi Zeid Daou, Brian D Boyd, Manus J Donahue, Kimberly Albert, Warren D Taylor
Vascular pathology is common in late-life depression, contributing to changes in cerebral function. We examined whether late-life depression was associated with differences in cerebral blood flow (CBF) and whether such differences were related to vascular risk and cerebrovascular pathology, specifically white matter hyperintensity (WMH) volumes. Twenty-three depressed elders and 20 age- and sex-matched elders with no psychiatric history completed cranial 3T MRI. MRI procedures included a pseudo-continuous Arterial Spin Labeling (pcASL) acquisition obtained while on room air and during a hypercapnia challenge allowing for calculation of cerebrovascular reactivity (CVR)...
November 11, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/29156343/native-and-exotic-oysters-in-brazil-comparative-tolerance-to-hypercapnia
#4
Anthony Moreira, Etelvina Figueira, Iracy L Pecora, Amadeu M V M Soares, Rosa Freitas
Environmental hypercapnia in shallow coastal marine ecosystems can be exacerbated by increasing levels of atmospheric CO2. In these ecosystems organisms are expected to become increasingly subjected to pCO2 levels several times higher than those inhabiting ocean waters (e.g.: 10,000µatm), but still our current understanding on different species capacity to respond to such levels of hypercapnia is limited. Oysters are among the most important foundation species inhabiting these coastal ecosystems, although natural oyster banks are increasingly threatened worldwide...
November 17, 2017: Environmental Research
https://www.readbyqxmd.com/read/29149867/efficacy-and-safety-of-nasal-high-flow-oxygen-in-copd-patients
#5
Helene Vogelsinger, Michael Halank, Silke Braun, Heinrike Wilkens, Thomas Geiser, Sebastian Ott, Armin Stucki, Christian M Kaehler
BACKGROUND: Nasal high-flow oxygen therapy (HFOT) is a novel treatment option for patients suffering from acute or chronic respiratory failure. Aim of our study was to compare safety and efficacy of HFOT with those of conventional oxygen treatment (COT) in normo- and hypercapnic COPD patients. METHODS: A single cohort of 77 clinically stable hypoxemic patients with an indication for long-term oxygen treatment (LTOT) with or without hypercapnia successively received COT and HFOT for 60 min each, including oxygen adaption and separated by a 30 min washout phase...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29148094/acid-base-alterations-in-esrd-and-effects-of-hemodialysis
#6
REVIEW
Qi Qian
Acid-base alterations in patients with kidney failure and on hemodialysis (HD) treatment contribute to (1) intradialytic hypercapnia and hypoxia, (2) hemodynamic instability and cardiac arrhythmia, (3) systemic inflammation, and (4) a number of associated electrolyte alterations including potentiating effects of hypokalemia, hypocalcemia and, chronically, soft-tissue and vascular calcification, imparting poor prognosis and mortality. This paper discusses acid-base regulation and pathogenesis of dysregulation in patients with kidney failure...
November 16, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/29144241/shifting-risks-and-conflicting-outcomes-ecmo-for-neonates-with-congenital-diaphragmatic-hernia-in-the-modern-era
#7
Joseph W Turek, Joseph R Nellis, Brenton G Sherwood, Meera Kotagal, Andrew L Mesher, Ravi R Thiagarajan, Sonali S Patel, Jeffrey R Avansino, Peter T Rycus, D Michael McMullan, Thomas V Brogan
OBJECTIVES: To update previously described trends for neonates with congenital diaphragmatic hernia (CDH) receiving ECMO with changes in recommendations for care, and to determine how recent advancements in respiratory care have affected this patient population. STUDY DESIGN: This study is a retrospective review of more than 2500 neonates with CDH who received ECMO listed in the Extracorporeal Life Support Organization (ELSO) registry. Cochran-Armitage and multivariate regression analyses were used to analyze changes in the patient population over time and in mortality-related risk factors...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29142384/hypercapnic-respiratory-failure-in-case-of-chiari-1-5-malformation-case-report-and-review-of-the-literature
#8
Viralkumar M Vasani, Subhas Kanti Konar, S Satish
Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2 of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29125372/matched-increases-in-cerebral-artery-shear-stress-irrespective-of-stimulus-induce-similar-changes-in-extra-cranial-arterial-diameter-in-humans
#9
Kurt J Smith, Ryan L Hoiland, Ryan Grove, Hamish McKirdy, Louise Naylor, Philip N Ainslie, Daniel J Green
The mechanistic role of arterial shear stress in the regulation of cerebrovascular responses to physiological stimuli (exercise and hypercapnia) is poorly understood. We hypothesised that, if shear stress is a key regulator of arterial dilation, then matched increases in shear, induced by distinct physiological stimuli, would trigger similar dilation of the large extra-cranial arteries. Participants ( n = 10) participated in three 30-min experimental interventions, each separated by ≥48 h: (1) mild-hypercapnia (FICO2:∼0...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29122649/the-impact-of-global-hemodynamics-oxygen-and-carbon-dioxide-on-epileptiform-eeg-activity-in-comatose-survivors-of-out-of-hospital-cardiac-arrest
#10
C Moonen, R Lemmens, W Van Paesschen, A Wilmer, W Eertmans, B Ferdinande, M Dupont, C De Deyne, J Dens, S Janssens, K Ameloot
AIM: To study the association between global hemodynamics, blood gases, epileptiform EEG activity and survival after out-of-hospital CA (0HCA). METHODS: We retrospectively analyzed 195 comatose post-CA patients. At least one EEG recording per patient was evaluated to diagnose epileptiform EEG activity. Refractory epileptiform EEG activity was defined as persisting epileptic activity on EEG despite the use of 2 or more anti-epileptics. The time weighted average mean arterial pressure 48hours (TWA-MAP48), the percentage of time with a MAP below 65 and above 85mmHg and the percentage of time with normoxia, hypoxia (<70mmHg), hyperoxia (>150mmHg), normocapnia, hypocapnia (<35mmHg) and hypercapnia (>45mmHg) were calculated...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29117962/lower-cardiac-index-levels-relate-to-lower-cerebral-blood-flow-in-older-adults
#11
Angela L Jefferson, Dandan Liu, Deepak K Gupta, Kimberly R Pechman, Jennifer M Watchmaker, Elizabeth A Gordon, Swati Rane, Susan P Bell, Lisa A Mendes, L Taylor Davis, Katherine A Gifford, Timothy J Hohman, Thomas J Wang, Manus J Donahue
OBJECTIVE: To assess cross-sectionally whether lower cardiac index relates to lower resting cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) among older adults. METHODS: Vanderbilt Memory & Aging Project participants free of stroke, dementia, and heart failure were studied (n = 314, age 73 ± 7 years, 59% male, 39% with mild cognitive impairment). Cardiac index (liters per minute per meter squared) was quantified from echocardiography. Resting CBF (milliliters per 100 grams per minute) and hypercapnia-induced CVR were quantified from pseudo-continuous arterial spin-labeling MRI...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29108613/obesity-hypoventilation-syndrome-choosing-the-appropriate-treatment-of-a-heterogeneous-disorder
#12
REVIEW
Amanda J Piper, Ahmed S BaHammam, Shahrokh Javaheri
The obesity hypoventilation syndrome (OHS) is associated with significant morbidity and increased mortality compared with simple obesity and eucapnic obstructive sleep apnea. Accurate diagnosis and commencement of early and appropriate management is fundamental in reducing the significant personal and societal burdens this disorder poses. Sleep disordered breathing is a major contributor to the developmental of sleep and awake hypercapnia, which characterizes OHS, and is effectively addressed through the use of positive airway pressure (PAP) therapy...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#13
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29103805/a-genetically-defined-circuit-for-arousal-from-sleep-during-hypercapnia
#14
Satvinder Kaur, Joshua L Wang, Loris Ferrari, Stephen Thankachan, Daniel Kroeger, Anne Venner, Michael Lazarus, Andrew Wellman, Elda Arrigoni, Patrick M Fuller, Clifford B Saper
The precise neural circuitry that mediates arousal during sleep apnea is not known. We previously found that glutamatergic neurons in the external lateral parabrachial nucleus (PBel) play a critical role in arousal to elevated CO2 or hypoxia. Because many of the PBel neurons that respond to CO2 express calcitonin gene-related peptide (CGRP), we hypothesized that CGRP may provide a molecular identifier of the CO2 arousal circuit. Here, we report that selective chemogenetic and optogenetic activation of PBel(CGRP) neurons caused wakefulness, whereas optogenetic inhibition of PBel(CGRP) neurons prevented arousal to CO2, but not to an acoustic tone or shaking...
October 24, 2017: Neuron
https://www.readbyqxmd.com/read/29102173/interactive-effects-of-increased-temperature-pco2-and-the-synthetic-progestin-levonorgestrel-on-the-fitness-and-breeding-of-the-amphipod-gammarus-locusta
#15
P G Cardoso, E M Loganimoce, T Neuparth, M J Rocha, E Rocha, F Arenas
Given the lack of knowledge regarding climate change-chemical exposure interactions, it is vital to evaluate how these two drivers jointly impact aquatic species. Thus, for the first time, we aimed at investigating the combined effects of increased temperature, pCO2 and the synthetic progestin levonorgestrel on survival, growth, consumption rate and reproduction of the amphipod Gammarus locusta. For that, a full factorial design manipulating temperature [ambient temperature and warming (+4 °C)], pCO2 [normocapnia and hypercapnia (Δ pH 0...
October 25, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/29097171/the-impact-of-intermittent-or-sustained-carbon-dioxide-on-intermittent-hypoxia-initiated-respiratory-plasticity-what-is-the-effect-of-these-combined-stimuli-on-apnea-severity
#16
REVIEW
Jason H Mateika, Gino Panza, Raichel Alex, Mohamad El-Chami
The following review explores the effect that intermittent or sustained hypercapnia coupled to intermittent hypoxia has on respiratory plasticity. The review explores published work which suggests that intermittent hypercapnia leads to long-term depression of respiration when administered in isolation and prevents the initiation of long-term facilitation when administered in combination with intermittent hypoxia. The review also explores the impact that sustained hypercapnia alone and in combination with intermittent hypoxia has on the magnitude of long-term facilitation...
October 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29090956/obstructive-sleep-apnea-and-atherosclerosis-both-the-gut-microbiome-and-hypercapnia-matter
#17
Isaac Almendros, Núria Farré
No abstract text is available yet for this article.
November 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#18
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29070631/the-k%C3%A3-lliker-fuse-orchestrates-the-timing-of-expiratory-abdominal-nerve-bursting
#19
William H Barnett, Sarah E M Jenkin, William K Milsom, Julian F R Paton, Ana P L Abdala, Yaroslav I Molkov, Daniel B Zoccal
Coordination of respiratory pump and valve muscle activity is essential for normal breathing. A hallmark respiratory responses to hypercapnia and hypoxia is the emergence of active exhalation, characterized by abdominal muscle pumping during the late one-third of expiration (late-E phase). Late-E abdominal activity during hypercapnia has been attributed to the activation of expiratory neurons located within the parafacial respiratory group (pFRG). However, the mechanisms that control emergence of active exhalation, and its silencing in restful breathing, are not completely understood...
October 25, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29066879/efficacy-of-long-term-noninvasive-positive-pressure-ventilation-in-stable-hypercapnic-copd-patients-with-respiratory-failure-a-meta-analysis-of-randomized-controlled-trials
#20
Hao Liao, Wendi Pei, Hongfu Li, Yuwen Luo, Kai Wang, Rui Li, Limei Xu, Xin Chen
INTRODUCTION: The efficacy of long-term noninvasive positive pressure ventilation (NPPV) in stable hypercapnic COPD patients with respiratory failure remains unclear. The aim of this meta-analysis was to critically assess the efficacy of long-term NPPV on mortality, acute exacerbation, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange). PATIENTS AND METHODS: We performed an electronic literature search using the PubMed, Cochrane Library, Embase, OVID and Chinese Biomedical Literature Database in May 2017...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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