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Hypercapnia

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https://www.readbyqxmd.com/read/29784264/stop-bang-assessment-and-postoperative-outcomes
#1
Cody D Legler
PURPOSE: Obstructive sleep apnea (OSA) is a common cause of intraoperative and postoperative complications in the surgical setting. DESIGN: Retrospective chart analysis. METHODS: Complete review of 150 patient charts over a 3-month period. FINDING: Findings indicated that of the 150 charts reviewed, 87 (58%) screened high (STOP-Bang score of 3 or greater) for OSA. Patients at a high risk for OSA preoperatively had a higher rate of postoperative complications compared with patients at low risk (79...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784025/prevalence-of-electrolyte-disturbances-in-perinatal-asphyxia-a-prospective-study
#2
Jitendra Thakur, Nisha Keshary Bhatta, Rupa Rajbhandari Singh, Prakash Poudel, Madhab Lamsal, Anjum Shakya
BACKGROUND: Birth asphyxia is defined as the presence of hypoxia, hypercapnia, and acidosis leading the newborn to systemic disturbances probably electrolyte disturbance also. Knowledge of these electrolyte disturbances is very valuable as it can be an important parameter affecting perinatal morbidity, mortality and ongoing management. METHODS: Serum sodium, potassium and ionized calcium of asphyxiated term newborn were sent within one hour of birth as per the inclusion criteria...
May 21, 2018: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29779589/chest-wall-diseases-respiratory-pathophysiology
#3
REVIEW
George E Tzelepis
The chest wall consists of various structures that function in an integrated fashion to ventilate the lungs. Disorders affecting the bony structures or soft tissues of the chest wall may impose elastic loads by stiffening the chest wall and decreasing respiratory system compliance. These alterations increase the work of breathing and lead to hypoventilation and hypercapnia. Respiratory failure may occur acutely or after a variable period of time. This review focuses on the pathophysiology of respiratory function in specific diseases and disorders of the chest wall, and highlights pathogenic mechanisms of respiratory failure...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29766685/test-retest-reliability-of-brain-mitochondrial-cytochrome-c-oxidase-assessed-by-functional-near-infrared-spectroscopy
#4
Lisa Holper, J John Mann
Functional near-infrared spectroscopy (fNIRS) is a noninvasive method for measuring in vivo both hemodynamic and mitochondrial metabolic activities in brain cortical structures. Although the test-retest reliability of the hemodynamic measures, such as reflected by oxygenated (HbO2), deoxygenated (HHb) hemoglobin, and the tissue oxygenation index (TOI), has been previously reported to be good to excellent, the reliability of the metabolic signal indexed by oxidized cytochrome-c-oxidase (oxCCO) has not been reported...
May 2018: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29766604/sodium-nitroglycerin-induces-middle-cerebral-artery-vasodilation-in-young-healthy-adults
#5
Jenna M Schulz, Baraa K Al-Khazraji, J Kevin Shoemaker
Recent evidence indicates that basal cerebral conduit vessels dilate with hypercapnia, with a nitric oxide (NO) mechanism explaining one way in which parenchymal cerebral arterioles dilate. However, whether NO affects basal cerebral artery dilation remains unknown. This study quantified the effect of an exogenous NO donor [sodium nitroglycerin (NTG); 0.4 mg sublingual spray] on the right middle cerebral artery (rMCA) cross-sectional area (CSA), blood velocity and overall blood flow. Measures of vessel CSA (7 Tesla magnetic resonance imaging) and MCA blood velocity (transcranial Doppler ultrasound) were made at baseline (BL), and following exogenous NTG or placebo (PLO) administration in young, healthy individuals (n = 10, 2 males, age range 20-23 years)...
May 15, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29746270/evidence-regarding-the-use-of-bubble-continuous-positive-airway-pressure-in-the-extremely-low-birth-weight-infant-benefits-challenges-and-implications-for-nursing-practice
#6
Samantha Alessi
BACKGROUND: Gentle ventilation with optimal oxygenation is integral to prevention of chronic lung disease in the extremely low birth-weight (ELBW) infant. Various types of noninvasive ventilation are used in neonatal intensive care units worldwide. Bubble continuous positive airway pressure (BCPAP) has been in use in newborn intensive care since 1975. PURPOSE: To synthesize the current evidence on the use of BCPAP in the ELBW infant and its relationship to outcomes, particularly morbidity and mortality...
May 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29739425/naked-mole-rat-cortical-neurons-are-resistant-to-acid-induced-cell-death
#7
Zoé Husson, Ewan St John Smith
Regulation of brain pH is a critical homeostatic process and changes in brain pH modulate various ion channels and receptors and thus neuronal excitability. Tissue acidosis, resulting from hypoxia or hypercapnia, can activate various proteins and ion channels, among which acid-sensing ion channels (ASICs) a family of primarily Na+ permeable ion channels, which alongside classical excitotoxicity causes neuronal death. Naked mole-rats (NMRs, Heterocephalus glaber) are long-lived, fossorial, eusocial rodents that display remarkable behavioral/cellular hypoxia and hypercapnia resistance...
May 9, 2018: Molecular Brain
https://www.readbyqxmd.com/read/29738908/rodent-cerebral-blood-volume-cbv-changes-during-hypercapnia-observed-using-magnetic-particle-imaging-mpi-detection
#8
Clarissa Zimmerman Cooley, Joseph B Mandeville, Erica E Mason, Emiri T Mandeville, Lawrence L Wald
Magnetic Particle Imaging (MPI) is a rapidly developing imaging modality that directly measures and maps the concentration of injected superparamagnetic iron oxide nanoparticles (SPIOs). Since the agent does not cross the blood-brain barrier, cerebral SPIO concentration provides a direct probe of Cerebral Blood Volume (CBV). Here we provide an initial demonstration of the ability of MPI to detect functional CBV changes (fCBV) by monitoring SPIO concentration during hypercapnic manipulation in a rat model. As a tracer detection method, MPI offers a more direct probe of agent concentration and therefore fCBV than MRI measurements in which the agent is indirectly detected through perturbation of water relaxation time constants such as T2 ∗ ...
May 5, 2018: NeuroImage
https://www.readbyqxmd.com/read/29732186/right-ventricular-dysfunction-during-acute-respiratory-distress-syndrome-and-veno-venous-extracorporeal-membrane-oxygenation
#9
REVIEW
Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers, Dinis Reis Miranda
Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29716909/survival-of-patients-with-severe-acute-respiratory-distress-syndrome-treated-without-extracorporeal-membrane-oxygenation
#10
Sarina K Sahetya, Roy G Brower, R Scott Stephens
BACKGROUND: Case series have reported favorable outcomes with extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome. However, those patients were generally young, with few comorbid conditions. OBJECTIVE: To characterize the clinical features and survival rates of patients with severe acute respiratory distress syndrome who met criteria for ECMO but were managed without it. METHODS: Patients who met the study criteria were identified prospectively...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29710683/aging-decreases-co2-reactivity-in-the-retinal-artery-but-not-in-the-ocular-choroidal-vessels-a-cross-sectional-study
#11
Akane Miyaji, Tsukasa Ikemura, Naoyuki Hayashi
BACKGROUND: The CO2 reactivity is often used to assess vascular function, but it is still unclear whether this reactivity is affected by aging. OBJECTIVE: To investigate the effects of aging on the CO2 reactivity in ocular and cerebral vessels, both of which are highly sensitive to hypercapnia, we compared the CO2 reactivity in the retinal artery (RA), retinal and choroidal vessels (RCV), optic nerve head (ONH), and middle cerebral artery (MCA) between young and middle-aged subjects...
April 14, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29698749/the-role-of-ca-2-and-bk-channels-of-locus-coeruleus-lc-neurons-as-a-brake-to-the-co-2-chemosensitivity-response-of-rats
#12
Ann N Imber, Luis G A Patrone, Ke-Yong Li, Luciane H Gargaglioni, Robert W Putnam
The cellular mechanisms by which LC neurons respond to hypercapnia are usually attributed to an "accelerator" whereby hypercapnic acidosis causes an inhibition of K+ channels or activation of Na+ and Ca+2 channels to depolarize CO2 -sensitive neurons. Nevertheless, it is still unknown if this "accelerator" mechanism could be controlled by a brake phenomenon. Whole-cell patch clamping, fluorescence imaging microscopy and plethysmography were used to study the chemosensitive response of the LC neurons...
April 24, 2018: Neuroscience
https://www.readbyqxmd.com/read/29697839/brain-derived-erythropoietin-protects-from-intermittent-hypoxia-induced-cardiorespiratory-dysfunction-and-oxidative-stress-in-mice
#13
Elizabeth Elliot-Portal, Sofien Laouafa, Christian Arias-Reyes, Tara Adele Janes, Vincent Joseph, Jorge Soliz
Study Objectives: Based on the fact that erythropoietin (Epo) administration in rodents protects against spatial learning and cognitive deficits induced by chronic intermittent hypoxia (CIH)-mediated oxidative damage, here we tested the hypothesis that Epo in the brain protects against cardiorespiratory disorders and oxidative stress induced by CIH in adult mice. Methods: Adult control and transgenic mice overexpressing Epo in the brain only (Tg21) were exposed to CIH (21%-10% O2-10 cycles/hour-8 hours/day-7 days) or room air...
April 25, 2018: Sleep
https://www.readbyqxmd.com/read/29696617/-clinical-and-neuropsychological-characteristics-in-congenital-central-hypoventilation-syndrome
#14
R Seijas-Gomez, B Esteso-Orduna, J Melero-Llorente, M C Fournier-Del Castillo
INTRODUCTION: Congenital central hypoventilation syndrome (CCHS) syndrome is a rare disease caused by mutations in the PHOX2B gene. Patients show a reduced response to hypercapnia and hypoxia accompanied by diffuse disturbances of the autonomic nervous system and occasionaly also disturbances in neuroimaging. A specific neuropsychological profile has not been described in children and adolescents with CCHS. CASE REPORTS: We describe three cases (aged between 4 and 19 years) with different profiles of affectation in cognitive and functionality...
May 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29691310/oxygen-drives-skeletal-muscle-remodeling-in-an-amphibious-fish-out-of-water
#15
Giulia S Rossi, Andy J Turko, Patricia A Wright
Skeletal muscle remodeling in response to terrestrial acclimation improves the locomotor performance of some amphibious fishes on land, but the cue for this remodeling is unknown. We tested the hypothesis that muscle remodeling in the amphibious Kryptolebias marmoratus on land is driven by higher O2 availability in atmospheric air, and the alternative hypothesis that remodeling is induced by a different environmental or physiological condition fish experience on land. Fish were acclimated to 28 days of air, aquatic hyperoxia, hypercapnia, hypoxia, elevated temperature, or fasting conditions...
April 24, 2018: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29690757/hypercapnia-does-not-shorten-emergence-time-from-propofol-anesthesia-a-pilot-randomized-clinical-study
#16
Ki-Hyug Kwon, Hansu Bae, Hyun Gu Kang, Junyong In
Background: The elimination of anesthetic agents is a decisive factor in the emergence from general anesthesia. In this pilot study, we hypothesized that hypercapnia would decrease the emergence time from propofol anesthesia by increasing cardiac output and cerebral blood flow. Methods: A total of 32 patients were randomly divided into two groups based on the end-tidal carbon dioxide values: 30 mmHg (the hypocapnia group) and 50 mmHg (the hypercapnia group). Propofol and remifentanil were infused to maintain a bispectral index of 40-50...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29688929/general-anesthetic-management-of-a-child-with-horseshoe-lung-and-left-lung-hypoplasia-for-cheiloplasty-a-case-report
#17
Aiji Sato Boku, Maki Morita, Haruko Ota, Yuji Kamimura, Hidekazu Ito, MinHye So, Tetsuya Tamura, Eisuke Kako, Jun Harada, Kazuya Sobue
Horseshoe lung is an extremely rare congenital malformation in which the right and left lungs are fused due to stenosis of the lung parenchyma. In anesthetic management, it is important to avoid hypoxemia and hypercapnia caused by a decline in lung capacity and functional residual capacity. A 3-year-old boy with horseshoe lung and left lung hypoplasia was scheduled to undergo cheiloplasty. Regarding respiratory management, to prevent hypoxemia and hypercapnia, we avoided intraoperative peripheral airway obstruction with positive end-expiratory pressure, set a long inspiratory phase time for sufficient alveolar expansion, and maintained sufficient gas exchange in lungs with low reserve capacity...
April 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29687909/breath-hold-diving
#18
John R Fitz-Clarke
Breath-hold diving is practiced by recreational divers, seafood divers, military divers, and competitive athletes. It involves highly integrated physiology and extreme responses. This article reviews human breath-hold diving physiology beginning with an historical overview followed by a summary of foundational research and a survey of some contemporary issues. Immersion and cardiovascular adjustments promote a blood shift into the heart and chest vasculature. Autonomic responses include diving bradycardia, peripheral vasoconstriction, and splenic contraction, which help conserve oxygen...
March 25, 2018: Comprehensive Physiology
https://www.readbyqxmd.com/read/29685533/imaging-of-adult-obstructive-sleep-apnoea
#19
REVIEW
Andy Whyte, Daren Gibson
Obstructive sleep apnoea (OSA) is characterised by recurrent upper airway collapse during sleep resulting in chronic and repetitive hypoxia, hypercapnia, subsequent arousal and fragmented sleep. Symptoms are insidious and diagnosis is usually delayed. Moderate to severe OSA has serious health implications with significant increase in all causes of mortality in patients with the condition as compared with unaffected individuals. The prevalence of OSA in the 30-70 year age group is estimated at 27% of males and 11% of females and it increases with age...
May 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29681886/importance-of-collateralization-in-patients-with-large-artery-intracranial-occlusive-disease-long-term-longitudinal-assessment-of-cerebral-hemodynamic-function
#20
Larissa McKetton, Lakshmikumar Venkatraghavan, Julien Poublanc, Olivia Sobczyk, Adrian P Crawley, Casey Rosen, Frank L Silver, James Duffin, Joseph A Fisher, David J Mikulis
Patients with large artery intracranial occlusive disease (LAICOD) are at risk for both acute ischemia and chronic hypoperfusion. Collateral circulation plays an important role in prognosis, and imaging plays an essential role in diagnosis, treatment planning, and prognosis of patients with LAICOD. In addition to standard structural imaging, assessment of cerebral hemodynamic function is important to determine the adequacy of collateral supply. Among the currently available methods of assessment of cerebral hemodynamic function, measurement of cerebrovascular reactivity (CVR) using blood oxygen level-dependent (BOLD) MRI and precisely controlled CO2 has shown to be a safe, reliable, reproducible, and clinically useful method for long-term assessment of patients...
2018: Frontiers in Neurology
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