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Hypercapnia

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https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#1
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28328587/bedside-breath-wise-visualization-of-bronchospasm-by-electrical-impedance-tomography-could-improve-perioperative-patient-safety-a-case-report
#2
Pedro de la Oliva, Andreas D Waldmann, Stephan H Böhm, Cristina Verdú-Sánchez, Antonio Pérez-Ferrer, Elena Alvarez-Rojas
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28324779/frontocingulate-cerebral-blood-flow-and-cerebrovascular-reactivity-associated-with-antidepressant-response-in-late-life-depression
#3
Margarita Abi Zeid Daou, Brian D Boyd, Manus J Donahue, Kimberly Albert, Warren D Taylor
BACKGROUND: Vascular pathology is common in late-life depression (LLD) and may contribute to alterations in cerebral blood flow (CBF) and cerebrovascular reactivity (CVR). In turn, such hemodynamic deficits may adversely affect brain function and clinical course. The goal of this study was to examine whether altered cerebral hemodynamics in depressed elders predicted antidepressant response. METHODS: 21 depressed elders completed cranial 3T MRI, including a pseudo-continuous Arterial Spin Labeling (pcASL) acquisition on both room air and during a hypercapnia challenge...
March 16, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28323759/hypercapnia-caused-by-a-therapeutic-dosage-of-pregabalin-in-a-tetraplegic-patient-with-cervical-spinal-cord-injury
#4
Kyung Hee Do, Eun Jung Choi, Min Cheol Chang, Hea-Eun Yang
Pregabalin is often used for the treatment of neuropathic pain in patients with spinal cord injury (SCI). We reported a patient with C5 [S(C5/C6)] ASIA Impairment Scale C SCI due to cervical myelopathy who presented CO2 retention when taking a therapeutic dosage of pregabalin. An 88-year-old patient with cervical SCI was transferred to the department of physical medicine and rehabilitation. When he had transferred, his neuropathic pain had been treated with 150-mg pregabalin per day (75 mg twice a day); however, he still exhibited severe neuropathic pain with a Numeric Pain Rating Scale score of 7 to 8...
March 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28323164/mapping-the-pharmacological-modulation-of-brain-oxygen-metabolism-the-effects-of-caffeine-on-absolute-cmro2-measured-using-dual-calibrated-fmri
#5
Alberto Merola, Michael A Germuska, Esther Ah Warnert, Lewys Richmond, Daniel Helme, Sharmila Khot, Kevin Murphy, Peter J Rogers, Judith E Hall, Richard G Wise
This study aims to map the acute effects of caffeine ingestion on grey matter oxygen metabolism and haemodynamics with a novel MRI method. Sixteen healthy caffeine consumers (8 males, age = 24.7±5.1) were recruited to this randomised, double-blind, placebo-controlled study. Each participant was scanned on two days before and after the delivery of an oral caffeine (250mg) or placebo capsule. Our measurements were obtained with a newly proposed estimation approach applied to data from a dual calibration fMRI experiment that uses hypercapnia and hyperoxia to modulate brain blood flow and oxygenation...
March 17, 2017: NeuroImage
https://www.readbyqxmd.com/read/28306210/benchmarking-transverse-spin-relaxation-based-oxygenation-measurements-in-the-brain-during-hypercapnia-and-hypoxia
#6
Wendy W Ni, Thomas Christen, Greg Zaharchuk
PURPOSE: To simultaneously assess reproducibility of three MRI transverse relaxation parameters ( R2', R2*, and R2 ) for brain tissue oxygenation mapping and to assess changes in these parameters with inhalation of gases that increase and decrease oxygenation, to identify the most sensitive parameter for imaging brain oxygenation. MATERIALS AND METHODS: Forty-eight healthy subjects (25 male, ages 35 ± 8 years) were scanned at 3.0 Tesla, each with one of four gases (mildly and strongly hypercapnic and hypoxic) administered in a challenge paradigm, using a gas delivery setup designed for patient use...
March 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28302375/risk-factors-for-unplanned-transfer-to-the-intensive-care-unit-after-emergency-department-admission
#7
Lena M Boerma, Eef P J Reijners, Roger A P A Hessels, Martijn A A V Hooft
INTRODUCTION: Unplanned Intensive Care Unit (ICU) admission has been used as a surrogate marker of adverse events, and is used by the Australian Council of Healthcare Accreditation as a reportable quality indicator. If we can identify independent variables predicting deterioration which require ICU transfer within 24h after emergency department (ED) admission, direct ICU admission should be considered. This may improve patient safety and reduce adverse events by appropriate disposition of patients presenting to the ED...
March 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283852/short-term-general-anesthesia-for-retro-bulbar-block-in-ophthalmic-surgery-generates-no-significant-hypercapnia
#8
Werner Baulig, Monica Weber, Beatrice Beck-Schimmer, Oliver M Theusinger, Peter Biro
To assess the impact of short time hypnosis for retro-bulbar anesthesia on ventilation in patients undergoing ophthalmic surgery of the anterior eye chamber. In all patients, a combined continuous transcutaneous carbon dioxide tension (PtcCO2) and partial oxygen saturation (SpO2) measurement was applied in addition to routine monitoring. To enable unconscious application of retro-bulbar anesthesia, intravenous thiopental was given in one to multiple bolus doses. Transient breathing support included chin lift, Esmarch maneuver and manual hand-bag ventilation via face mask...
March 11, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28282963/multimodal-brain-imaging-with-magnetoencephalography-a-method-for-measuring-blood-pressure-and-cardiorespiratory-oscillations
#9
Teemu Myllylä, Norman Zacharias, Vesa Korhonen, Aleksandra Zienkiewicz, Hermann Hinrichs, Vesa Kiviniemi, Martin Walter
Studies with magnetoencephalography (MEG) are still quite rarely combined simultaneously with methods that can provide a metabolic dimension to MEG investigations. In addition, continuous blood pressure measurements which comply with MEG compatibility requirements are lacking. For instance, by combining methods reflecting neurovascular status one could obtain more information on low frequency fluctuations that have recently gained increasing interest as a mediator of functional connectivity within brain networks...
December 2017: Scientific Reports
https://www.readbyqxmd.com/read/28279732/intra-individual-variability-in-cerebrovascular-and-respiratory-chemosensitivity-can-we-characterize-a-chemoreflex-reactivity-profile
#10
Kennedy J Borle, Jamie R Pfoh, Lindsey M Boulet, Maria Abrosimova, Michael M Tymko, Rachel J Skow, Amy Varner, Trevor A Day
Intra-individual variability in the magnitude of human cerebrovascular and respiratory chemoreflex responses is largely unexplored. By comparing response magnitudes of cerebrovascular CO2 reactivity (CVR; middle and posterior cerebral arteries; MCA, PCA), central (CCR; CO2) and peripheral respiratory chemoreflexes (PCR; CO2 and O2), we tested the hypothesis that a within-individual reactivity magnitude profile could be characterized. The magnitudes of CVR and CCR were tested with hyperoxic rebreathing and PCR magnitudes were tested through transient respiratory tests (TT-CO2, hypercapnia; TT-N2, hypoxia)...
March 6, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28267435/-the-right-ventricle-in-acute-respiratory-distress-syndrome
#11
REVIEW
Vasileios Zochios, Ken Parhar, William Tunnicliffe, Andrew Roscoe, Fang Gao
Acute respiratory distress syndrome is associated with poor clinical outcomes with a pooled mortality rate of approximately 40% despite best standards of care. Current therapeutic strategies are based upon improving oxygenation and pulmonary compliance while minimizing ventilator induced lung injury. It has been demonstrated that relative hypoxemia can be well tolerated and improvements in oxygenation do not necessarily translate into survival benefit. Cardiac failure, in particular right ventricular dysfunction, is commonly encountered in moderate to severe acute respiratory distress syndrome and is reported to be one of the major determinants of mortality...
March 3, 2017: Chest
https://www.readbyqxmd.com/read/28267376/favorable-neurocognitive-outcome-with-low-tidal-volume-ventilation-after-cardiac-arrest
#12
Jeremy R Beitler, Tiffany Bita Ghafouri, Sayuri P Jinadasa, Ariel Mueller, Leeyen Hsu, Ryan J Anderson, Jisha Joshua, Sanjeev Tyagi, Atul Malhotra, Rebecca E Sell, Daniel Talmor
RATIONALE: Neurocognitive outcome after out-of-hospital cardiac arrest (OHCA) often is poor even when initial resuscitation succeeds. Lower tidal volumes (VT) attenuate extrapulmonary organ injury in other disease states and are neuro-protective in preclinical models of critical illness. OBJECTIVE: To evaluate the association between VT and neurocognitive outcome following OHCA. METHODS: Propensity-adjusted analysis of two-center retrospective cohort of OHCA patients who received mechanical ventilation for at least the first 48 hours of hospitalization...
March 7, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28259372/-gas-tamponade-following-intraoperative-pneumothorax-on-a-single-lung-a-case-study
#13
S D El Jaouhari, O Mamane Nassirou, M Meziane, M Bensghir, C Haimeur
Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation...
March 1, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28254864/arterial-co2-as-a-potent-coronary-vasodilator-a-preclinical-pet-mr-validation-study-with-implications-for-cardiac-stress-testing
#14
Hsin-Jung Yang, Damini Dey, Jane Sykes, Michael Klein, John Butler, Michael Kovacs, Olivia Sobczyk, Behzad Sharif, Xiaoming Bi, Avinash Kali, Ivan Cokic, Richard Tang, Roya Yumul, Antonio Conte, Sotirios Tsaftaris, Mourad Tighiouart, Debiao Li, Piotr J Slomka, Daniel Berman, Frank Prato, Joseph Fisher, Rohan Dharmakumar
Myocardial blood flow (MBF) is the critical determinant of cardiac function. However, its response to increases in partial pressure of arterial CO2 (PaCO2), particularly with respect to adenosine, is not well characterized due to challenges in blood gas control and limited availability of validated approaches to ascertain MBF in vivo. By prospectively and independently controlling PaCO2 and combining it with (13)N-ammonia Positron Emission Tomography (PET) measurements, we investigated whether a physiologically tolerable hypercapnic stimulus (~25-mmHg increase in PaCO2) can increase MBF to that observed with adenosine in three groups of canines: (i) without coronary stenosis; (ii) subjected to non-flow limiting coronary stenosis; and (iii) following pre-administration of caffeine...
March 2, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28251147/the-influence-of-age-on-interaction-between-breath-holding-test-and-single-breath-carbon-dioxide-test
#15
Nikita Trembach, Igor Zabolotskikh
Introduction. The aim of the study was to compare the breath-holding test and single-breath carbon dioxide test in evaluation of the peripheral chemoreflex sensitivity to carbon dioxide in healthy subjects of different age. Methods. The study involved 47 healthy volunteers between ages of 25 and 85 years. All participants were divided into 4 groups according to age: 25 to 44 years (n = 14), 45 to 60 years (n = 13), 60 to 75 years (n = 12), and older than 75 years (n = 8). Breath-holding test was performed in the morning before breakfast...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28238671/cardiac-autonomic-ganglia-ablation-suppresses-atrial-fibrillation-in-a-canine-model-of-acute-intermittent-hypoxia
#16
Xiaomei Yu, Zhibing Lu, Wenbo He, Bo He, Ruisong Ma, Jing Xie, Hong Jiang
BACKGROUND: Atrial fibrillation (AF) is associated with hypoxia in which cardiac autonomic nerve system (ANS) plays an important role. Our previous studies indicated that ANS is activated in an intermittent hypoxia model and contributes to AF initiation. This study aimed to investigate the effects of cardiac ganglionated plexus (GP) ablation on AF in this model. METHODS AND RESULTS: In thirteen anesthetized male dogs, GP ablation was applied after 1h of intermittent hypoxia in the first group (n=7) and before that in the second group (n=6)...
February 23, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28217807/-role-of-trpc6-in-pulmonary-artery-smooth-muscle-cells-proliferation-and-apoptosis-under-hypoxia-and-hypercapnia
#17
Xu-Guang Jia, Meng-Xiao Zheng, Jing-Jing Zhang, Cong-Cong Zhang, Mei-Ping Zhao, Yi-Ming Wu, Xi-Wen Chen, Wan-Tie Wang
The present study was to investigate the role of TRPC6 in pulmonary artery smooth muscle cells (PASMCs) proliferation and apoptosis under hypoxia and hypercapnia. PASMCs were isolated from chloral hydrate-anesthetized male Sprague-Dawley (SD) rats. Cellular purity was assessed by immunofluorescence staining for smooth muscle α-actin under fluorescence microscopy. Passage 4-6 PASMCs were starved for 24 h in serum-free DMEM and divided into 5 groups randomly: normoxia, hypoxia and hypercapnia, DMSO, TRPC6 inhibitor SKF-96365 and TRPC6 activator OAG groups...
February 25, 2017: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/28217183/affection-of-the-respiratory-muscles-in-combined-complex-i-and-iv-deficiency
#18
Josef Finsterer, Helmut Rauschka, Liane Segal, Gabor G Kovacs, Boris Rolinski
OBJECTIVES: Combined complex I+IV deficiency has rarely been reported to manifest with the involvement of the respiratory muscles. CASE REPORT: A 45y male was admitted for hypercapnia due to muscular respiratory insufficiency. He required intubation and mechanical ventilation. He had a previous history of ophthalmoparesis since age 6y, ptosis since age 23y, and anterocollis since at least age 40y. Muscle biopsy from the right deltoid muscle at age 41y was indicative of mitochondrial myopathy...
2017: Open Neurology Journal
https://www.readbyqxmd.com/read/28215596/sex-specific-respiratory-effects-of-acute-and-chronic-caffeine-administration-in-newborn-rats
#19
REVIEW
Hayet Kouchi, NagaPraveena Uppari, Vincent Joseph, Aida Bairam
Caffeine is widely used for the treatment of apnea of prematurity (AoP) but whether this effect varies with sex is unknown. To shed some light on this question, we present a summary of data obtained on the effects of caffeine on the respiratory chemoreflexes and apnea frequency in 1- and 12-days old male and female rats. Caffeine was either administered as a single acute injection (10mg/kg, i.p.) or for 10 consecutive days (7.5mg/kg/day between 3 and 12days of life by gavage, simulating its clinical use). Acute caffeine had little effects on breathing in 1-day old male and female rats...
February 16, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28215270/decreased-cerebral-vasomotor-reactivity-in-patients-with-obstructive-sleep-apnea-syndrome
#20
Oguzhan Oz, Serdar Tasdemir, Hakan Akgun, Murat Erdem, Adem Balikci, Ahmet Cetiz, Mehmet Yucel, Umit Hidir Ulas, Seref Demirkaya, Yasar Kutukcu, Fuat Özgen
OBJECTIVE: In obstructive sleep apnea syndrome (OSAS), any of the activated neural, vascular, hemodynamic, metabolic, inflammatory, and thrombotic mechanisms may be related to increased cerebrovascular disease and risk of death; however, the possible pathophysiological process between obstructive sleep apnea syndrome and stroke has not been clearly explained. We hypothesize that alterations in vasomotor reactivity in patients may be responsible for their altered cerebral blood flow, and may contribute to the increased risk of ischemic stroke...
February 2017: Sleep Medicine
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