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Respiratory acidosis

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https://www.readbyqxmd.com/read/27923944/membrane-oxygenator-use-with-biventricular-assist-device-facilitation-of-support-and-lung-recovery
#1
Kristen Nelson-McMillan, William J Ravekes, William R Thompson, Kristen M Brown, Larry Wolff, Rajeev S Wadia, LeAnn M McNamara, Donald H Shaffner, Ivor D Berkowitz, Marshall L Jacobs, Luca A Vricella
We present the use of a low-resistance membrane oxygenator (Quadrox D, Maquet) in series with a pulsatile right ventricular assist device (Berlin Heart EXCOR, Berlin Heart) in a patient with biventricular support who required high-frequency oscillatory ventilation (HFOV), due to refractory acute respiratory distress syndrome associated with Cytomegalovirus pneumonia. The high mean airway pressure associated with the use of HFOV resulted in a significant negative impact on left ventricular assist device (LVAD) filling that led to a combined respiratory and metabolic acidosis and the need for vasopressor support...
December 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#2
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27896594/global-cerebral-ischemia-due-to-circulatory-arrest-insights-into-cellular-pathophysiology-and-diagnostic-modalities
#3
REVIEW
Santosh K Sanganalmath, Purva Gopal, John R Parker, Richard K Downs, Joseph C Parker, Buddhadeb Dawn
Circulatory arrest (CA) remains a major unresolved public health problem in the United States; the annual incidence of which is ~0.50 to 0.55 per 1000 population. Despite seminal advances in therapeutic approaches over the past several decades, brain injury continues to be the leading cause of morbidity and mortality after CA. In brief, CA typically results in global cerebral ischemia leading to delayed neuronal death in the hippocampal pyramidal cells as well as in the cortical layers. The dynamic changes occurring in neurons after CA are still unclear, and predicting these neurological changes in the brain still remains a difficult issue...
November 28, 2016: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/27890436/respiratory-acid-base-disorders-in-the-critical-care-unit
#4
REVIEW
Kate Hopper
The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco2 may have a significant impact on outcome. Monitoring Pco2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Treatment of respiratory acid-base disorders is largely focused on resolution of the primary disease, although mechanical ventilation may be indicated in cases with severe respiratory acidosis...
November 24, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27881583/acute-oesophageal-necrosis-in-a-young-man-with-cocaine-and-alcohol-abuse
#5
Caleb Evans Pineo, Thomas Zeitler Pineo
We report a case of acute oesophageal necrosis (AEN) and non-occlusive mesenteric ischaemia in an otherwise healthy 30-year-old man with cocaine and alcohol abuse. Although cocaine might be expected more frequently to cause oesophageal necrosis through sympathomimetic vasoconstriction, this is only the second known case report of AEN in a patient with cocaine abuse. His symptoms at presentation included epigastric abdominal pain, haematemesis and generalised weakness. He developed moderate neutropenia and severe lactic acidosis...
November 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27871516/pediatric-patients-on-ketogenic-diet-undergoing-general-anesthesia-a-medical-record-review
#6
Elif Soysal, Heike Gries, Carter Wray
STUDY OBJECTIVE: To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). DESIGN: Retrospective medical record review. SETTING: Postoperative recovery area. PATIENTS: All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871165/acute-pancreatitis-complicated-with-diabetic-ketoacidosis-in-a-young-adult-without-hypertriglyceridemia-a-case-report
#7
Jung Hyun Kim, Myung Jin Oh
Systemic complications related to acute pancreatitis include acute respiratory distress syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation, hypocalcemia, hyperglycemia, and insulin dependent diabetes or diabetic ketoacidosis. In practice, the development of diabetic ketoacidosis induced by acute pancreatitis is rare and generally associated with hypertriglyceridemia. However, herein we report a case of a 34-year-old female without hypertriglyceridemia, who was diagnosed with acute pancreatitis complicated with diabetic ketoacidosis...
November 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/27858372/severe-respiratory-acidosis-in-status-epilepticus-as-a-possible-etiology-of-sudden-death-in-lesch-nyhan-disease-a-case-report-and-review-of-the-literature
#8
Alison Christy, William Nyhan, Jenny Wilson
INTRODUCTION: Lesch-Nyhan disease (LND) is an X-linked disorder of purine metabolism, associated with self-mutilation, dystonia, and chorea. Seizures are uncommon in LND. Patients with LND are at risk for sudden and unexpected death. The etiology of this is unknown, but appears to occur from a respiratory process. We propose that respiratory failure secondary to subclinical seizure may lead to sudden death in these patients. CASE: We report a case of an 11-year-old boy with LND who had two episodes of nocturnal gasping...
November 18, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27832132/coordinated-respiratory-motor-activity-in-nerves-innervating-the-upper-airway-muscles-in-rats
#9
Satoshi Tachikawa, Kiyomi Nakayama, Shiro Nakamura, Ayako Mochizuki, Takehiko Iijima, Tomio Inoue
Maintaining the patency of the upper airway during breathing is of vital importance. The activity of various muscles is related to the patency of the upper airway. In the present study, we examined the respiratory motor activity in the efferent nerves innervating the upper airway muscles to determine the movements of the upper airway during respiration under normocapnic conditions (pH = 7.4) and in hypercapnic acidosis (pH = 7.2). Experiments were performed on arterially perfused decerebrate rats aged between postnatal days 21-35...
2016: PloS One
https://www.readbyqxmd.com/read/27815843/coxpd9-an-evolving-multisystem-disease-congenital-lactic-acidosis-sensorineural-hearing-loss-hypertrophic-cardiomyopathy-cirrhosis-and-interstitial-nephritis
#10
C Bursle, A Narendra, R Chuk, J Cardinal, R Justo, B Lewis, D Coman
We present the second report of combined oxidative phosphorylation deficiency-9. The infant presented in the neonatal period with poor feeding, lactic acidosis and sensorineural hearing loss. He subsequently developed a lethal hypertrophic cardiomyopathy during infancy. Cirrhosis and interstitial nephritis were identified at autopsy. Exome sequencing has detected compound heterozygous mutations in the MRPL3 gene which encodes a large mitochondrial ribosome subunit protein. We identified a known heterozygous variant NM_007208 c...
November 5, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27815579/extracorporeal-membrane-oxygenation-improves-coagulopathy-in-an-experimental-traumatic-hemorrhagic-model
#11
M Larsson, P Forsman, P Hedenqvist, A Östlund, J Hultman, A Wikman, L Riddez, B Frenckner, M Bottai, C-M Wahlgren
PURPOSE: Hemorrhage is the most common cause of preventable death after trauma. Coagulopathy plays a central role in uncontrolled bleeding and is caused by multiple factors. Extracorporeal Membrane Oxygenation (ECMO) is an established treatment for patients with respiratory failure and has in recent years also been used in severely injured trauma patients with cardiopulmonary failure and coexisting bleeding shock. The aim of this study was to evaluate the effect of ECMO on hypothermia, acidosis, and coagulopathy in a traumatic hemorrhagic rabbit model...
November 4, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27815040/the-addition-of-ketone-bodies-alleviates-mitochondrial-dysfunction-by-restoring-complex-i-assembly-in-a-melas-cellular-model
#12
Samuel Frey, Guillaume Geffroy, Valerie Desquiret-Dumas, Naig Gueguen, Celine Bris, Sophie Belal, Patrizia Amati-Bonneau, Arnaud Chevrollier, Magalie Barth, Daniel Henrion, Guy Lenaers, Dominique Bonneau, Pascal Reynier, Vincent Procaccio
Ketogenic Diet used to treat refractory epilepsy for almost a century may represent a treatment option for mitochondrial disorders for which effective treatments are still lacking. Mitochondrial complex I deficiencies are involved in a broad spectrum of inherited diseases including Mitochondrial Encephalomyopathy, Lactic Acidosis and Stroke-like episodes syndrome leading to recurrent cerebral insults resembling strokes and associated with a severe complex I deficiency caused by mitochondrial DNA (mtDNA) mutations...
November 1, 2016: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27812731/assessment-of-heart-rate-acidosis-consciousness-oxygenation-and-respiratory-rate-to-predict-noninvasive-ventilation-failure-in-hypoxemic-patients
#13
Jun Duan, Xiaoli Han, Linfu Bai, Lintong Zhou, Shicong Huang
PURPOSE: To develop and validate a scale using variables easily obtained at the bedside for prediction of failure of noninvasive ventilation (NIV) in hypoxemic patients. METHODS: The test cohort comprised 449 patients with hypoxemia who were receiving NIV. This cohort was used to develop a scale that considers heart rate, acidosis, consciousness, oxygenation, and respiratory rate (referred to as the HACOR scale) to predict NIV failure, defined as need for intubation after NIV intervention...
November 3, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#14
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27799072/fluid-and-ion-transfer-across-the-blood-brain-and-blood-cerebrospinal-fluid-barriers-a-comparative-account-of-mechanisms-and-roles
#15
REVIEW
Stephen B Hladky, Margery A Barrand
The two major interfaces separating brain and blood have different primary roles. The choroid plexuses secrete cerebrospinal fluid into the ventricles, accounting for most net fluid entry to the brain. Aquaporin, AQP1, allows water transfer across the apical surface of the choroid epithelium; another protein, perhaps GLUT1, is important on the basolateral surface. Fluid secretion is driven by apical Na(+)-pumps. K(+) secretion occurs via net paracellular influx through relatively leaky tight junctions partially offset by transcellular efflux...
October 31, 2016: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/27793099/severe-respiratory-changes-at-end-stage-in-a-fus-induced-disease-state-in-adult-rats
#16
Kasey L Jackson, Hemangini A Dhaibar, Robert D Dayton, Sergio G Cananzi, William G Mayhan, Edward Glasscock, Ronald L Klein
BACKGROUND: Fused in sarcoma (FUS) is an RNA-binding protein associated with the neurodegenerative diseases amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. ALS manifests in patients as a progressive paralysis which leads to respiratory dysfunction and failure, the primary cause of death in ALS. We expressed human FUS in rats to determine if FUS would induce ALS relevant respiratory changes to serve as an early stage disease indicator. The FUS expression was initiated in adult rats by way of an intravenously administered adeno-associated virus vector serotype 9 (AAV9) providing an adult onset model...
October 28, 2016: BMC Neuroscience
https://www.readbyqxmd.com/read/27789806/the-frequency-and-severity-of-metabolic-acidosis-related-to-topiramate
#17
Hatice Türe, Özgül Keskin, Ülkem Çakır, Canan Aykut Bingöl, Uğur Türe
OBJECTIVE: We planned a cross-sectional analysis to determine the frequency and severity of metabolic acidosis in patients taking topiramate while awaiting craniotomy. METHODS: Eighty patients (18 - 65 years) taking topiramate to control seizures while awaiting elective craniotomy were enrolled. Any signs of metabolic acidosis or topiramate-related side effects were investigated. Blood chemistry levels and arterial blood gases, including lactate, were obtained. The severity of metabolic acidosis was defined according to base excess levels as mild or moderate...
October 26, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27785568/novel-mutations-in-iba57-are-associated-with-leukodystrophy-and-variable-clinical-phenotypes
#18
Alessandra Torraco, Anna Ardissone, Federica Invernizzi, Teresa Rizza, Giuseppe Fiermonte, Marcello Niceta, Nadia Zanetti, Diego Martinelli, Angelo Vozza, Daniela Verrigni, Michela Di Nottia, Eleonora Lamantea, Daria Diodato, Marco Tartaglia, Carlo Dionisi-Vici, Isabella Moroni, Laura Farina, Enrico Bertini, Daniele Ghezzi, Rosalba Carrozzo
Defects of the Fe/S cluster biosynthesis represent a subgroup of diseases affecting the mitochondrial energy metabolism. In the last years, mutations in four genes (NFU1, BOLA3, ISCA2 and IBA57) have been related to a new group of multiple mitochondrial dysfunction syndromes characterized by lactic acidosis, hyperglycinemia, multiple defects of the respiratory chain complexes, and impairment of four lipoic acid-dependent enzymes: α-ketoglutarate dehydrogenase complex, pyruvic dehydrogenase, branched-chain α-keto acid dehydrogenase complex and the H protein of the glycine cleavage system...
October 26, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27783661/the-high-level-of-aberrant-splicing-of-iscu-in-slow-twitch-muscle-may-involve-the-splicing-factor-srsf3
#19
Denise F R Rawcliffe, Lennart Österman, Hans Lindsten, Monica Holmberg
Hereditary myopathy with lactic acidosis (HML) is an autosomal recessive disease caused by an intronic one-base mutation in the iron-sulfur cluster assembly (ISCU) gene, resulting in aberrant splicing. The incorrectly spliced transcripts contain a 100 or 86 bp intron sequence encoding a non-functional ISCU protein, which leads to defects in several Fe-S containing proteins in the respiratory chain and the TCA cycle. The symptoms in HML are restricted to skeletal muscle, and it has been proposed that this effect is due to higher levels of incorrectly spliced ISCU in skeletal muscle compared with other energy-demanding tissues...
2016: PloS One
https://www.readbyqxmd.com/read/27761288/a-case-of-biotinidase-deficiency-in-an-adult-with-respiratory-failure-in-the-intensive-care-unit
#20
Zerrin Demirtürk, Evren Şentürk, Abbas Köse, Perihan Ergin Özcan, Lütfi Telci
BACKGROUND: Biotinidase deficiency (BD) is a rare, inherited autosomal recessive disorder that is treatable within childhood. We present a patient with pneumonia and respiratory acidosis who was not diagnosed with any systemic disorders; the patient was finally diagnosed as BD. CASE REPORT: A thirty-year-old woman was admitted to the emergency department with respiratory failure that had persisted for a few days and progressively weakening over the previous six months...
September 2016: Balkan Medical Journal
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