Search results for "Hyperventilation"

Clinical Assessment of Nasal Airway Obstruction

2019

For the evaluation of nasal airway obstruction physical examination, anterior rhinoscopy, laboratory workup, imaging studies, and rhinomanometric studies may be required. Laboratory workup may consist of counts of neutrophil investigating infectious diseases, eosinophil for allergy-related disorders, and mast cell in food allergy. Imaging workup contains computed tomography (CT) and magnetic resonance imaging. Physically based studies involve rhinomanometry and acoustic rhinometry techniques. Nasal resistance is responsible for more than 50% of the resistance of the total airway. Nasal resistance is made up of two layers: the deeper layer consists of underlying bone, cartilage, and muscle, …

Topiramate and Metabolic Acidosis in Infants and Toddlers

2002

Summary:  Purpose: Topiramate (TPM) inhibits carbonic anhydrase, with metabolic acidosis as a possible side effect, although this has been reported in only two adult cases. We investigated the acid–base metabolism in infants and toddlers treated with TPM. Methods: Nine infants and toddlers aged 5 months to 2.3 years (median, 6 months) were treated with TPM at maximal doses of 8.2–26 mg/kg/day (median, 11 mg/kg/day). The maximal TPM dose was achieved after 8–35 days (median, 17 days). TPM was given in addition to other antiepileptic drugs (AEDs) in five cases and as a sole AED in four patients with refractory epilepsy resistant to multiple AEDs. The diagnoses were infantile spasms (n = 5), e…

Hyperventilation in Adult TBI Patients: How to Approach It?

2021

Hyperventilation is a commonly used therapy to treat intracranial hypertension (ICTH) in traumatic brain injury patients (TBI). Hyperventilation promotes hypocapnia, which causes vasoconstriction in the cerebral arterioles and thus reduces cerebral blood flow and, to a lesser extent, cerebral blood volume effectively, decreasing temporarily intracranial pressure. However, hyperventilation can have serious systemic and cerebral deleterious effects, such as ventilator-induced lung injury or cerebral ischemia. The routine use of this therapy is therefore not recommended. Conversely, in specific conditions, such as refractory ICHT and imminent brain herniation, it can be an effective life-savin…

Tissue Oxygenation in Normal and Edematous Brain Cortex During Arterial Hypocapnia

1984

Since arterial hypocapnia causes a cerebral blood flow decrease, hypocapnic conditions are induced in patients with severe traumatic brain injury by controlled hyperventilation in order to reduce the intracranial pressure (Gordon, 1971). Beneficial effects on the clinical course of patients, however, can be observed only under conditions of moderate hypocapnia. As shown by animal experiments severe arterial hypocapnia results in insufficient oxygen supply conditions in brain tissue (Grote et al., 1981), which subsequently influences the brain metabolism (Granholm et al., 1969, 1971) and counteracts the influence of hypocapnia on cerebral blood flow regulation (Grote et al., 1981). The prese…

Effects of repeated hyperosmolar exposure on IL-8 release by bronchial epithelial cells

2010

TISSUE OXYGENATION AND TISSUE METABOLISM IN THE BRAIN CORTEX DURING PRONOUNCED ARTERIAL HYPOCAPNIA

1981

Publisher Summary This chapter describes the tissue oxygenation and tissue metabolism in the brain cortex during pronounced arterial hypocapnia. Acute arterial hypocapnia induced by hyperventilation leads to typical reactions in the circulation and the metabolism of the brain tissue. With a lowering of arterial CO2 tension, the cerebro-vascular resistance (CVR) increases resulting in a decrease of cerebral blood flow. The changes in CVR are a consequence of decreasing hydrogen ion and potassium ion concentrations in the perivascular space of the brain arterioles. The corresponding changes in the brain metabolism are characterized by elevated concentrations of lactate and pyruvate and an inc…

Effects of severe arterial hypocapnia on regional blood flow regulation, tissuePO2 and metabolism in the brain cortex of cats

1981

The effect of a stepwise decrease in PaCO2 from 3.9-1.6 kPa on rCBF, rCMRO2, tissue PO2 and concentrations of glucose, lactate, pyruvate, ATP, ADP, AMP and phosphocreatine in the brain cortex was studied in cats lightly anaesthetized with sodium pentobarbital. 1. Moderate lowering of PaCO2 to 2.5 kPa induced in all animals a homogeneous decrease of rCBF in corresponding areas of the right and left hemisphere. Mean rCBF fell from 129.2 to 103.1 ml X 100 g-1 X min-1, while rCMRO2 remained unchanged (12.7-12.9 ml X 100 g-1 X min-1). The tissue PO2 frequency histograms showed a shift to lower values without indicating the presence of brain tissue hypoxia. 2. Severe arterial hypocapnia (PaCO2 = …

Trainability of underwater breath-holding-time

1982

From diving practice we know that breath-holding time (BHT) can be increased by training. This examination was set up to illuminate whether BHT underwater can be trained decisively in a short period of time. The authors investigated whether physiologic or psychological aspects are the main constituents of the above-mentioned BHT phenomenon. BHT and the "onset point" of involuntary respiratory movements of 64 subjects were registered after deep inspiration and immersion in ca. 1 m. Two different tests were set up: (I) 2 breath-holds per day on 5 consecutive days, (II) 5 repeated breath-holds with pauses of 3 min in between. BHT of the first test was shorter underwater than in similar experim…

Metabolic control of respiratory neuronal activity and the accompanying changes in breathing movements of the rabbit

1976

Expiratory-related neurons have been classified according to their phase relation within the respiratory cycle, their response to lung distension and collapse (α- and β-type), and to hyperventilation (tonic firing denoted by “+”, cessation of activity by “−”). The dorsal surface of the medulla oblongata was superfused with a metabolite-containing CSF solution and the activity of expiratory (E) and inspiratory-expiratory (IE) neurons was extracellularly recorded. The neuronal sub-types established by their functional behaviour could equally be distinguished by their differential response to one or several metabolites. In contrast to inspiratory (I) neurons, E − α , E + β , E − β and IE − β n…

Possible Adverse Effects of Hyperventilation on rCBF during the Acute Phase of Total Proximal Occlusion of a Main Cerebral Artery

1969

Recent studies seem to favor a beneficial effect of hyperventilation (HV) in cases of cerebrovascular occlusion [1, 4] and brain trauma [2, 5]. On the other hand, it seems that, at least under certain circumstances, HV may exert an adverse effect upon cerebral blood flow and metabolism [3]. Since this question is not settled yet, it seems worthwhile to report briefly the present case of reversible total occlusion of the middle cerebral artery closely followed by successive rCBF studies (133Xe-gamma-clearance method), in which, during the acute phase, HV caused a latent ischemia to become manifest.