Search results for "hypercapnia"
showing 10 items of 29 documents
Regional anticoagulation with heparin of an extracorporeal CO2 removal circuit: a case report
2019
Abstract Background Extracorporeal carbon dioxide removal is an increasingly used respiratory support technique. As is true of all extracorporeal techniques, extracorporeal carbon dioxide removal needs proper anticoagulation. We report a case of a patient at risk of bleeding complications who was treated with extracorporeal carbon dioxide removal and anticoagulated with a regional technique. Case presentation A 56-year-old Caucasian man with a history of chronic obstructive pulmonary disease exacerbation required extracorporeal carbon dioxide removal for severe hypercapnia and acidosis despite mechanical ventilation. The extracorporeal circuit was anticoagulated using a regional heparin tec…
Dynamics of tumor oxygenation and red blood cell flux in response to inspiratory hyperoxia combined with different levels of inspiratory hypercapnia.
2002
Abstract Background and purpose : Increasing arterial oxygen partial pressure (pO 2 ) by breathing hyperoxic gases is an effective means of improving tumor oxygenation, although the efficacy of adding CO 2 to the inspiratory gas has been discussed controversially. This study aimed at analyzing the impact of different inspiratory CO 2 fractions on the time course of oxygenation and perfusion changes in experimental tumors during and after inspiratory hyperoxia. Material and methods : Perfusion and oxygenation of rat DS-sarcomas were studied during spontaneous breathing of pure oxygen or hyperoxic gas mixtures containing different CO 2 fractions (1, 2.5 or 5%). Red blood cell (RBC) flux was a…
Noninvasive Ventilatory Assistance During Exercise for Patients with Kyphoscoliosis
2007
The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cm H2O) plus positive end expiratory pressure (PEEP) (4 cm H2O) via a nasal mask. Of the compared parameters, heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 vs. 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 vs.…
Perioperative Adverse Events in Obstructive Sleep Apnea and Use of Noninvasive Mechanical Ventilation: Key Topics and Clinical Implications
2016
Obstructive sleep apnea (OSA) is a common public health care problem and, yet, the perioperative management of OSA remains inadequate. Patients affected by this condition are prone to early postoperative complications, in part due to the negative effects of sedative, analgesic, and anesthetic agents on pharyngeal tone and arousal responses to hypoxia, hypercapnia, and obstruction. The use of opioids may also contribute to late adverse events, mainly by suppressing the rapid eye movement phase of sleep. As a result, preoperative screening of patients at high risk of OSA, as well as the implementation of a perioperative strategy to reduce the risk of complications, should lead to early periop…
Dual orexin receptor blocker suvorexant attenuates hypercapnic ventilatory augmentation in mice
2022
Suvorexant (Belsomra(R)), a dual orexin receptor antagonist widely used in the treatment of insomnia, inhibits the arousal system in the brain. However, the drug’s ventilatory effects have not been fully explored. This study aims to investigate the expression of orexin receptors in respiratory neurons and the effects of suvorexant on ventilation. Immunohistology of brainstem orexin receptor OX2R expression was performed in adult mice (n = 4) in (1) rostral ventral respiratory group (rVRG) neurons projecting to the phrenic nucleus (PhN) retrogradely labeled by Fluoro-Gold (FG) tracer, (2) neurons immunoreactive for paired like homeobox 2b (Phox2b) in the parafacial respiratory group/retrotra…
New evidence in one-lung ventilation
2017
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recr…
Usefulness of transcutaneous PCO2to assess nocturnal hypoventilation in restrictive lung disorders
2016
Background and objectiveNocturnal hypoventilation is now an accepted indication for the initiation of non-invasive ventilation. Nocturnal hypoventilation may be an under diagnosed condition in chronic respiratory failure. The most appropriate strategy to identify sleep hypoventilation is not yet clearly defined. In clinical practice, it is indirectly assessed using nocturnal pulse oximetry (NPO) and morning arterial blood gases (mABG). Even though continuous transcutaneous carbon dioxide partial pressure (TcPCO2) monitoring is theoretically superior to NPO plus mABG, it is not routinely used. We aimed to prospectively compare NPO plus mABG with nocturnal TcPCO2 for the detection of alveolar…
Noninvasive ventilation during the weaning process in chronically critically ill patients.
2016
Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials. Patients were transferred to NIV when it proved impossible to increase the duration of spontaneous breathing trials beyond 18 h. 2…
Long-term volume-targeted pressure-controlled ventilation: sense or nonsense?
2017
The technology underlying the development of novel ventilatory modes for long-term noninvasive ventilation of patients with chronic hypercapnia is continuously evolving. Volume-targeted pressure-controlled ventilation is a hybrid ventilation mode designed to combine the advantages of conventional ventilation modes, while avoiding their drawbacks. However, manufacturers have created different names and have patented algorithms and set-up variables, which can result in confusion for physicians and respiratory therapists. In addition, clear evidence for the superiority of this novel mode has not yet been established. These factors have most likely hindered more widespread use of this mode in c…
Genome-wide adaptive complexes to underground stresses in blind mole rats Spalax
2014
The blind mole rat (BMR), Spalax galili, is an excellent model for studying mammalian adaptation to life underground and medical applications. The BMR spends its entire life underground, protecting itself from predators and climatic fluctuations while challenging it with multiple stressors such as darkness, hypoxia, hypercapnia, energetics and high pathonecity. Here we sequence and analyse the BMR genome and transcriptome, highlighting the possible genomic adaptive responses to the underground stressors. Our results show high rates of RNA/DNA editing, reduced chromosome rearrangements, an over-representation of short interspersed elements (SINEs) probably linked to hypoxia tolerance, degene…