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Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficiency of extracorporeal membrane oxygenation was studied for 2-3 hours in experiments on dogs with severe ventilatory respiratory failure. Extracorporeal oxygenation led to the decrease in arterial hypoxaemia and hypercapnia in animals. However, the variables did not reach the initial levels and were closer to normal values during veno-venous and not veno-arterial perfusion. During extracorporeal membrane oxygenation total systemic blood flow exceeded the initial level irrespective of the means of perfusion and total oxygen transport did not decline lower than the initial level. At the same time during veno-arterial perfusion oxygen delivery provided by the cardiac output decreased almost two-fold by the second hour of perfusion. This might be the reason for inadequate oxygen delivery to the brain and heart. 67% and 71% of animals survived after veno-arterial and veno-venous perfusion, respectively.
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PMID:[Evaluation of the efficacy of extracorporeal membrane oxygenation of animals with acute respiratory insufficiency]. 373 May 80

Excess carbohydrate calories in total parenteral nutrition (TPN) solutions can precipitate acute hypercapnic respiratory failure in patients with chronic lung disease secondary to increased carbon dioxide (CO2) production. Two young patients recovering from the adult respiratory distress syndrome experienced hypercapnia during weaning as a result of nutritionally related increased CO2 production. As carbohydrate calories were decreased, CO2 production diminished and hypercapnia resolved. Hypercapnia as a complication of nutritional support during weaning can occur in patients without chronic lung disease and is corrected by decreasing carbohydrate calories.
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PMID:Hypercapnia during weaning. A complication of nutritional support. 392 89

Acute respiratory failure is a common life-threatening process with myriad causes. It is characterized by a failure of oxygenation or ventilation, or both. Hypoxemia is common to all causes of respiratory failure, whereas PaCO2 may be normal, decreased, or elevated. These abnormalities result from several pathophysiologic processes, including intrapulmonary venoarterial shunt, alveolar hypoventilation, diffusion impairment, and ventilation-perfusion mismatch. Type I failure results from processes that lead to hypocapnia or normocapnia; type II failure is distinguished by the presence of hypercapnia. The clinical manifestations of acute respiratory failure are nonspecific; for this reason, a high index of suspicion and early examination of arterial blood gases are essential to successful management.
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PMID:Acute respiratory failure. Pathophysiology, causes, and clinical manifestations. 394 15

The effect of home long-term oxygen therapy has been evaluated in 70 patients (52 men and 18 women) with chronic respiratory insufficiency due to chronic obstructive pulmonary disease. The mean duration of the observation period was 17.5 months, lasting at least 6 months and in a few cases over 40 months. The cumulative death rate was 22.6% in the first 12 months, 36.5% after two years and 40.7% in the third year. Compared to a previous period of 19.5 months there was an obvious reversal in hypoxemia, an increase in physical capacity and a reduction in the hospitalization rate. Patients with marked respiratory failure and with the clinical features of the "blue bloater" type of chronic bronchitis responded better to the home oxygen therapy than a group of "advanced pink puffers" with hypercapnia and high pulmonary arterial pressure. The present results do however confirm the beneficial effects of long-term domiciliary oxygen administration, and should encourage critical use of this new therapeutic regimen according to the indications so far recommended.
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PMID:[Oxygen home therapy in chronic respiratory insufficiency. Report of experience with 70 patients]. 398 85

This study describes the case of a 58 year old man who presented with an episode of acute respiratory failure and right heart decompensation. After recovery from the acute illness, hypoxaemia, hypercapnia and pulmonary arterial hypertension remained, the causes of which were not known. There was no airway obstruction, only a moderate restrictive ventilatory defect, a little weight increase and a unilateral diaphragmatic paralysis. Obstructive sleep apnoea was finally suspected and confirmed by sleep recording. The obstructive sleep apnoea probably explained the respiratory insufficiency and the pulmonary hypertension. Loss of weight was associated with the disappearance of hypercapnia and pulmonary hypertension. As a result of this study, the value of sleep recording is emphasized. When respiratory failure or pulmonary hypertension seem unexplained, think of obstructive sleep apnoea.
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PMID:[Value of sleep polygraph examination in the etiological diagnosis of apparently inexplicable respiratory insufficiency]. 404 63

Forty-five newborn infants in respiratory failure with respiratory distress syndrome were treated with intermittent negative pressure ventilation (INPV). There was a survival rate of 38% (17/45).All infants were initially treated without nasotracheal intubation. However, 24 of these developed a Paco(2) greater than 70 mm. Hg and were subsequently intubated. Intubation was followed by a decrease in the degree of hypercarbia in each instance and simultaneous increase in Pao(2).COMPLICATIONS ENCOUNTERED DURING VENTILATION WERE: emphysema (one patient), aspiration pneumonia (two patients), septicemia (two patients), misplaced nasotracheal tube (one patient).Follow-up of the 17 surviving patients for periods of four to 36 months disclosed two patients with post-intubation hoarseness. One infant initially had spastic quadriplegia with EEG abnormalities, both of which cleared by 5 months of age. In the remaining 14 infants, the results of physical, neurological and psychological examinations have remained within normal limits.
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PMID:Negative pressure artificial respiration: use in treatment of respiratory distress syndrome of the newborn. 526 98

DIAPHRAGM ACTIVITY DURING CARBON DIOXIDE BREATHING AND TOTAL CHEST COMPLIANCE DURING DIAPHRAGM RELAXATION WERE MEASURED IN EIGHT OBESE SUBJECTS: four with normal blood gases and four with hypercapnia and hypoxemia. Whereas there were no significant differences in the values of total chest compliance between the two groups, there were marked differences in diaphragm activity. The increase in integrated electrical activity in the diaphragm, per millimeter increment in carbon dioxide tension in the arterial blood, averaged 66 units (range: 48-90) in the obese-normal subjects and 17 units (range: 12-22) in the obese-hypoventilation subjects. These results suggest that an incapacity to increase the activity in the respiratory muscles, to levels necessary to overcome the load caused by obesity, plays a major role in the genesis of respiratory failure in obese subjects.
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PMID:Diaphragm activity in obesity. 582 73

A controlled trial of long term domiciliary oxygen therapy has been carried out in three centres in the U.K. The 87 patients, all under 70 years of age, who took part had chronic bronchitis or emphysema with irreversible airways obstruction, severe arterial hypoxaemia, carbon dioxide retention, and a history of congestive heart failure. The patients were randomised to oxygen therapy (treated) or no oxygen (controls). Oxygen was given by nasal prongs for at least 15 h daily, usually at 2 1/min. The two groups were well matched, both clinically and in terms of lung function and other laboratory findings. 19 of the 42 oxygen treated patients died in the five years of survival follow-up compared with 30 out of 45 controls: in the 66 men in this trial the survival advantage of oxygen did not emerge until 500 days had elapsed. Survival for the 12 female controls was surprisingly poor, 8 of them being dead at 3 years. Mortality was not easy to predict, though a summation of arterial carbon dioxide tension and red cell mass was helpful. Neither time spent in hospital because of exacerbations of respiratory failure nor work attendance were affected by oxygen therapy, but these patients were very ill at the start of the trial and many had already retired on grounds of age or ill-health. Physiological measurements suggested that oxygen did not slow the progress of respiratory failure in those who died early. However, in longer term survivors on oxygen, arterial oxygenation did seem to stop deterioration.
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PMID:Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Report of the Medical Research Council Working Party. 611 Sep 12

The respiratory effects of intravenously infused almitrine were evaluated in healthy volunteers. In the dose range 0.25-1.0 mg/kg/hour it caused large and dose-dependent increases in hypoxic chemosensitivity, which were longlasting and more persistent than the drug's retention in the plasma. Increases in sensitivity to hypercapnia were much less and were detected only when the plasma almitrine exceeded 200 ng/ml. Small increases in resting ventilation and metabolic rate with a decrease in mixed venous carbon dioxide tension occurred only at the highest infusion rate. The findings accord with an action of almitrine in the peripheral chemoreceptors, which may be of therapeutic value in managing some cases of respiratory failure.
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PMID:Increased respiratory chemosensitivity induced by infusing almitrine intravenously in healthy man. 613 50

Very few therapeutic measures of proven effectiveness are available for the management of chronic bronchitis with chronic respiratory failure. Long-term oxygen therapy undoubtedly improves functional and vital prognoses in patients with severe hypoxaemia (55 less than or equal to PaO2 less than or equal to 60 mmHg) or chronic post-hypoxia cor pulmonale, but its indications are limited by its cost and by numerous practical problems. Owing to its mode of action and pharmacological effects, almitrine bismesylate corrects the main physiopathological disorders underlying hypoxaemia and its complications in chronic bronchitis. Improvement in arterial and tissue oxygen supply and decrease in hypercapnia result from the specific and original action of the drug on the distribution of alveolar ventilation-perfusion ratios--an action that has been clearly demonstrated by the inert gas method and by radioisotopic techniques. Such a mode of action differentiates almitrine bismesilate from long-term oxygen therapy which has similar effects, at least qualitatively, on tissue oxygenation. The lack of undesirable effects on central nervous system, pulmonary circulation and respiratory mechanics confirms the originality and safety of a drug which unquestionably constitutes a novel and major contribution to the long-term treatment of chronic bronchitis with hypoxaemia.
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PMID:[Originality of the mode of action of almitrine dimesylate]. 614 36


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