Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UMLS:C0020440 (
hypercapnia
)
7,939
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Purpose/Aim:
Macroglossia is a rare condition, especially in patients with motor neuron disease. In this case report, we describe a patient with macroglossia in the early stages of motor neuron disease.
Case report:
A 62-year-old woman presented with macroglossia in the early stages of motor neuron disease. She was referred to the department of physical medicine and rehabilitation of a university hospital for rehabilitation with the diagnosis of motor neuron disease, most likely primary lateral sclerosis. Her speech was incomprehensible, and she also showed significant sialorrhea and had difficulty in chewing large solid food. Her tongue was enlarged on examination, and she could not close her mouth fully. No other possible causes of macroglossia were found. She showed nocturnal
hypercapnia
on overnight capnography examination coupled with desaturation, which was believed to result from the macroglossia. After commencing non-invasive ventilation with pressure control mode, follow-up overnight capnography revealed EtCO
2
values within the normal range.
Conclusions:
To the best of our knowledge, this is the first report of macroglossia in
PLS
. Further study would be needed to ascertain the pathogenesis of this phenomenon.
...
PMID:Macroglossia in primary lateral sclerosis: a case report. 3130 59
While
hypercapnia
is typically well treated with modern membrane oxygenators, there are cases where respiratory acidosis persists despite maximal extracorporeal membrane oxygenation support. To better understand the physiology of gas exchange within the membrane oxygenator, CO
2
clearance within an adult Maquet Quadrox-iD oxygenator was evaluated at varying blood CO
2
tensions and V/Q ratios in an ex vivo extracorporeal membrane oxygenation circuit. A closed blood-primed circuit incorporating two Maquet Quadrox-iD oxygenators in series was attached to a Maquet
PLS
Rotaflow pump. A varying blend of CO
2
and air was connected to the first oxygenator to provide different levels of pre-oxygenator blood CO
2
levels (P
v
CO
2
) to the second oxygenator. Varying sweep gas flows of 100% O
2
were connected to the second oxygenator to provide different V/Q ratios. Exhaust CO
2
was directly measured, and then VCO
2
and oxygenator dead space fraction (V
D
/V
T
) were calculated. VCO
2
increased with increasing gas flow rates with plateauing at V/Q ratios greater than 4.0. Exhaust CO
2
increased with P
v
CO
2
in a linear fashion with the slope of the line decreasing at high V/Q ratios. Oxygenator dead space fraction varied with V/Q ratio-at lower ratios, dead space fraction was 0.3-0.4 and rose to 0.8-0.9 at ratios greater than 4.0. Within the Maquet Quadrox-iD oxygenator, CO
2
clearance is limited at high V/Q ratios and correlated with elevated oxygenator dead space fraction. These findings have important implications for patients requiring high levels of extracorporeal membrane oxygenation support.
...
PMID:Extracorporeal membrane oxygenation and V/Q ratios: an ex vivo analysis of CO
2
clearance within the Maquet Quadrox-iD oxygenator. 3239 80
