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

In vitro, the affinity of Hb for O2 depends on pH and capnia by the intermediate of the 2-3 DPG level, the concentration of which lowers in the case of acidosis and hypercapnia. Thus, an increase in the affinity results, but while Bohr's effect is immediate, on the contrary the 2-3 DPG effect is slow. Authors have verified the importance of this modification by studying the affinity of Hb for O2 thanks to the P50 technique in 15 normal non-smokers subjects and in 10 subjects with compensated or not respiratory acidosis but normally saturated thanks to continuous O2 administration.
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PMID:[Study of P50 in patients under continuous O2 inhalation and during chronic respiratory acidosis]. 0 19

Blood and tissue gas exchange properties of mole rats in normoxic and hypoxic-hypercapnic conditions were compared to the common mammalian pattern. RBC count was 14.0 +/- 1.2-10(6)/microliter. Hb concentration was 15.0 +/- 0.4g/100 ml. P50 (at pH 7.4 and 37 degrees C) was 29.5 +/- 0.5 mm Hg. Oxygen capacity averaged 20.2 +/- 0.4 vol% and the Hill coefficient was 2.9 +/- 0.1. The Bohr effect was -0.53 +/- 0.02 (deltalog P/deltapH). The temperature coefficient was 0.0152 +/- 0.0014 (deltalog P/delta degrees C). The Haldane effect was 4.8 +/- 0.5 (deltaCCO2 vol%)at PCO2 =40 mm Hg. Steady-state partial pressures in gas pockets were PO2 = 15.1 +/- 1.4 mm Hg and PCO2 = 85.8 +/- 3.9 mm Hg in normoxia, and 11.5 +/- 3.0 and 101.8 +/- 3.5 repectively in hypoxia-hypercapnia (PIO2 congruent to 85 mm Hg). Under the same conditions 2,3-DPG dropped from 0.87 and 0.88 to 0.62 and 0.65 (mol/mol Hb) in the rat and in the white rat, respectively. Heart muscle myoglobin concentration of the mole rat (1.44 mg/g) did not differ significantly from that of the white rat (1.96 mg/g), whereas masseter myoglobin was 4.0 mg/g--significantly different from the rat (1.21 mg/g). Results indicate that the strategy used by the mole rat to maintain a normal metabolic rate under variable atmospheric conditions, besides having high oxygen affinity, is to expand the physiological range of the oxygen dissociation curve to very low oxygen tensions, at the expense of its acid-base regulation. The regulation of the shape of the oxygen dissociation curve is discussed.
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PMID:Blood-gas properties and function in the fossorial mole rat under normal and hypoxic-hypercapnic atmospheric conditions. 1 98

The effects on hemoglobin oxygen transport of acute respiratory acidosis have been studied in dogs inhaling a gaseous mixture with 12% CO2 (O2 21%) for two to five hours. In a first series of experiments, it was shown that the shape of the oxyhemoglobin dissociation curve (ODC) was not modified by severe acidosis (pH congruent to 7) lasting for two and a half hours. The Hill number (N equals 2.6) did not change significantly. The aim of the second experimental series was to stuey the Bohr effect and the hemoglobin oxygen affinity (P50). The control value for the respiratory Bohr coefficient (B) was --0.54; neither after two hours (--0.52), nor after five hours of hypercapnia (--0.55) was it significantly modified. The P50 expressed at arterial pH was much increased in acidosis (congruent to 45 torr); when expressed at standard p/ 7.4, it was slightly but significantly decreased (congruent to 1 torr) at the fifth hour. At the same time there was a decrease (p smaller than 0.05) in the erythrocyte 2,3-DPG approaching 15 p. cent; on the other hand the ATP concentration did not change significantly. No significant individual correlation was found between P50(7.4), 2,3-DPG and mean hemoglobin corpuscular concentration. These results suggest that during severe respiratory acidosis neither a change in the shape of ODC, nor a change in Bohr effect do affect the hemoglobin oxygen transport. The main characteristic remains the decrease in oxygen affinity of hemoglobin, due to the erythrocyte [H+] increase induced by hypercapnia ; this phenomenon is observed as long as the 2,3-DPG decrease stays moderate.
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PMID:[Hemoglobin oxygen transport during experimental acute hypercapnia (author's transl)]. 23 80

The activity and the isozyme B and C levels of red cell carbonic anhydrase was examined before and during CO2 inhalation in 18 patients with chronic respiratory failure. Carbonic anhydrase B and C levels did not change during 5 min breathing of high (8-9%) and low (3-5%) CO2 mixture. Carbonic anhydrase activity decreased in patients with combined hypercarbia (Paco2 greater than or equal to 45 mmHg) and hypoxemia (Pao2 less than or equal to 60 mmHg). This was accompanied by an increase in red cell K+ content, 2, 3-DPG and Hct/Hb. The activity did not change in patients with only hypoxemia. Carbonic anhydrase activity and plasma HCO-3 concentration were positively correlated (r = 0.4, P less than 0.05). A significant inverse correlation was also found between changes in red cell K+ content and those in carbonic anhydrase activity (r = - 0.42, P less than 0.05). These results indicate that 1), there is a dissociation between activity and isozyme levels in red cell carbonic anhydrase during the initial 5 min of CO2 breathing in patients with combined hypercarbia and hypoxemia, and 2), there seems a linkage exists between K+ movement across the red cell membrane and carbonic anhydrase activity.
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PMID:Effect of CO2 on carbonic anhydrase activity and isozyme levels in respiratory failure. 41 57

Multivariate analysis of P50 changes in hypoxia, hypercapnia and polycythaemia was performed in an heterogeneous group of forty three patients: hypoxic subjects with or without hypercapnia, with or without polycythaemia and polycythaemic subjects without hypoxia. A statistical analysis was undertaken using comparison of the means, study of the correlations, principal component analysis, multiple regression and correspondence analysis. In the patients studied, P50 changes were not wholly explained by those of 2-3 DPG and pH; PaCO2, per se, did not play an important part. Haemoglobin concentration and P50 value would represent an adaptative mechanism to hypoxia: when hypoxia is moderate (80 greater than PaO2 greater than or equal to 65 torr) and isolated, oxygen haemoglobin affinity decreases (P50 increases); when hypoxia is severe (PaO2 less than 65 torr) and combined with hypercapnia and disturbed acid-base equilibrium, P50 comes back to normal range but haemoglobin increases, restoring thus, the normal blood oxygen content.
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PMID:Changes of P50 in hypoxaemia, hypercapnia and polycythaemia: multivariate analysis. 60 4

2,3-DPG and P50 were measured in 23 patients with chronic obstructive lung disease. All patients had a chronic hypercapnia (PaCO2 greater than or equal to 45 Torr). They are shared in 3 groups, according to hemoglobin content [Hb] and hypoxia : group I(PaO2 = 48.0 +/- 2.4 Torr ; [Hb] = 15.9 +/- 0.3 g. 100 ml-1; n = 9), (M +/- 1 SE); group II (PaO2 = 46.4 +/- 5.0 Torr; [Hb] = 11.6 +/- 0.7 g. 100 m[-1; n = 7); group III(PaO2 = 61.4 +/- 2.4 Torr; [Hb] = 13.3 +/- 0.4 g. 100 ml-1; n = 7). 2,3-DPG (group I : 1.05 +/- 0.06 mole.moleHb-1; group II : 1.02 +/- 0.08; group III : 1.11 +/- 0.08) was not significantly different of 2,3-DPG value of 12 control subjects (0.96 +/- 0.04). P50 of group I (26.9 +/- 0.9 Torr) and group III patients (28.1 +/- 1.6 Torr) was not significantly different of control value of P50 (27.4 +/- 0.5 Torr). P50 of group II patients (29.6 +/- 0.8 Torr) was significantly higher than P50 control and group I values (p less than 0.05). All the patients of group II died. These results suggest that in patients with chronic obstructive lung disease : 1) P50 value is different with various clinical conditions; 2) P50 increase is a compensatory mechanism in severe hypoxemia with anemia, but is not sufficient; 3) [Hb] is the best data for clinical prognosis.
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PMID:[Study of P50 and 2,3-diphosphoglycerate in 23 bronchoemphysema patients as a function of hypoxia and hemoglobin concentration]. 89 17

Ten mongrel dogs (mean weight: 27 kg) awake and with an implanted femoral catheter have been maintained for three days in a controlled chamber (10% CO2 and 21% O2). Arterial blood samples, taken before admission and after one, two, four, six, 24, 48 and 72 hours of exposure, allowed to study blood gases and acid-base equilibrium. Glycemia, phosphatemia, erythrocyte concentration of glucose-6-phosphate (G-6-P), fructose-6-phosphate (F-6-P), fructose-1,6-diphosphate (F-1,6-DP), 2,3-diphosphoglycerate (2,3-DPG), pyruvate, lactate and ATP were also titrated by various enzymatic methods. In addition, nine reference subjects were studied in air (without CO2). During the hypercapnia, [H+] rapidly increases to 70 nmol/1, then progressively decreases after 24 hours, while [HCO3-] slowly rises. The glycemia stays high during the whole exposure. There is also an increase in inorganic phosphate, G-6-P and F-6-P, but during the first 24 hours only. F-1,6-DP, pyruvate and lactate remain lowered during the whole exposure. The 2,3-DPG diminishes after the sixth hour. These phenomena, related to the acidosis and probably to the phosphofructokinase inhibition don't arise in the reference subjects. However the latter present after a two and four hour-stay in the chamber a small decrease in pyruvicemia and lactacidemia.
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PMID:[Intermediates of erythrocyte glycolysis during three days hypercapnia in the dog (author's transl)]. 101 72

Ten patients with respiratory insufficiency (mean age: 63 years) are studied during the first 12 hours of intubation and assisted ventilation by a strong volumic respirator (Bennett MA1, FIO2: 0.40). Arterial blood samples are taken before, and after 30 min, one, two, four, six and 12 hours of assisted ventilation, for measurement of blood gases, acid-base equilibrium, haemoglobin and haematocrit, and, by various enzymatic methods, of lactate, pyruvate, ATP and 2,3-DPG concentrations. The PaCO2 rapidly decreases from 75 to 44 mmHg within 30 min ventilation. At the same time, SH+] decreases from 50 to 34 nmol/l. This "reventilation alkalosis" is still more marked later on (PaCO2: 34 mmHg; H+: nmol/l at the sixth hour). The mean PaO2 remains to about 70 mmHg during the assisted ventilation. The glycemia varies little and remains at a high level (140 mg%). The arterial blood lactate concentration progressively increases (from 1.6 to 2.5 mmol/l) at the second hour of ventilation, then decreases to 1.8 mmol/l at the 12th hour. The arterial blood pyruvate concentration also increases, with a peak at the fourth hour. The 2,3-DPG concentration significantly increases from the fourth hour on, whilst the blood ATP decrease is already significant at the first hour of assisted ventilation. These transient changes in glycolysis in chronic hypercapnic patients during assisted ventilation are similar to those observed in the dog when PaCO2 is rapidly normalized after a long term hypercapnia.
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PMID:[Transient blood modifications of glycolysis in hypercapnic patients with artificial ventilation (author's transl)]. 107 Oct 11

In order to study the effect of the decrease in P-Pi caused by low pH on hemoglobin-oxygen affinity, we measured P-Pi,2,3-diphosphoglycerate (2,3-DPG), and oxygen tension at 50% saturation (P50) in 36 cases with acute exacerbation of chronic respiratory failure with hypercapnia. The cases were classified into two groups by arterial blood pH values obtained on the day of admission. Group A: pH less than or equal to 7.35 and Group B: pH greater than or equal to 7.36. P50 was calculated by a modification of Severinghaus' equation developed by Yusa and Kohsaka, and it was corrected by applying the carboxy-hemoglobin (COHb) coefficient. On the day of admission (stage I), 2,3-DPG and P50 in both groups were slightly higher than in the control group. In Group A, a week after admission (stage II), these values decreased and became significantly lower than they had been at stage I. Especially 2,3-DPG in stage II was even lower than those of the control group. Approximately 14 days after admission, in stage III, it was found that these values had risen to the initial level at stage I. In Group A, similar changes were also observed for P-Pi. The value of P-Pi was low in stage II and recovered to the initial value in stage III. On the other hand, we found that the urinary excretion of phosphorus (U-Pi) increased at stage I in Group A. It was supposed that the increase in U-Pi at stage I caused a decrease in P-Pi, which caused the decrease in 2,3-DPG, in stage II.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Hemoglobin-oxygen affinity in acute exacerbation of chronic respiratory failure]. 207

The hemoglobin-oxygen dissociation curve and the relationships between the parameters of tension, saturation, capacity, affinity and concentration of oxygen in the course of respiratory failure in chronic obstructive lung diseases (COLD) were studied. The study included 141 patients divided into four basic groups according to the value of pO2 (a): patients with normoxia, mild, moderate and severe arterial hypoxia. The blood-gas status was determined using the ABL-330 and OSM-3 analyzers (Radiometer A/S, Denmark). It is concluded that: 1. Presence of normoxia (pO2 and sO2 in norm) in COLD patients does not exclude abnormalities in their arterial blood oxygen transport and increased risk of tissue hypoxia. 2. Total oxygen concentration in respiratory failure is relatively stable and "independent" from the stepwise decrease of the arterial pO2, which results from the compensatory increase of the total and effective hemoglobin. 3. There are phase fluctuations of the ctO2/pO2 dissociation curve in the reference interval, expressed in the "lowering" of P50 and p90 in mild hypoxia and the "centering" or "raising" of their values in severe hypoxia. Such fluctuations are more pronounced in the p90 than in the p50. 4. The oxygen extraction tension lowers progressively (without reaching the anaerobic threshold) and the oxygen compensation factor elevates with the pO2 (a) reduction and the arising of hypercapnia and acidemia. 5. The calculated 2,3-diphosphoglycerate (2,3-DPG) concentration values are significantly higher in hypercapnics with COHb > 1% than in those with COHb < 1%. The relationships between hypoxia, oxygen affinity, hemoglobinemia and oxygen affinity as well as the dissociation curve properties in chronic respiratory failure are discussed.
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PMID:Relationships between blood oxygen parameters in patients with chronic obstructive lung disease. 819 1


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