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

After successful rescue from drowning there may develop a situation which is called secondary drowning, resulting in acute respiratory distress characterized by interstitial pulmonary oedema, hypoxaemia, hypercapnia and acidosis during drowning, direct alteration of the alveolar membrane by aspirated water and particulate matters and a volume overloading by adsorption and--not seldom--inept therapy. This situation requires mechanical ventilation and forced diuresis, combined with high doses of steroids, antibiotics and digitalis. We present the case of an eleven year old patient whose clinical course demonstrate the necessity of exact clinical observation after rescue from drowning. After development of acute respiratory distress only the immediate utilization of the therapeutic modalities of an intensive care may result in a satisfactory outcome. Four months later our patient had normal pulmonary function except for a moderate reduction of compliance.
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PMID:[Acute respiratory distress syndrome after near-drowning (author's transl)]. 90 76

The cardiopulmonary effects of mechanical distension of the rumen were studied in nonanesthetized sheep. Results in group I ewes indicated that simply increasing intraruminal pressure by compressed air insufflation did not seriously affect cardiopulmonary hemodynamics. Changes were more serious in group II ewes when water injection was followed by ruminal insufflation with compressed air. Heart rate, total peripheral resistance, and total pulmonary resistance increased, with a concommitant increase in arterial and pulmonary blood pressure and decrease in stroke volume. Infusion of water alone increased heart rate and cardiac output. The blood gas data indicated a definite arterial hypoxemia and hypercapnia, suggesting impaired ventilation during ruminal distension. The increase in total pulmonary resistance was thought to be due to alveolar hypoxia caused by a significant decrease in ventilation.
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PMID:Cardiopulmonary effects of mechanical distension of the rumen in nonanesthetized sheep. 93 5

It is well accepted that hyperventilation before breath hold swimming and diving makes it possible for a person to extend the time under water. Less well known is the fact that this maneuver can cause loss of consciousness due to hypoxia. This accident happens almost exclusively to males (56 cases). The most common age group was 16-20 years (range 12-33 years). All were known to be good swimmers or divers. Approximately 80% of the cases occurred in guarded pools. Thirty-five subjects survived the accident and of the twenty-three fatalities, there was only one good autopsy report. In this instance the findings were those associated with classical drowning preceded by hypoxia and hypercapnia. Breath holding experiments indicated that the times between loss of consciousness and death may be no longer than 2.5 minutes. The patterns associated with these cases suggest that those who are responsible for aquatic safety as supervisors or guards of pools could prevent most accidents by watching for young male swimmers who are practicing hyperventilation and underwater swimming in competition with themselves or with others.
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PMID:Summary of 58 cases of loss of consciousness during underwater swimming and diving. 97 64

The total CO2 is titrated in liver, abdominal and leg's muscles, brain and thigh-bone of rats exposed to 8 +/- 1% of carbon dioxide under normoxic (20-23% of O2) and normobaric conditions during zero, two, four or six weeks. Total (H2Ot) and extracellular (H2Oe) water is measured in these organs by the 3H-inulin method. The CO2 storage in organs is expressed in relation to the PaCO2 increase (mmol-kg-1 fresh tissue-torr-1). During a four week hypercapnia, this CO2 increase is very important in bone and brain compared with that of other organs and of the whole body. With regard to the whole body, the bone CO2 content is still increasing after four weeks. The increase in extracellular bicarbonate (delta[HCO3-e]/delta PaCO2) is negligible (1/100 th) in comparison with the whole carbonic increase (delta CO2/delta PaCO2). The bone extracellular compartment diminishes in relation with the experimentation duration, without any significant change in H2Oi (Student's analysis). A factorial analysis (BENZECRI) shows that the weight of H2Oe in the information diminishes for all organs, both with the duration of normal subjects observation (ageing) and with the hypercapnia duration.
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PMID:[CO2 storage in various organs during chronic experimental hypercapnia (author's transl)]. 101 73

The role of the skeleton in electrolyte equilibrium, well known for various diseases, remains difficult to understand during chronic hypercapnia. An experimental study of normoxic (O2:21%) hypercapnia (CO2:8 +/- 1%) was carried out for two, four and six weeks, followed by a systematic quantitative determination, in thigh-bone samples of Na+, K+, Ca++, PO4--, N2 and CO2 in 72 rats, and of total H2O and extracellular H2O (H2Oe) in 129 rats. Considering the mean values of groups (from 16 to 42 subjects for each group), at various times of hypercapnia, bone K+ was increased during hypercapnia (+3 to 4 X 10(-3) mEq/g fresh tissue), Ca++ diminished (--12.5 to 15.4 mEq). PO4-- and Na+ temporarily decreased at two and four weeks of hypercapnia. On account of the scatter of individual results, only the variation of K+ was statistically significant (at two weeks). This increase in bone K+, accompanying a partially compensated acidaemia, is to compare with the significant hyperkaliemia observed at two and four weeks, whereas this period is characterized by a decrease in K+ in skeletal muscle, as shown in a previous work. In a group of 72 rats, the analysis of correspondances and correlations points out the bone CO2 as a very significant variable, opposite to the variable H2Oe. PO4--is positively correlated to Na+. The complexity of the results does not permit a decisive interpretation of the phenomenon. On the other hand, this study corroborates the bone calcium loss and reveals the gain in bone potassium during hypercapnia.
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PMID:[Bone electrolytes in experimental chronic hypercapnia (author's transl)]. 101 78

Impaired water excretion has been described in stable, nonedematous patients with chronic obstructive lung disease (COLD). To elucidate the mechanism involved, we measured basal glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and water, sodium, and solute excretion for 4 hours after water loading (20 ml. per kilogram orally or as D5W intravenously) in two groups of 10 age-matched, hypoxic, stable, nonedematous COLD normocapneic and hypercapneic patients (PCO2 less than or greater than 45 mm. Hg, respectively). In 5 patients of each group, additional measurements of plasma and urine osmolality and plasma vasopressin were made at 30-minute intervals after oral water loading and the results compared to those obtained in 10 normal control subjects. Hypoxic (PO2 61 plus or minus 2 mm. Hg), normocapneic (PCO2 39 plus or minus 1 mm. Hg) patients had normal GFR (114 plus or minus 5 ml. per minute) and ERPF (517 plus or minus 31 ml. per minute) and excreted the load normally (101 plus or minus 5 per cent of oral or intravenous water per 4-hours). This was associated with a normal rate of sodium excretion (34 plus or minus 5 mEq. per 4-hours) and low-normal plasma vasopressin (1.9 plus or minus 0.7 pg. per milliliter) which was suppressed appropriately with water loading. Hypercapneic (PCO2' 62 plus or minus 5), hypoxic (PCO2' 57 plus or minus 2) patients had normal GFR (106 plus or minus 7), low baseline vasopressin (1.1 plus or minus 0.2) which was suppressed appropriately, and decreased (p less than 0.05) 4-hour water excretion (63 plus or minus 8 per cent), 4-hour sodium excretion (15 plus or minus 9), and ERPF (394 plus or minus 31). A significant correlation was observed between impaired water and impaired sodium excretion (p less than 0.05). These studies indicate that in COLD patients: (1) hypercapnia but not hypoxemia is related to the abnormal water handling and to the increased reabsorption of sodium by the renal tubule; (2) the defect in water excretion is not related to abnormal vasopressin secretion or metabolism; (3) the alteration in sodium excretion may be due to hypercapneic-induced increase in renal bicarbonate reabsorption and/or abnormal renal blood flow.
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PMID:Impaired water handling in chronic obstructive lung disease. 114 29

Brain uptake of antipyrine, water and ethanol was studied in rats under normo-, hypo- and hypercapnic conditions. Brain uptake of D- and L-lactate was studied in normal rats. The uptake was determined with the Oldendorf method, using single common carotid arterial injections of a mixture of -14C-labeled test substance and tritiated reference substance. The results demonstrate that L-lactate is taken up by the brain in significant amounts. The results also demonstrate marked differences in the uptakes of antipyrine, water and ethanol. The brain uptake of antipyrine is lower, the brain uptake of ethanol higher, than of water. The brain uptake of all 3 substances was shown not to be affected by changes in cerebral blood flow, although a decrease of brain uptake of antipyrine relative to ethanol was observed during hypo- and hypercapnia.
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PMID:Brain uptake of lactate, antipyrine, water and ethanol. 114 66

The degree of disability of a patient with chronic respiratory failure must be determined on a theoretical basis. Using a water filled spirometer, VC and FEV1 tracings are observed several times until the maximal values are clearly reproduced. The percentage deficit of the patients' ventilatory capacity is determined by the formula (see article) and represents the first approximation of the degree of disability (in %). The result must now be corrected by arterial blood gas data obtained during 5 mon exhaustive work on a bicycle or tread-mill ergometer. The percentage disability results from a correction depending on the arterial pO2 and the pCO2 found during exercise: deterioration of the arterial hypoxemia and/or hypercapnia leads to an increase and their normalization to a decrease in the disability quota found during spirometry. Patients with unstable chronic obstructive lung disease and respiratory failure should be evaluated only after adequate rehabilitation at home and at work, and after cessation of smoking. Patients under tuberculostatic treatment must also be excluded from disability evaluation. The degree of disability determined on the basis of lung function tests is a theoretical one; the tests must be performed by trained staff in a pulmonary function laboratory.
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PMID:[Proceedings: Home treatment of chronic respiratory insufficiency: criteria of disability]. 121 92

The effects of hypoxia and superimposed hypercapnia or hypertension during hypoxia on brain tissue water content, pH, and electric activity were studied in Sprague-Dawley and stroke-prone spontaneously hypertensive rats. Auditory brainstem responses and sensory evoked potentials were recorded during the experiment as the indices for cerebral oxygen metabolism. The brains were removed immediately, 1 day, and 2 days after hypoxic insult for gravimetric study. The brain water content increased in all groups on the 1st and 2nd days after hypoxia. The percentage change from the control water content increased only on the 1st day in hypoxic rats. In contrast, it increased on both the 1st and 2nd days after hypoxia in hypercapnic or hypertensive rats. The evoked potentials of hypoxic and hypercapnic-hypoxic rats showed that peak latencies were prolonged significantly during hypoxia and recovered 1 and 2 days after hypoxia. The brain tissue pH decreased during hypoxia and recovered after hypoxia. This study suggests that brain edema develops within 2 days of hypoxic insult and that superimposed hypercapnia or hypertension promotes the brain edema.
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PMID:The effect of hypoxia on brain edema--the promoting effect of superimposed hypercapnia or hypertension. 128 17

Digoxin-like immunoreactive factor (DLIF) is an endogenous substance with natriuretic and diuretic activity. Elevated plasma levels of DLIF are found in various clinical states characterized by water and sodium retention. Chronic respiratory failure, particularly of an advanced stage, also is frequently associated with water and sodium retention. In order to determine whether elevated plasma levels of DLIF are present in chronic respiratory failure, we measured plasma DLIF levels in seven patients (four with COPD [two of whom had associated sleep apnea disturbance] and three with kyphoscoliosis) suffering from advanced chronic respiratory failure with severe hypoxemia and hypercapnia. We found that in these patients plasma levels of DLIF were significantly higher than in healthy control subjects. We conclude that patients with advanced chronic respiratory failure respond with increased levels of DLIF. This may represent an attempt at homeostasis of water and sodium metabolism which is frequently deranged in this clinical condition.
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PMID:Endogenous digoxin-like immunoreactive factor is elevated in advanced chronic respiratory failure. 130 96


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