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Anesthesiology
Description:
e and severity of lung injury induced by systemic sepsis. Methods In the hypercapnic acidosis series, adult male Sprague-Dawley rats were randomized to normocapnia or hypercapnic acidosis-produced by adding 5% carbon dioxide to the inspired gas-and cecal ligation and puncture performed. In the buffered hypercapnia series, animals were first randomized to housing under conditions of environmental normocapnia or hypercapnia-produced by exposure to 8% carbon dioxide-to allow renal buffering. After 96 h, cecal ligation and puncture was performed. In both series, the animals were ventilated for 6 h, and the severity of the lung injury and hemodynamic deterioration were assessed. Results Both hypercapnic acidosis and buffered hypercapnia attenuated the development and severity of hypotension and reduced lactate accumulation compared to normocapnia. Hypercapnic acidosis reduced lung injury and inflammation, decreased mean (+ or - SD) bronchoalveolar lavage protein concentration (232 + or - 50 versus 279 + or - 27 microg x ml(-1)) and median neutrophil counts (3,370 versus 9,120 cells x ml(-1)), and reduced histologic lung injury. In contrast, buffered hypercapnia did not reduce the severity of systemic sepsis induced lung injury. Conclusions Both hypercapnic acidosis and buffered hypercapnia attenuate the hemodynamic consequences of systemic sepsis. In contrast, hypercapnic acidosis, but not buffered hypercapnia, reduced the severity of sepsis-induced lung injury....
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Keywords {🔍}
hypercapnia, lung, hca, normocapnia, buffered, injury, acidosis, protocol, hypercapnic, significantly, table, systemic, compared, effects, sepsis, arterial, groups, carbon, dioxide, animals, reduced, group, baseline, bal, acute, pressure, setting, blood, oxygen, hemodynamic, bacterial, decreased, tension, time, fig, volume, clp, severity, min, pulmonary, data, induced, bicarbonate, experimental, effect, concentrations, differences, versus, buffering, histologic,
Topics {✒️}
high-stretch mechanical ventilation cellular immune function37–39reduction student-newman-keuls testing endotoxin9-induced lung injury hypercapnia-induced sympathetic stimulation sepsis-induced lung injury bal tnf-α levels ventilator-induced lung injury reduced bal tnf-α severe evolving11and established12pneumonia positive end-expiratory pressure acute lung injury clp-induced systemic sepsis important clinical issue quantitative stereological techniques traditional tidal volumes differential cell counts carbon dioxide pneumoperitoneum lung injury induced acute hypercapnic acidosis volume expansion caused central venous pressure carbon dioxide tension bal protein concentrations complicate critical illness severe lung injury central venous pressures median neutrophil counts lower tidal volumes foregoing issues tidal volume sympathetic nervous system rights reserved arterial oxygen tension increased bacterial load hypercapnia-induced acidosis added carbon dioxide generate carbon dioxide systemic sepsis induced arterial lactate concentrations systemic organ injury bal colony counts dynamic lung compliance bal tnf-α lung injury produced post hoc testing peak airway pressure oxygen saturation measurement acid-base status acid–base status
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