J Am Soc Nephrol 2018 Apr 20. Epub 2018 Apr 20.

Section of Nephrology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.

Urine citrate is reabsorbed exclusively along the renal proximal tubule the apical Na-dicarboxylate cotransporter NaDC-1. We previously showed that an acid load and media acidification increase NaDC-1 activity through endothelin-1 (ET-1)/endothelin B (ET) signaling. Here, we further examined the signaling pathway mediating acid-induced NaDC-1 activity. Read More

Ann Intensive Care 2018 Apr 19;8(1):48. Epub 2018 Apr 19.

Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Background: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease.

Results: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data. Read More

J Pharmacol Exp Ther 2018 Apr 19. Epub 2018 Apr 19.

Massachusetts General Hospital

Thyrotropin releasing hormone (TRH) is a tripeptide hormone and a neurotransmitter widely-expressed in the CNS that regulates thyroid function and that maintains physiologic homeostasis. Following injection in rodents, TRH has multiple effects including increased blood pressure and breathing. We tested the hypothesis that TRH and its long-acting analog, taltirelin, will reverse morphine-induced respiratory depression in anesthetized rats following intravenous(IV) or intratracheal(IT) administration. Read More

Nephron 2018 Apr 12. Epub 2018 Apr 12.

Renal, Electrolyte and Hypertension Division of the Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Background: Acid-base disturbances are frequent in critically ill patients. Arterial blood gas (ABG) is the gold standard in the diagnosis of these disturbances, but it is invasive with potential hazards. For patients with a central venous catheter, venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool. Read More

J Anaesthesiol Clin Pharmacol 2018 Jan-Mar;34(1):117-119

Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Read More

A A Pract 2018 Feb 6. Epub 2018 Feb 6.

From the Departments of Pediatric Anesthesiology and Pediatric General Surgery at Westchester Medical Center, New York Medical College, Valhalla, New York.

We present the case of the first stage of separation of 9-month-old pygopagus conjoined twins who demonstrated minimal shared vasculature on preoperative imaging and no cross-sedation or cross-neuromuscular blockade during separate inductions of anesthesia. Laparoscopy was implemented in 1 twin at a time, then in both twins simultaneously. Despite insufflation of a single-twin's abdomen, both twins demonstrated hypercapnia and signs of a concomitant respiratory acidosis because of carbon dioxide diffusion through a shared peritoneal membrane. Read More

Tuberk Toraks 2017 Dec;65(4):333-336

Intensive Care Unit, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Noninvasive ventilation is the first line treatment of choice in acute respiratory failure in many diseases including post-extubation respiratory failure. Herein we report a case unresponsive to noninvasive ventilation due to tracheal stenosis. A 49- year -old female was admitted to intensive care unit after successful resuscitation of cardiac arrest. Read More

BMJ Case Rep 2018 Apr 5;2018. Epub 2018 Apr 5.

Neurology, Vinayaka Neuro Multispecialty Clinic, Warangal, India.

A 24-year-old woman came to the emergency room of our hospital, 6 hours after a sting to the pulp of her middle finger of her left upper limb by an Indian red scorpion. On examination, she had tachycardia, tachypnoea, hypotension and low oxygen saturation at room temperature. On auscultation, there was poor air entry in all areas of the right lung along with crackles. Read More

J Hum Genet 2018 Apr 4. Epub 2018 Apr 4.

Department of General Paediatrics, Metabolic Diseases, University Children's Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Muenster, Germany.

Seven subunits of the mitochondrial contact site and cristae junction (CJ) organizing system (MICOS) in humans have been recently described in function and structure. QIL1 (also named MIC13) is a small complex that is crucial for the maintenance and assembling of MICOS. A novel mutation of an essential splice site in the C19orf70 gene encoding QIL1 induces severe mitochondrial encephalopathy, hepatopathy and lactate acidosis consistent with psychomotor retardation. Read More

J Pediatr Endocrinol Metab 2018 Mar;31(4):399-405

Uludag University Faculty of Medicine, Department of Pediatrics, Division of Metabolism, Bursa, Turkey.

Background: The purpose of this study is to help elucidate which part of the mitochondria is causing a problem through anamnesis, physical examination, and routine biochemical tests in the event of a suspected mitochondrial disease case.

Methods: The data were obtained retrospectively from the medical records of 75 cases; the mitochondrial-derived disease (MDD) cases were observed in our center from 2011 to 2017.

Results: The most commonly observed MDDs were oxidative phosphorylation disorders at 44%, followed by fatty acid oxidation disorder at 40%, pyruvate metabolism disorder at 12%, and ketone metabolism disorder at 4%, respectively. Read More

Case Rep Infect Dis 2018 15;2018:4165960. Epub 2018 Jan 15.

Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba 272-0824, Japan.

We report an aggressive case of polymicrobial bacteremia in a patient with renal pelvis carcinoma. A 76-year-old man developed watery diarrhea after undergoing chemotherapy. He became unconscious and went into shock. Read More

Case Rep Crit Care 2018 17;2018:6039045. Epub 2018 Jan 17.

Division of Cardiothoracic Surgery, Washington University, St. Louis, MO, USA.

Though rare, rituximab has been reported to induce severe pulmonary edema. We describe the first report of ECLS utilization for this indication. A 31-year-old female with severe thrombotic thrombocytopenic purpura developed florid pulmonary edema after rituximab infusion. Read More

Front Immunol 2018 7;9:475. Epub 2018 Mar 7.

Laboratoire académique de Pédiatrie, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium.

In humans, acid-base balance is crucial to cell homeostasis. Acidosis is observed in numerous inflammatory processes, primarily acute conditions such as sepsis, trauma, or acute respiratory distress where females tend to exhibit better prognosis compared with males. The mechanisms underlying these gender-dependent differences are multiple, probably involving hormonal and genetic factors, particularly the X chromosome. Read More

Ann Intensive Care 2018 Mar 27;8(1):43. Epub 2018 Mar 27.

Intensive Care Unit, 1st Department of Respiratory Medicine, "Sotiria" Hospital, National and Kapodistrian University of Athens, 152 Mesogion Av., 115 27, Athens, Greece.

Chloride represents-quantitatively-the most prevalent, negatively charged, strong plasma electrolyte. Control of chloride concentration is a probable major mechanism for regulating the body's acid-base balance and for maintaining homeostasis of the entire internal environment. The difference between the concentrations of chloride and sodium constitutes the major contributor to the strong ion difference (SID); SID is the key pH regulator in the body, according to the physicochemical approach. Read More

Pediatr Neonatol 2018 Mar 5. Epub 2018 Mar 5.

Ann and Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Aim: Our study objectives were to evaluate umbilical cord blood acid-base balance in presence of nuchal cord at delivery, effects of nuchal cord at delivery on perinatal outcomes and incidence of nuchal cord in a racially diverse population.

Methods: Perinatal records of 2530 women (predominantly African American and Hispanic) who delivered in 2012 were examined. Perinatal outcomes of women who delivered a baby with nuchal cord were compared with those without nuchal cord. Read More

Int J Cardiol 2018 May;259:100-102

St. Josefs-Hospital, Wiesbaden, Germany. Electronic address:

Background: Pulmonary vein isolation (PVI) is generally performed under analgosedation, but sedation protocols vary and no optimal protocol has been defined. We investigated procedural, respiratory and hemodynamic parameters in patients undergoing PVI using analgosedation either with or without midazolam.

Methods: In a prospective observational study, we compared n = 43 consecutive patients (54% male, mean age 62 years) undergoing PVI using analgosedation either with or without midazolam added to propofol and fentanyl. Read More

Clin Respir J 2018 Mar 23. Epub 2018 Mar 23.

Department of Respiratory Diseases, Akdeniz University, School of Medicine, Antalya, Turkey.

Introduction: An increased risk of cardiovascular complications has been defined in community-acquired pneumonia (CAP), but limited data is available for patients with severe CAP.

Objective: The aim of the present study was to define the prevalence, characteristics, risk factors and impact on mortality of acute cardiac events in patients with severe CAP during short and long term.

Method: This investigation was a multicenter, retrospective cohort sudy of patients with severe CAP. Read More

Crit Care Med 2018 Mar 21. Epub 2018 Mar 21.

Medical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France.

Objectives: To describe an unusual complication on extracorporeal membrane oxygenation.

Data Sources: Clinical observation.

Study Selection: Case report. Read More

Electron Physician 2017 Dec 25;9(12):6087-6093. Epub 2017 Dec 25.

Ph.D. of Reproductive Health, Assistant professor, Department of Midwifery, School of Nursing & Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.

Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies. Read More

Am J Emerg Med 2018 Mar 13. Epub 2018 Mar 13.

Kocaeli University, Faculty of Medicine, Dept. of Emergency Medicine, Kocaeli, Turkey.

Introduction: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. Read More

Lab Anim 2018 Jan 1:23677218764024. Epub 2018 Jan 1.

2 Division of Obstetrics and Gynaecology, University of Western Australia, Australia.

Short-term anaesthesia of the pregnant ewe may be required for caesarean delivery of a preterm foetus within a research protocol. The aim of this study was to evaluate and compare the acid-base and haematological status of the ewe and foetus at the time of surgical delivery by collecting maternal and foetal arterial blood samples. Fifteen date-mated singleton-pregnant merino cross ewes at 122. Read More

J Matern Fetal Neonatal Med 2018 Apr 3:1-8. Epub 2018 Apr 3.

a Mater Research Institute, University of Queensland , Brisbane , Australia.

Objective: To determine obstetric, intrapartum, and perinatal outcomes for pregnancies with isolated foetal congenital heart defects (CHDs).

Methods: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Read More

Acta Anaesthesiol Scand 2018 Mar 12. Epub 2018 Mar 12.

Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden.

Background: In a previous study, we found a rebound of arterial carbon dioxide tension (PaCO ) after stopping THAM buffer administration. We hypothesized that this was due to reduced pulmonary CO elimination during THAM administration. The aim of this study was to investigate this hypothesis in an experimental porcine hypercapnic model. Read More

Pediatr Pulmonol 2018 Mar 12. Epub 2018 Mar 12.

Division of Pediatric Emergency Medicine, Dokuz Eylul University, School of Medicine, Izmir, Turkey.

Aim: High-flow nasal cannula (HFNC) is a new treatment option for pediatric respiratory distress and we aimed to assess early predictive factors of unresponsiveness to HFNC therapy in a pediatric emergency department (ED).

Method: Patients who presented with respiratory distress and were treated by HFNC, were included. The age, gender, weight, medical history, diagnosis, vital signs, oxygen saturation/fraction of inspired oxygen (SpO /FiO ) ratio, modified Respiratory Distress Assessment Instrument (mRDAI) scores, medical interventions, duration of HFNC therapy, time to escalation, adverse effects, and laboratory test results were obtained from medical and nursing records. Read More

Top Companion Anim Med 2017 Dec 18;32(4):146-150. Epub 2017 Aug 18.

Servei d'Emergències i Cures Intensives. Fundació Hospital Clínic Veterinari UAB. Universitat Autònoma de Barcelona, Barcelona, Spain; Departament de Medicina i Cirurgia Animal. Facultat de Veterinària de la UAB. Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address:

A 3-month-old intact male Prague ratter was presented to the emergency service for evaluation of progressive lethargy, weakness, coughing and labour breathing after an episode of resistance to oral deworming. The patient exhibited depression, increased respiratory effort and cyanosis at initial presentation. Results of first diagnostic work-up (complete blood cell count, biochemistry panel and thoracic x-rays) were all consistent with aspiration pneumonia. Read More

Case Rep Oncol 2017 Sep-Dec;10(3):1085-1091. Epub 2017 Nov 28.

Department of Internal Medicine, OLVG West Amsterdam, Amsterdam, The Netherlands.

Lactic acidosis is a commonly observed clinical condition that is associated with a poor prognosis, especially in malignancies. We describe a case of an 81-year-old patient who presented with symptoms of tachypnea and general discomfort. Arterial blood gas analysis showed a high anion gap acidosis with a lactate level of 9. Read More

J Intensive Care Med 2018 Jan 1:885066618762335. Epub 2018 Jan 1.

3 David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.

Background And Objectives: In severe circulatory failure agreement between arterial and mixed venous or central venous values is poor; venous values are more reflective of tissue acid-base imbalance. No prior study has examined the relationship between peripheral venous blood gas (VBG) values and arterial blood gas (ABG) values in hemodynamic compromise. The objective of this study was to examine the correlation between hemodynamic parameters, specifically systolic blood pressure (SBP) and the arterial-peripheral venous (A-PV) difference for all commonly used acid-base parameters (pH, Pco, and bicarbonate). Read More

EBioMedicine 2018 Apr 24;30:86-93. Epub 2018 Feb 24.

Wellcome Centre for Mitochondrial Research, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK. Electronic address:

Mutations in the m.13094T>C MT-ND5 gene have been previously described in three cases of Leigh Syndrome (LS). In this retrospective, international cohort study we identified 20 clinically affected individuals (13 families) and four asymptomatic carriers. Read More

Rev Esp Anestesiol Reanim 2018 Feb 27. Epub 2018 Feb 27.

Critical Care Department, King's College Hospital, London, Reino Unido. Electronic address:

Threatening refractory metabolic acidosis due to short-term starvation nondiabetic ketoacidosis is rarely reported. Severe ketoacidosis due to starvation itself is a rare occurrence, and more so in pregnancy with a concomitant stressful clinical situation. This case report presents a nondiabetic woman admitted in intensive care for respiratory failure type 1 during the third trimester of pregnancy with a severe metabolic acidosis refractory to medical treatment. Read More

Medicine (Baltimore) 2018 Mar;97(9):e0010

Department of Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Rationale: Circulatory failure, especially with low systemic vascular resistance (SVR), as observed in septic shock, thyrotoxicosis, and anemia, is a particular pattern that should suggest thiamine (vitamin B1) deficiency. The clinical picture of wet beriberi secondary to thiamine deficiency only demonstrates non-specific clinical manifestations. For a diagnosis of wet beriberi, medical history is very important. Read More

Med Intensiva 2018 Feb 24. Epub 2018 Feb 24.

Servicio de Medicina Intensiva, Hospital Universitario Sagrat Cor, Barcelona, España; Universidad Autónoma de Barcelona, Sabadell, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, España.

Important recent insights have emerged regarding the cellular and molecular role of carbon dioxide (CO) and the effects of hypercapnia. The latter may have beneficial effects in patients with acute lung injury, affording reductions in pulmonary inflammation, lessened oxidative alveolar damage, and the regulation of innate immunity and host defenses by inhibiting the expression of inflammatory cytokines. However, other studies suggest that CO can have deleterious effects upon the lung, reducing alveolar wound repair in lung injury, decreasing the rate of reabsorption of alveolar fluid, and inhibiting alveolar cell proliferation. Read More

Acta Paediatr 2018 Feb 26. Epub 2018 Feb 26.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Aim: This study evaluated the medical quality of acute airborne transports carried out by a neonatal emergency transport service in a Swedish healthcare region from 2012 to 2015.

Methods: The transport charts and patient records of all infants transported to the regional centre were reviewed for transport indications and vital parameters and outcomes.

Results: We identified 187 acute airborne transports and the main indications for referral were therapeutic hypothermia after perinatal asphyxia, extremely preterm birth and respiratory failure. Read More

Eur J Appl Physiol 2018 04 22;118(4):865-866. Epub 2018 Feb 22.

Department of Anesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.

Shock 2018 Feb 21. Epub 2018 Feb 21.

Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11). Read More

Am J Obstet Gynecol 2018 Feb 17. Epub 2018 Feb 17.

Mater Research Institute - University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland, Australia, QLD 4101; Mater Mothers' Hospital, Raymond Terrace, South Brisbane, Queensland, Australia, QLD 4101; School of Medicine, The University of Queensland, Brisbane, Australia. Electronic address:

Background: Small-for-gestational age (SGA) infants (birthweight <10 centile) are at increased risk of perinatal complications but are frequently not identified antenatally, particularly in low risk women delivering at term (>37 weeks gestation). This is compounded by the fact that late pregnancy ultrasound is not the norm in many jurisdictions for this cohort of women. We thus investigated the relationship between birthweight <10 centile and serious neonatal outcomes in low risk women at term. Read More

JA Clin Rep 2017 9;3(1):34. Epub 2017 Jun 9.

3Department of Anesthesia, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902 Japan.

Aortobronchial fistula (ABF) is a rare and potentially lethal complication of thoracic aortic replacement surgery. Currently, thoracic endovascular aortic repair (TEVAR) has emerged as a less invasive alternative to open surgery for ABF to facilitate prompt hemostasis. However, there are no published reports of TEVAR for ABF, particularly for presentation with life-threatening respiratory failure from massive hemoptysis. Read More

BMJ Case Rep 2018 Feb 8;2018. Epub 2018 Feb 8.

Paediatric Department, University Hospital of Wales, Cardiff, UK.

A 6-month-old male infant with Stuve-Wiedemann syndrome (SWS) presented with an acute respiratory arrest secondary to a rhinovirus respiratory infection from which he was rapidly resuscitated. He developed an acute kidney injury requiring supportive treatment and on day 3 of his illness was noted to have developed severe rhabdomyolysis (creatine kinase level 132 040 U/L (normal <320 U/L)). He was born from consanguineous parents with homozygous mutations in the leukaemia inhibitory factor receptor. Read More

Exp Ther Med 2018 Feb 14;15(2):1775-1780. Epub 2017 Dec 14.

Department of Neonatology, Xuzhou Chlidren's Hospital, Xuzhou, Jiangsu 221002, P.R. China.

Acute respiratory distress syndrome (ARDS) mainly involves acute respiratory failure. In addition to this affected patients feel progressive arterial hypoxemia, dyspnea, and a marked increase in the work of breathing. The only clinical solution for the above pathological state is ventilation. Read More

Ann Transl Med 2018 Jan;6(2):31

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.

Extracorporeal carbon dioxide removal (ECCOR) has been proposed as an adjunctive intervention to avoid worsening respiratory acidosis, thereby preventing or shortening the duration of invasive mechanical ventilation (IMV) in patients with exacerbation of chronic obstructive pulmonary disease (COPD). This review will present a comprehensive summary of the pathophysiological rationale and clinical evidence of ECCOR in patients suffering from severe COPD exacerbations. Read More

Am J Hum Genet 2018 Mar 8;102(3):460-467. Epub 2018 Feb 8.

Department of Pediatrics, Salzburger Landeskliniken and Paracelsus Medical University Salzburg, 5020 Salzburg, Austria. Electronic address:

Respiratory chain complex I deficiency is the most frequently identified biochemical defect in childhood mitochondrial diseases. Clinical symptoms range from fatal infantile lactic acidosis to Leigh syndrome and other encephalomyopathies or cardiomyopathies. To date, disease-causing variants in genes coding for 27 complex I subunits, including 7 mitochondrial DNA genes, and in 11 genes encoding complex I assembly factors have been reported. Read More

Clin Toxicol (Phila) 2018 Feb 8:1-9. Epub 2018 Feb 8.

a Division of Medical Toxicology, Department of Emergency Medicine , University of Virginia School of Medicine , Charlottesville , VA , USA.

Objective: The aim of this systematic review was to identify isolated acute cyanide poison cases and to identify reported signs, symptoms, and laboratory findings.

Methods: We searched MEDLINE, Cochrane Reviews, and Web of Science case reports and series using a number of MeSH descriptors pertaining to cyanide, toxicity, and poisonings. We excluded studies on plants, laboratory analyses, smoke inhalation poisonings, animals as well as non-English language articles and those in which data were not available. Read More

Br J Anaesth 2018 Feb 2;120(2):274-283. Epub 2017 Dec 2.

Department of General Internal Medicine & Emergency Medicine, Hirslanden Klinik im Park, Zurich, Switzerland.

Background: This double-blind randomised controlled trial investigated whether normal saline or a balanced crystalloid has distinct effects on vasopressor use in patients undergoing major abdominal surgery.

Methods: Patients received either normal saline 0.9% or an acetate-buffered crystalloid for intraoperative volume replacement in a goal-directed fashion. Read More

G Ital Nefrol 2018 Feb;35(1)

S.S. Nefrologia e Dialisi, Ospedale E. Agnelli, Pinerolo, Turin, ASL TO3.

Background: Lactic acidosis (LA) is the most common form of metabolic acidosis, defined by lactate values greater than 5 mmol/L and pH<7.34. The pathogenesis of LA involves hypoxic causes (type A) and non-hypoxic (type B), often coexisting. Read More

Arch Bronconeumol 2018 Mar 19;54(3):149-154. Epub 2018 Jan 19.

Lane Fox Respiratory Unit, St Thomas' Hospital, London.

Patients with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure have high levels of morbidity and mortality. The clinical efficacy of long term home oxygen therapy has been well documented in this patient group but despite the efficacy of non-invasive ventilation (NIV) during acute decompensated respiratory failure the addition of home NIV has been associated with equivocal results. The physiological efficacy of home NIV to improve gas exchange in chronic stable hypercapnic respiratory failure has been proven in small studies but larger clinical trials failed to translate this into clinical efficacy. Read More

Aquat Toxicol 2018 Mar 31;196:124-131. Epub 2018 Jan 31.

Zoophysiology, Department of Bioscience, Aarhus University, Building 1131 C.F. Møllers Allé 3, DK-8000 Aarhus C., Denmark. Electronic address:

Nitrite and carbon dioxide are common environmental contaminants in the intensive aquaculture ponds used to farm clown knifefish (Chitala ornata) in the Mekong delta, Vietnam. Here we tested the hypothesis that hypercapnia reduces nitrite uptake across the gills, because pH regulation will reduce chloride uptake and hence nitrite uptake as the two ions compete for the same transport route via the branchial HCO/Cl exchanger. Fish fitted with arterial catheters were exposed to normocapnic/normoxic water (control), nitrite (1 mM), hypercapnia (21 mmHg CO), or combined hypercapnia (acclimated hypercapnia) and nitrite for 96 h. Read More

J Exp Biol 2018 Mar 21;221(Pt 6). Epub 2018 Mar 21.

Department of Biological Sciences, University of Manitoba, Winnipeg, MB, R3T2N2, Canada

Many studies have investigated ammonia excretion and acid-base regulation in aquatic arthropods, yet current knowledge of marine chelicerates is non-existent. In American horseshoe crabs (), book gills bear physiologically distinct regions: dorsal and ventral half-lamellae, a central mitochondria-rich area (CMRA) and peripheral mitochondria-poor areas (PMPAs). In the present study, the CMRA and ventral half-lamella exhibited characteristics important for ammonia excretion and/or acid-base regulation, as supported by high expression levels of Rhesus-protein 1 (LpRh-1), cytoplasmic carbonic anhydrase (CA-2) and hyperpolarization-activated cyclic nucleotide-gated K channel (HCN) compared with the PMPA and dorsal half-lamella. Read More