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    Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review.
    Am J Perinatol 2017 Mar 22. Epub 2017 Mar 22.
    Maternal and Child Health Program, University of Maryland, College Park, Maryland.
    Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. Read More

    Hypercapnia Caused by a Therapeutic Dosage of Pregabalin in a Tetraplegic Patient With Cervical Spinal Cord Injury.
    Am J Phys Med Rehabil 2017 Mar 20. Epub 2017 Mar 20.
    From the Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea (KHD, EJC, H-EY); and Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Korea (MCC).
    Pregabalin is often used for the treatment of neuropathic pain in patients with spinal cord injury (SCI). We reported a patient with C5 [S(C5/C6)] ASIA Impairment Scale C SCI due to cervical myelopathy who presented CO2 retention when taking a therapeutic dosage of pregabalin. An 88-year-old patient with cervical SCI was transferred to the department of physical medicine and rehabilitation. Read More

    Extracellular acidosis and very low [Na(+) ] inhibit NBCn1- and NHE1-mediated net acid extrusion from mouse vascular smooth muscle cells.
    Acta Physiol (Oxf) 2017 Mar 20. Epub 2017 Mar 20.
    Department of Biomedicine, Aarhus University, Denmark.
    Aim: The electroneutral Na(+) ,HCO3(-) -cotransporter NBCn1 and Na(+) /H(+) -exchanger NHE1 regulate acid-base balance in vascular smooth muscle cells (VSMCs) and modify artery function and structure. Pathological conditions-notably ischemia-can dramatically perturb intracellular (i) and extracellular (o) pH and [Na(+) ]. We examined effects of low [Na(+) ]o and pHo on NBCn1 and NHE1 activity in VSMCs of small arteries. Read More

    Effects of sevoflurane and clonidine on acid base status and long-term emotional and cognitive outcomes in spontaneously breathing rat pups.
    PLoS One 2017 20;12(3):e0173969. Epub 2017 Mar 20.
    Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.
    Background: Numerous experiments in rodents suggest a causative link between exposure to general anaesthetics during brain growth spurt and poor long-lasting neurological outcomes. Many of these studies have been questioned with regard of their translational value, mainly because of extremely long anaesthesia exposure. Therefore, the aim of the present study was to assess the impact of a short sevoflurane anaesthesia, alone or combined with clonidine treatment, on respiratory function in spontaneously breathing rat pups and overall effects on long-lasting emotional and cognitive functions. Read More

    Benefits of 21% Oxygen Compared with 100% Oxygen for Delivery of Isoflurane to Mice (Mus musculus) and Rats (Rattus norvegicus).
    J Am Assoc Lab Anim Sci 2017 Mar;56(2):148-154
    Unit for Laboratory Animal Medicine, Department of Pathology, University of Michigan, Ann Arbor, Michigan.
    At research institutions, isoflurane delivered by precision vaporizer to a face mask is the standard for rodent surgery and for procedures with durations that exceed a few minutes. Pure oxygen is often used as the carrier gas for isoflurane anesthesia, despite documented complications from long-term 100% oxygen use in humans and known occupational safety risks. We therefore examined the effect of anesthetic delivery gas on physiologic variables in mice and rats. Read More

    Intravenous 15% isoflurane lipid nanoemulsion for general anesthesia in dogs.
    Vet Anaesth Analg 2017 Jan 7. Epub 2017 Jan 7.
    Faculty of Agronomy and Veterinary Medicine, Central Institute of Sciences, University of Brasilia, Brasilia, DF, Brazil.
    Objective: To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs.

    Study Design: Prospective, crossover, experimental study.

    Animals: Seven healthy, mature, mixed-breed dogs, three male and four female, weighing 11. Read More

    [Severe imported malaria in adults: a retrospective study of thirteen cases admitted to the Intensive Care Unit in Marrakech].
    Pan Afr Med J 2016 21;25:179. Epub 2016 Nov 21.
    Service de Parasitologie Mycologie, Hôpital Militaire Avicenne Marrakech, Maroc.
    Imported malaria is being seen with increasing frequency in non-endemic areas. Severe forms represent 10% of cases of Plasmodium falciparum malaria. In Morocco, more than 50 cases of malaria occur each year, 83% of which with Plasmodium falciparum malaria. Read More

    Acid-base disturbances in nephrotic syndrome: analysis using the CO2/HCO3 method (traditional Boston model) and the physicochemical method (Stewart model).
    Clin Exp Nephrol 2017 Mar 13. Epub 2017 Mar 13.
    Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
    Background: The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome.

    Methods: Twenty-nine patients with nephrotic syndrome and six patients without urinary protein or acid-base disturbances provided blood and urine samples for analysis that included routine biochemical and arterial blood gas tests, plasma renin activity, and aldosterone. Read More

    White sturgeon (Acipenser transmontanus) acid-base regulation differs in response to different types of acidoses.
    J Comp Physiol B 2017 Mar 11. Epub 2017 Mar 11.
    Department of Zoology, University of British Columbia, Vancouver, BC, Canada.
    White sturgeon (Acipenser transmontanus) completely protect intracellular tissue pH (pHi) despite large reductions in extracellular (blood) pH (pHe), termed preferential pHi regulation, in response to elevated environmental PCO2 (hypercarbia) and in general appear to be relatively resilient to stressors. Preferential pHi regulation is thought to be associated with hypercarbia tolerance in general, but has also recently been observed to protect pHi against metabolic acidoses induced by exhaustive exercise and anoxia in a tropical air breathing catfish. We hypothesized that preferential pHi regulation may also be a general strategy of acid-base regulation in sturgeon. Read More

    Guillain-Barré Syndrome Presenting with Sinus Node Dysfunction and Refractory Shock.
    Am J Case Rep 2017 Mar 11;18:251-254. Epub 2017 Mar 11.
    Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY, USA.
    BACKGROUND Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy that is usually associated with preceding respiratory or gastrointestinal infection and has the hallmark manifestation of ascending flaccid paralysis. We report an atypical presentation of GBS. CASE REPORT A 76-year-old male presented with acute onset of diaphoresis and altered mental status. Read More

    Lifetime exercise intolerance with lactic acidosis as key manifestation of novel compound heterozygous ACAD9 mutations causing complex I deficiency.
    Neuromuscul Disord 2017 Feb 14. Epub 2017 Feb 14.
    Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address:
    We report a 36-year-old female having lifetime exercise intolerance and lactic acidosis with nausea associated with novel compound heterozygous Acyl-CoA dehydrogenase 9 gene (ACAD9) mutations (p.Ala390Thr and p.Arg518Cys). Read More

    A Rare Cause of Neonatal Hemolytic Anemia: Glutathione Synthetase Deficiency.
    J Pediatr Hematol Oncol 2017 Mar 6. Epub 2017 Mar 6.
    *Pediatric Nutrition and Metabolism Clinic †Pediatric Hematology and Oncology Clinic ‡Genetic Clinic §Neonatalogy Clinic ∥Pediatric Nefrology Clinic, Health Sciences University, Kayseri Training and Research Hospital, Kayseri, Turkey.
    Background: Isolated hemolysis or hemolytic anemia and 5-oxoprolinuria are 2 distinct medical conditions in the clinical spectrum associated with glutathione synthetase deficiency.

    Clinical Observation: A 1-day-old female baby presented with anemia and respiratory distress. Her hemoglobin level was 9. Read More

    JSA guideline for the management of malignant hyperthermia crisis 2016.
    • Authors:
    J Anesth 2017 Feb 28. Epub 2017 Feb 28.
    Malignant hyperthermia (MH) can be fatal if the crisis is not appropriately treated. It is an inherited disease usually triggered by the administration of volatile inhalational anesthetics and/or succinylcholine, a muscle relaxant. In a patient with suspected MH, the mechanism of calcium release from storage in the sarcoplasmic reticulum in the skeletal muscle is abnormally accelerated. Read More

    Effects of three methadone doses combined with acepromazine on sedation and some cardiopulmonary variables in dogs.
    Vet Anaesth Analg 2017 Jan 7. Epub 2017 Jan 7.
    School of Veterinary Medicine, University of Vila Velha, Vila Velha, ES, Brazil. Electronic address:
    Objective: To evaluate the sedative and cardiopulmonary effects of three methadone doses, combined with acepromazine, in dogs.

    Study Design: Prospective, randomized, complete block study.

    Animals: Six healthy, adult, cross-bred dogs weighing 17. Read More

    Vinculin variant M94I identified in sudden unexplained nocturnal death syndrome decreases cardiac sodium current.
    Sci Rep 2017 Feb 20;7:42953. Epub 2017 Feb 20.
    Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin, Madison, WI 53792, USA.
    Sudden unexplained nocturnal death syndrome (SUNDS) remains an autopsy negative disorder with unclear etiology. Vinculin (VCL) was linked to sudden arrhythmia death in VCL knockout mice prior to the appearance of cardiomyopathy. We hypothesized VCL mutations underlie risk for SUNDS. Read More

    The influence of mechanical ventilation on physiological parameters in ball pythons (Python regius).
    Comp Biochem Physiol A Mol Integr Physiol 2017 Feb 10;207:30-35. Epub 2017 Feb 10.
    Centre for Zoo and Wildlife Health, Copenhagen Zoo, Roskildevej 32, 2000 Frederiksberg, Denmark.
    Mechanical ventilation is widely recommended for reptiles during anesthesia, and while it is well-known that their low ectothermic metabolism requires much lower ventilation than in mammals, very little is known about the influence of ventilation protocol on the recovery from anesthesia. Here, 15 ball pythons (Python regius) were induced and maintained with isoflurane for 60min at one of three ventilation protocols (30, 125, or 250mlmin(-1)kg(-1) body mass) while an arterial catheter was inserted, and ventilation was then continued on 100% oxygen at the specified rate until voluntary extubation. Mean arterial blood pressure and heart rate (HR) were measured, and arterial blood samples collected at 60, 80, 180min and 12 and 24h after intubation. Read More

    Dynamics of acid-base and hematological regulation in day 15 chicken embryos (Gallus gallus domesticus) exposed to graded hypercapnia and hypoxia.
    Respir Physiol Neurobiol 2017 May 9;239:55-63. Epub 2017 Feb 9.
    Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, 1155 Union Circle #305220, Denton, TX 76203, USA.
    Most experiments examining acid-base regulation of chicken embryos have employed static, single time point measurements rather than dynamic, multiple time point measurements that might reveal additional components of developing acid-base regulation. Thus, we studied blood acid-base balance and hematology of day 15 chicken embryos under 24h exposure to graded hypercapnia (1%-7% CO2) accompanied by graded hypoxia (20% O2 down to 13% O2). Across all hypercapnic/hypoxic environments, respiratory acidosis occurred 2h after exposure in proportion to the magnitude of hypercapnia. Read More

    [Systemic lupus erythematosus presenting as severe alveolar hypoventilation and the shrinking lung syndrome].
    Rev Mal Respir 2017 Feb 8. Epub 2017 Feb 8.
    Service des maladies respiratoires, unité Inserm 903, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France. Electronic address:
    Introduction: The shrinking lung syndrome (SLS) is a rare complication of systemic lupus erythematosus.

    Case Report: A 69-year-old man presented with exertional dyspnoea, muscle weakness, and weight loss of 15kg in 6months. Pulmonary function tests revealed a restrictive lung disorder, with a dramatic decrease in maximal inspiratory pressure (17% of theoretical value), and alveolar hypoventilation (pH 7. Read More

    Lactic Acidosis with Chloramphenicol Treatment in a Child with Cystic Fibrosis.
    J Popul Ther Clin Pharmacol 2017 Jan 30;24(1):40-45. Epub 2017 Jan 30.
    Department of Pediatrics, University of Montreal.
    Children with cystic fibrosis are commonly colonized with multi-resistant bacteria. In such patients, infectious exacerbation may require salvage therapy with uncommonly used antimicrobials, including chloramphenicol. Chloramphenicol is rarely used nowadays because of the associated severe adverse events. Read More

    Blast-Burn Combined Injury Followed by Immediate Seawater Immersion Induces Hemodynamic Changes and Metabolic Acidosis: An Experimental Study in a Canine Model.
    Clin Lab 2016 Jul;62(7):1193-1199
    Background: Severe burn-blast combined injury often causes systematic dysfunction related to blood coagulation, anticoagulation, and fibrinolysis. However, studies of burn-blast combined injury followed by immersion in seawater are rarely reported.

    Methods: A canine burn-blast combined injury model was established including blast injury caused by explosion immediately followed by burning with gelatinized gasoline flames. Read More

    Pulmonary gas exchange and acid-base status during immobilisation of black rhinoceroses (Diceros bicornis) in Zimbabwe.
    J S Afr Vet Assoc 2016 Dec 2;87(1):e1-e9. Epub 2016 Dec 2.
    Department of Clinical Sciences, Swedish University of Agricultural Sciences.
    When immobilising wildlife, adverse side effects can include hypoxaemia, acidosis and hypertension. Pulmonary gas exchange and acid-base status were evaluated during immobilisation of 25 free-ranging and one boma-held black rhinoceros (Diceros bicornis) in Zimbabwe. The effect of different body positions on arterial oxygenation was evaluated. Read More

    Further delineation of a rare recessive encephalomyopathy linked to mutations in GFER thanks to data sharing of whole exome sequencing data.
    Clin Genet 2017 Feb 2. Epub 2017 Feb 2.
    Centre de Génétique et Centre de référence «Anomalies du Développement et Syndromes Malformatifs», Hôpital d'Enfants, Centre Hospitalier Universitaire de Dijon, Dijon, France.
    Background: Alterations in GFER gene have been associated with progressive mitochondrial myopathy, congenital cataracts, hearing loss, developmental delay, lactic acidosis and respiratory chain deficiency in 3 siblings born to consanguineous Moroccan parents by homozygosity mapping and candidate gene approach (OMIM#613076). Next generation sequencing recently confirmed this association by the finding of compound heterozygous variants in 19-year-old girl with a strikingly similar phenotype, but this ultra-rare entity remains however unknown from most of the scientific community.

    Materials And Methods: Whole exome sequencing was performed as part of a "diagnostic odyssey" for suspected mitochondrial condition in 2 patients, presenting congenital cataracts, progressive encephalomyopathy and hypotrophy and detected unreported compound heterozygous variants in GFER. Read More

    A case of rapid progression of postoperative hyperthermia: Dantrolene or not dilemma?
    Int J Crit Illn Inj Sci 2016 Oct-Dec;6(4):203-205
    Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA.
    Malignant hyperthermia (MH) is an extremely rare and life-threatening differential diagnosis of postoperative fever. We present an 8-month-old child scheduled for elective outpatient procedure who rapidly developed high fever, tachycardia, and respiratory acidosis shortly after transfer to the postanesthesia care unit. MH hotline expert recommended administering dantrolene, but there was no evidence of hypermetabolism or lactic acidosis. Read More

    Bilateral putaminal necrosis in a comatose patient with metabolic acidosis.
    Indian J Crit Care Med 2016 Dec;20(12):745-748
    Department of Neurology, Institute of Neurological Sciences, Apollo Hospitals, Hyderabad, Telangana, India.
    We present a case of acute-onset coma in a young woman, associated with metabolic acidosis, respiratory distress, and hypotension. Magnetic resonance imaging of the brain done on day 2 of admission showed features of bilateral putaminal necrosis. History of methanol ingestion, though not forthcoming at admission, was confirmed later after the patient regained consciousness. Read More

    Acidosis Activates Endoplasmic Reticulum Stress Pathways through GPR4 in Human Vascular Endothelial Cells.
    Int J Mol Sci 2017 Jan 27;18(2). Epub 2017 Jan 27.
    Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA;.
    Acidosis commonly exists in the tissue microenvironment of various pathophysiological conditions such as tumors, inflammation, ischemia, metabolic disease, and respiratory disease. For instance, the tumor microenvironment is characterized by acidosis and hypoxia due to tumor heterogeneity, aerobic glycolysis (the "Warburg effect"), and the defective vasculature that cannot efficiently deliver oxygen and nutrients or remove metabolic acid byproduct. How the acidic microenvironment affects the function of blood vessels, however, is not well defined. Read More

    [Metabolic acidosis].
    G Ital Nefrol 2016 Nov-Dec;33(6)
    Metabolic acidosis is frequently observed in clinical practice, especially among critically ill patients and/or in the course of renal failure. Complex mechanisms are involved, in most cases identifiable by medical history, pathophysiology-based diagnostic reasoning and measure of some key acid-base parameters that are easily available or calculable. On this basis the bedside differential diagnosis of metabolic acidosis should be started from the identification of the two main subtypes of metabolic acidosis: the high anion gap metabolic acidosis and the normal anion gap (or hyperchloremic) metabolic acidosis. Read More

    A definition of gentle ventilation in congenital diaphragmatic hernia: a survey of neonatologists and pediatric surgeons.
    J Perinat Med 2017 Jan 28. Epub 2017 Jan 28.
    Ventilation practices have changed significantly since the initial reports in the mid 1980 of successful use of permissive hypercapnia and spontaneous ventilation [often called gentle ventilation (GV)] in infants with congenital diaphragmatic hernia (CDH). However, there has been little standardization of these practices or of the physiologic limits that define GV. We sought to ascertain among Diaphragmatic Hernia Research and Exploration; Advancing Molecular Science (DHREAMS) centers' GV practices in the neonatal management of CDH. Read More

    MELAS (Mitochondrial Encephalomyopathy, Lactic Acidosis, Stroke) - a Diagnosis Not to be Missed.
    Ir Med J 2016 Sep 9;109(8):455. Epub 2016 Sep 9.
    Departments of Paediatrics, Neurology and Radiology, Childrens University Hospital, Temple St, Dublin 1.
    MELAS is a rare mitochondrial disorder. We report two cases in Irish males where the characteristics were evident, but the diagnosis not made for a considerable period of time. In one of the cases the symptoms were presumed secondary to prematurity. Read More

    Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.
    Intensive Care Med 2017 Feb 20;43(2):200-208. Epub 2017 Jan 20.
    CIBER Enfermedades Respiratorias, Madrid, Spain.
    Purpose: To analyze the relationship between hypercapnia developing within the first 48 h after the start of mechanical ventilation and outcome in patients with acute respiratory distress syndrome (ARDS).

    Patients And Methods: We performed a secondary analysis of three prospective non-interventional cohort studies focusing on ARDS patients from 927 intensive care units (ICUs) in 40 countries. These patients received mechanical ventilation for more than 12 h during 1-month periods in 1998, 2004, and 2010. Read More

    Preventing Hospitalizations From Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
    Am J Med Sci 2017 Jan 2;353(1):31-40. Epub 2016 Jul 2.
    , Johnson City, Tennessee.
    Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. Read More

    Strategies to Prevent Cast Formation in Patients with Plastic Bronchitis Undergoing Heart Transplantation.
    Pediatr Cardiol 2017 Jan 19. Epub 2017 Jan 19.
    The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
    Plastic bronchitis, a rare complication after Fontan palliation, carries a high morbidity and mortality risk. Heart transplantation is an effective treatment option, but casts may occur in the early post-operative period. We present a case series detailing peri-operative management strategies to minimize morbidity and mortality related to plastic bronchitis in patients undergoing heart transplantation. Read More

    Sepsis-related acute respiratory distress syndrome in children with cancer: the respiratory dynamics of a devastating condition.
    Rev Bras Ter Intensiva 2016 Oct-Dec;28(4):436-443
    Departamento de Oncologia Pediátrica, Grupo de Apoio ao Adolescente e à Criança com Câncer, Instituto de Oncologia Pediátrica, Universidade Federal de São Paulo - São Paulo (SP), Brasil.
    Objective:: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome.

    Methods:: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Read More

    Disseminated adenovirus infection causing severe ARDS.
    BMJ Case Rep 2017 Jan 17;2017. Epub 2017 Jan 17.
    Department of Infectious Diseases, Ohio State University College of Medicine, Columbus, Ohio, USA.
    A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. Read More

    Non-invasive respiratory support for infants with bronchiolitis: a national survey of practice.
    BMC Pediatr 2017 Jan 17;17(1):20. Epub 2017 Jan 17.
    Children's Acute Transport Service, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
    Background: Bronchiolitis is a common respiratory illness of early childhood. For most children it is a mild self-limiting disease but a small number of children develop respiratory failure. Nasal continuous positive airway pressure (nCPAP) has traditionally been used to provide non-invasive respiratory support in these children, but there is little clinical trial evidence to support its use. Read More

    Clinical indicators of blood gas disturbances, elevated L-lactate concentration and other abnormal blood parameters in newborn beef calves.
    Vet J 2017 Jan 6;219:49-57. Epub 2016 Dec 6.
    Department of Production Animal Health, University of Calgary Faculty of Veterinary Medicine, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada. Electronic address:
    Blood gas disturbances, commonly resulting from dystocia, are associated with failed transfer of passive immunity, morbidity and mortality in newborn calves. Modified APGAR scores intended to identify compromised calves are not widely adopted due to lack of practicality and inconsistent associations with blood parameters. The objective of this study was to determine clinical indicators of acidemia in newborn beef calves. Read More

    The midpoint between ventilatory thresholds approaches maximal lactate steady state intensity in amateur cyclists.
    Biol Sport 2016 Dec 10;33(4):373-380. Epub 2016 Oct 10.
    Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain.
    The aim was to determine whether the midpoint between ventilatory thresholds (MPVT) corresponds to maximal lactate steady state (MLSS). Twelve amateur cyclists (21.0 ± 2. Read More

    Assessment of the optimal operating parameters during extracorporeal CO2 removal with the Abylcap® system.
    Int J Artif Organs 2017 01 12;39(11):580-585. Epub 2017 Jan 12.
    Intensive Care, Ghent University Hospital, Ghent - Belgium.
    Purpose: Lung protective ventilation is recommended in patients with acute respiratory distress syndrome (ARDS) needing mechanical ventilation. This can however be associated with hypercapnia and respiratory acidosis, such that extracorporeal CO2 removal (ECCO2R) can be applied. The aim of this study was to derive optimal operating parameters for the ECCO2R Abylcap® system (Bellco, Italy). Read More

    Treatment of Acidified Blood Using Reduced Osmolarity Mixed-Base Solutions.
    Front Physiol 2016 26;7:625. Epub 2016 Dec 26.
    Medical and Research Services, Veterans Health Administration Greater Los Angeles Area Healthcare SystemLos Angeles, CA, USA; Division of Nephrology, Veterans Health Administration Greater Los Angeles Area Healthcare SystemLos Angeles, CA, USA; Membrane Biology Laboratory, David Geffen School of Medicine, University of California, Los AngelesLos Angeles, CA, USA.
    We hypothesize that reduced osmolarity mixed-base (ROMB) solutions can potentially serve as customizable treatments for acidoses, going beyond standard solutions in clinical use, such as 1.0 M sodium bicarbonate. Through in silico quantitative modeling, by treating acidified canine blood using ROMB solutions, and by performing blood-gas and optical microscopy measurements in vitro, we demonstrate that ROMB solutions having a high proportion of a strong base, such as disodium carbonate or sodium hydroxide, can be effective in reducing carbon dioxide pressure PCO2 while raising pH and bicarbonate ion concentration without causing significant osmotic damage to red blood cells, which can occur during rapid administration of hypertonic solutions of weak bases. Read More

    Respiratory gas exchange as a new aid to monitor acidosis in endotoxemic rats: relationship to metabolic fuel substrates and thermometabolic responses.
    Physiol Rep 2017 Jan;5(1)
    Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
    This study introduces the respiratory exchange ratio (RER; the ratio of whole-body CO2 production to O2 consumption) as an aid to monitor metabolic acidosis during the early phase of endotoxic shock in unanesthetized, freely moving rats. Two serotypes of lipopolysaccharide (lipopolysaccharide [LPS] O55:B5 and O127:B8) were tested at shock-inducing doses (0.5-2 mg/kg). Read More

    Activity of Tachykinin1-Expressing Pet1 Raphe Neurons Modulates the Respiratory Chemoreflex.
    J Neurosci 2017 Feb 16;37(7):1807-1819. Epub 2017 Jan 16.
    Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, and
    Homeostatic control of breathing, heart rate, and body temperature relies on circuits within the brainstem modulated by the neurotransmitter serotonin (5-HT). Mounting evidence points to specialized neuronal subtypes within the serotonergic neuronal system, borne out in functional studies, for the modulation of distinct facets of homeostasis. Such functional differences, read out at the organismal level, are likely subserved by differences among 5-HT neuron subtypes at the cellular and molecular levels, including differences in the capacity to coexpress other neurotransmitters such as glutamate, GABA, thyrotropin releasing hormone, and substance P encoded by the Tachykinin-1 (Tac1) gene. Read More

    Is potassium thiosulfate a poison? Is it safe? A case series.
    J Pak Med Assoc 2017 Jan;67(1):137-139
    Department of Emergency Medicine, Marmara University Pendik Research and Training Hospital, Istanbul, Turkey.
    Potassium Thiosulfate is a liquid substance used for producing fertilizers. In this case series, we present five patients who have been exposed to potassium thiosulfate inhalation. Three of them were intubated in the scene by paramedics because of confusion and respiratory depression. Read More

    Acute salicylate poisoning: risk factors for severe outcome.
    Clin Toxicol (Phila) 2017 Mar 9;55(3):175-180. Epub 2017 Jan 9.
    c Division of Medical Toxicology, Department of Emergency Medicine , Icahn School of Medicine at Mount Sinai , New York , NY , USA.
    Context: Salicylate poisoning remains a significant public health threat with more than 20,000 exposures reported annually in the United States.

    Objective: We aimed to establish early predictors of severe in-hospital outcomes in Emergency Department patients presenting with acute salicylate poisoning.

    Methods: This was a secondary data analysis of adult salicylate overdoses from a prospective cohort study of acute drug overdoses at two urban university teaching hospitals from 2009 to 2013. Read More

    3-MeO-PCP intoxication in two young men: First in vivo detection in Italy.
    Forensic Sci Int 2016 Dec 26. Epub 2016 Dec 26.
    Forensic Toxicology Division, Department of Health Science, University of Florence, Italy. Electronic address:
    3-MeO-PCP or 3-methoxyphencyclidine is a derivative of phencyclidine. It acts as a dissociative anesthetic and it has allegedly hallucinogenic and sedative effects. There are almost no documented intoxication cases and references about its pharmacology and toxicity in literature. Read More

    Assessment of resuscitation as measured by markers of metabolic acidosis and features of injury.
    Bone Joint J 2017 Jan;99-B(1):122-127
    MetroHealth Medical Center, Case Western Reserve University, Department of Orthopaedic Surgery, 2500 MetroHealth Drive, Cleveland, Ohio, 44109, USA.
    Aims: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery.

    Patients And Methods: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Read More

    Severe Hypoxemia in Muskoxen ( Ovibos moschatus ) Immobilized with Etorphine and Xylazine Corrected with Supplemental Nasal Oxygen.
    J Wildl Dis 2017 Jan 4. Epub 2017 Jan 4.
    3 Department of Forestry and Wildlife Management, Hedmark University of Applied Sciences, Campus Evenstad, NO-2480 Koppang, Norway.
    Twenty-three muskoxen ( Ovibos moschatus ) housed in a captive facility for rewilding in Sweden were chemically immobilized for annual health evaluations and hoof trimming. The muskoxen were darted in May to September (2012-2015) in their holding pen with etorphine (0.015 mg/kg) and xylazine (0. Read More

    The effectiveness of apneic oxygenation during tracheal intubation in various clinical settings: a narrative review.
    Can J Anaesth 2017 Apr 3;64(4):416-427. Epub 2017 Jan 3.
    Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, MC2-405, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada.
    Purpose: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. Read More

    The dangers of accepting a single diagnosis: case report of concurrent Plasmodium knowlesi malaria and dengue infection.
    Malar J 2017 Jan 3;16(1). Epub 2017 Jan 3.
    Hospital Raja Perempuan Zainab II, 15000, Kota Bharu, Kelantan, Malaysia.
    Background: Dengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Read More

    Mutations in the accessory subunit NDUFB10 result in isolated complex I deficiency and illustrate the critical role of intermembrane space import for complex I holoenzyme assembly.
    Hum Mol Genet 2016 Dec 30. Epub 2016 Dec 30.
    Department of Chemistry, Institute of Biochemistry, University of Cologne, Cologne, Germany
    An infant presented with fatal infantile lactic acidosis and cardiomyopathy, and was found to have profoundly decreased activity of respiratory chain complex I in muscle, heart and liver. Exome sequencing revealed compound heterozygous mutations in NDUFB10, which encodes an accessory subunit located within the PD part of complex I. One mutation resulted in a premature stop codon and absent protein, while the second mutation replaced the highly conserved cysteine 107 with a serine residue. Read More

    Respiratory acidosis in obese gynecological patients undergoing laparoscopic surgery independently of the type of ventilation.
    Acta Anaesthesiol Taiwan 2016 Dec 1;54(4):131-133. Epub 2016 Dec 1.
    Moscow Institute of Physics and Technology (State University), Dolgoprudny, Moscow Region, Russia; The Russian National Research Medical University named after N.I. Pirogov, Moscow, Russia. Electronic address:

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