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    2321 results match your criteria Respiratory Alkalosis

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    Acetazolamide Usage in Severe Chronic Obstructive Pulmonary Disease: Pros and Cons.
    Ann Am Thorac Soc 2017 Jun 16. Epub 2017 Jun 16.
    Puget Sound VA Hospital, Pulmonary and Critical Care Medicine, Seattle, Washington, United States.
    Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with COPD with the goal of improving oxygenation, reducing carbon dioxide retention and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex since CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves. Read More

    Cystic fibrosis prevalence among a group of high-risk children in the main referral children hospital in Iran.
    J Educ Health Promot 2017 5;6:54. Epub 2017 Jun 5.
    Department of Pediatric Pulmonology, Child Growth and Development Research Center, Faculty of Medicine, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
    Background: Knowledge about cystic fibrosis (CF) in Iran is very limited. The objective of this study was to determine the prevalence of CF among a group of high-risk children with suggestive clinical features in the main referral hospital in Iran.

    Materials And Methods: This study children consisted of 505 patients who had presented with one or more of the following symptoms: chronic or recurrent respiratory symptoms, gastrointestinal symptoms as rectal prolapse, steatorrhea, hepatobiliary disease as prolonged jaundice, failure to thrive, hyperglycemia and glycosuria, hypochloremic metabolic alkalosis, hypoprothrombinemia, anemia or edema, and positive family history of CF. Read More

    Water, electrolyte, acid-base, and trace elements alterations in cirrhotic patients.
    Int Urol Nephrol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Medicine, Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
    Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group. Read More

    Metabolic Acidosis or Respiratory Alkalosis? Evaluation of a Low Plasma Bicarbonate Using the Urine Anion Gap.
    Am J Kidney Dis 2017 Jun 6. Epub 2017 Jun 6.
    Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT.
    Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history. Read More

    Sedative and cardiorespiratory effects of detomidine constant rate infusion in sheep.
    Lab Anim 2017 Jan 1:23677217714013. Epub 2017 Jan 1.
    Department of Veterinary Medicine, Federal University of Goiás, Brazil.
    The use of sheep in experiments is widespread and is increasing worldwide, and so is the need to develop species-specific anaesthetic techniques to ensure animal safety. Previous studies have mentioned several protocols involving the administration of alpha-2 adrenergic agonists in sheep; however, assessment of the efficacy and safety of these infusion techniques is still relatively new. Thus, the aim of the present study is to assess the effectiveness of detomidine constant rate infusion (CRI) in sheep by measuring the cardiovascular and respiratory parameters, blood gas variables and sedation scores. Read More

    Effect of voluntary hypocapnic hyperventilation or moderate hypoxia on metabolic and heart rate responses during high-intensity intermittent exercise.
    Eur J Appl Physiol 2017 May 19. Epub 2017 May 19.
    Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Ibaraki, 305-8574, Japan.
    Purpose: To investigate the effect of voluntary hypocapnic hyperventilation or moderate hypoxia on metabolic and heart rate responses during high-intensity intermittent exercise.

    Methods: Ten males performed three 30-s bouts of high-intensity cycling [Ex1 and Ex2: constant-workload at 80% of the power output in the Wingate anaerobic test (WAnT), Ex3: WAnT] interspaced with 4-min recovery periods under normoxic (Control), hypocapnic or hypoxic (2500 m) conditions. Hypocapnia was developed through voluntary hyperventilation for 20 min prior to Ex1 and during each recovery period. Read More

    [Procedural analysis of acid-base balance disorder: case serials in 4 patents].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 May;29(5):436-441
    Department of Nephrology, Shuyang People's Hospital, Suqian 223600, Jiangsu, China (Ma CY); Teaching Section of Mathematics, China Medical University, Shenyang 110000, Liaoning, China (Wang GJ). Corresponding author: Wang Guijie, Email:
    Objective: To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph.

    Methods: The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. Read More

    Renal manifestations of primary mitochondrial disorders.
    Biomed Rep 2017 05 12;6(5):487-494. Epub 2017 Apr 12.
    Paulista de Medicina School, Federal University of São Paulo, Primeiro Andar CEP, São Paulo 04039-032, SP, Brazil.
    The aim of the present review was to summarize and discuss previous findings concerning renal manifestations of primary mitochondrial disorders (MIDs). A literature review was performed using frequently used databases. The study identified that primary MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) at onset or in the later course of the MID. Read More

    Electrolyte and Acid-Base Disturbances in End-Stage Liver Disease: A Physiopathological Approach.
    Dig Dis Sci 2017 May 13. Epub 2017 May 13.
    Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, 14080, Mexico City, Mexico.
    Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination. Read More

    Respiratory alkalosis may impair the production of vitamin D and lead to significant morbidity, including the fibromyalgia syndrome.
    Med Hypotheses 2017 May 8;102:99-101. Epub 2017 Mar 8.
    Department of Clinical Nutrition, Wake Forest Baptist Medical Center, Winston-Salem, NC 27157, USA.
    Hyperventilation caused by physical and/or psychological stress may lead to significant respiratory alkalosis and an elevated systemic pH. The alkalotic pH may in turn suppress the normal renal release of phosphate into the urine, thereby interrupting the endogenous production of 1,25-dihydroxyvitamin D (calcitriol). This could cause a shortfall in its normal production, leading to a variety of adverse consequences. Read More

    Hypercapnea and Acidemia despite Hyperventilation following Endotracheal Intubation in a Case of Unknown Severe Salicylate Poisoning.
    Case Rep Crit Care 2017 29;2017:6835471. Epub 2017 Mar 29.
    Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
    Salicylates are common substances for deliberate self-harm. Acute salicylate toxicity is classically associated with an initial respiratory alkalosis, followed by an anion gap metabolic acidosis. The respiratory alkalosis is achieved through hyperventilation, driven by direct stimulation on the respiratory centers in the medulla and considered as a compensatory mechanism to avoid acidemia. Read More

    Acidosis, but Not Alkalosis, Affects Anaerobic Metabolism and Performance in a 4-km Time Trial.
    Med Sci Sports Exerc 2017 Apr 11. Epub 2017 Apr 11.
    1Sports Science Research Group, Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, Brazil; 2Endurance Performance Research Group (GEDAE-USP), School of Physical Education and Sport, University of São Paulo, Brazil; 3Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Australia; 4School of Medical and Health Sciences, Edith Cowan University, Australia; 5Human Performance Research Group, Academic Department of Physical Education, Technological Federal University of Parana, Curitiba, Parana, Brazil.
    Purpose: To determine the effect of pre-exercise metabolic acidosis and alkalosis on power output (PO) and aerobic and anaerobic energy expenditure during a 4-km cycling time trial (TT).

    Methods: Eleven recreationally trained cyclists (VO2peak 54.1 ± 9. Read More

    Effect of arterial puncture on ventilation.
    Heart Lung 2017 May - Jun;46(3):149-152. Epub 2017 Apr 6.
    Division of Pulmonary and Critical Care, John H Stroger Jr Hospital of Cook County, Chicago, IL, USA.
    Background: Clinicians frequently assume that during arterial puncture for measuring arterial blood gases patients hyperventilate from pain and anxiety. This assumption leads clinicians to falsely interpret a PaCO2 and pH near the upper limit of normal as a chronic respiratory acidosis corrected by an acute respiratory alkalosis.

    Objective: Determine if participants hyperventilate during arterial puncture from pain and anxiety. Read More

    Hypocapnic hypothesis of Leigh disease.
    Med Hypotheses 2017 Apr 1;101:23-27. Epub 2017 Feb 1.
    The Children's Memorial Health Institute, Department of Pediatrics, Nutrition and Metabolic Diseases, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland. Electronic address:
    Leigh syndrome (LS) is a neurogenetic disorder of children caused by mutations in at least 75 genes which impair mitochondrial bioenergetics. The changes have typical localization in basal ganglia and brainstem, and typical histological picture of spongiform appearance, vascular proliferation and gliosis. ATP deprivation, free radicals and lactate accumulation are suspected to be the causes. Read More

    Persistent pulmonary hypertension of the newborn.
    Semin Fetal Neonatal Med 2017 Mar 23. Epub 2017 Mar 23.
    Departments of Pediatrics and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine and the Children's Hospital at Montefiore, Bronx, NY, USA. Electronic address:
    Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. 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

    Effects of early administration of acetazolamide on the duration of mechanical ventilation in patients with chronic obstructive pulmonary disease or obesity-hypoventilation syndrome with metabolic alkalosis. A randomized trial.
    Pulm Pharmacol Ther 2017 Jun 7;44:30-37. Epub 2017 Mar 7.
    Intensive Care Department, Hospital Sant Joan de Reus, Av. del Dr Josep Laporte, 2, 43204 Reus, Spain. Electronic address:
    Background: Metabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO2-retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. Read More

    VESTPD as a measure of ventilatory acclimatization to hypobaric hypoxia.
    Physiol Int 2016 Sep;103(3):377-391
    4 Department of Health, Exercise and Sports Sciences, The University of New Mexico , Albuquerque, NM, USA.
    This study compared the ventilation response to an incremental ergometer exercise at two altitudes: 633 mmHg (resident altitude = 1,600 m) and following acute decompression to 455 mmHg (≈4,350 m altitude) in eight male cyclists and runners. At 455 mmHg, the VESTPD at RER <1.0 was significantly lower and the VEBTPS was higher because of higher breathing frequency; at VO2max, both VESTPD and VEBTPS were not significantly different. 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

    Effects of hyperventilation on repeated pedaling sprint performance: short vs. long intervention duration.
    J Strength Cond Res 2017 Jan 20. Epub 2017 Jan 20.
    1Institute of Health and Sports Science & Medicine, Juntendo University 1-1 Hiraga-gakuendai, Inzai, Chiba 270-1695, Japan2Discipline of Exercise and Sport Science, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
    Previously, hyperventilation (HV) induced respiratory alkalosis, implemented during the last 30-s of each 60-s recovery that separated repeated pedaling sprints, has been shown to attenuate performance decrement. The present study investigated whether the ergogenic effects of HV would hold if the HV duration was shortened or extended. Seventeen power-trained athletes performed 10-s × 10 sets of standing pedaling sprints on a cycle ergometer, with 60-s inter-set recovery and the load (kp) set at 0. Read More

    [[Na+] - [Cl-] difference significantly contributes to acidemia in patients with liver cirrhosis].
    Vnitr Lek 2016 ;62(Supplementum 6):14-20
    Aim: To evaluate the role of strong ion difference (SID) in acid-base disorders in patients with liver disease.

    Patients And Methods: We evaluated the acid-base status in 11 patients with liver cirrhosis both by traditional and quantitative Stewart-Fencl methods.

    Results: Nine of eleven patients had pH within the norm, 2/11 had pH above 7. Read More

    Amitraz poisoning: A case report of an unusual pesticide poisoning in Sri Lanka and literature review.
    BMC Pharmacol Toxicol 2017 Jan 23;18(1). Epub 2017 Jan 23.
    National Hospital, Colombo, Sri Lanka.
    Background: Amitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Read More

    Hyperventilation with Maintenance of Isocapnia. An "Old New" Method in Carbon Monoxide Intoxication.
    PLoS One 2017 20;12(1):e0170621. Epub 2017 Jan 20.
    Department of Clinical Toxicology, Medical University of Gdańsk, Gdańsk, Poland.
    Introduction: Exposure to carbon monoxide (CO) is among the most common causes of acute and chronic poisonings worldwide. The crucial point of treatment of such acute poisonings is to eliminate CO from the body as fast as possible. There are currently two approaches to the management of the CO intoxication: hyperbaric oxygen therapy (HOT) and normobaric oxygen therapy (NOT). Read More

    Mixed acid-base disorder secondary to topiramate use in traumatic brain injury.
    Indian J Nephrol 2016 Nov-Dec;26(6):452-454
    Department of Neurosurgery, Yashoda Hospitals, Secunderabad, Telangana, India.
    We report a case of a man with traumatic brain injury. He was started on to prophylactic topiramate which led to a mixed acid-base disorder. He had severe metabolic acidosis secondary to renal tubular acidification defect and respiratory alkalosis secondary to hyperventilation. Read More

    A Quick Reference on Respiratory Alkalosis.
    Vet Clin North Am Small Anim Pract 2017 Mar 8;47(2):181-184. Epub 2016 Dec 8.
    Department of Surgical Sciences, University of Wisconsin - Madison, 2015 Linden Drive, Madison, WI 53706, USA. Electronic address:
    Respiratory alkalosis, or primary hypocapnia, occurs when alveolar ventilation exceeds that required to eliminate the carbon dioxide produced by tissues. Concurrent decreases in Paco2, increases in pH, and compensatory decreases in blood HCO3(-) levels are associated with respiratory alkalosis. Respiratory alkalosis can be acute or chronic, with metabolic compensation initially consisting of cellular uptake of HCO3(-) and buffering by intracellular phosphates and proteins. Read More

    Respiratory Acid-Base Disorders in the Critical Care Unit.
    Vet Clin North Am Small Anim Pract 2017 Mar 24;47(2):351-357. Epub 2016 Nov 24.
    Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, Room 2112, Tupper Hall, Davis, CA 95616, USA. Electronic address:
    The incidence of respiratory acid-base abnormalities in the critical care unit (CCU) is unknown, although respiratory alkalosis is suspected to be common in this population. Abnormal carbon dioxide tension can have many physiologic effects, and changes in Pco2 may have a significant impact on outcome. Monitoring Pco2 in CCU patients is an important aspect of critical patient assessment, and identification of respiratory acid-base abnormalities can be valuable as a diagnostic tool. Read More

    Acute exposure to high environmental ammonia (HEA) triggers the emersion response in the green shore crab.
    Comp Biochem Physiol A Mol Integr Physiol 2017 Feb 15;204:65-75. Epub 2016 Nov 15.
    Department of Zoology, University of British Columbia, Vancouver V6T 1Z4, BC, Canada; Bamfield Marine Sciences Centre, Bamfield V0R 1B0, BC, Canada.
    The physiological effects of high environmental ammonia (HEA) exposure have been well documented in many aquatic species. In particular, it has recently been demonstrated that exposure to ammonia in fish leads to a similar hyperventilatory response as observed during exposure to hypoxia. In littoral crabs, such as the green crab (Carcinus maenas), exposure to severe hypoxia triggers an emersion response whereby crabs escape hypoxia to breathe air. Read More

    TRPV1 deletion exacerbates hyperthermic seizures in an age-dependent manner in mice.
    Epilepsy Res 2016 Dec 25;128:27-34. Epub 2016 Oct 25.
    Department of Pediatrics, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Alberta Children's Hospital Research Institute, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada; Department of Clinical Neuroscience, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada. Electronic address:
    Febrile seizures (FS) are the most common seizure disorder to affect children. Although there is mounting evidence to support that FS occur when children have fever-induced hyperventilation leading to respiratory alkalosis, the underlying mechanisms of hyperthermia-induced hyperventilation and links to FS remain poorly understood. As transient receptor potential vanilloid-1 (TRPV1) receptors are heat-sensitive, play an important role in adult thermoregulation and modulate respiratory chemoreceptors, we hypothesize that TRPV1 activation is important for hyperthermia-induced hyperventilation leading to respiratory alkalosis and decreased FS thresholds, and consequently, TRPV1 KO mice will be relatively protected from hyperthermic seizures. Read More

    Fluid and ion transfer across the blood-brain and blood-cerebrospinal fluid barriers; a comparative account of mechanisms and roles.
    Fluids Barriers CNS 2016 Oct 31;13(1):19. Epub 2016 Oct 31.
    Department of Pharmacology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1PD, UK.
    The two major interfaces separating brain and blood have different primary roles. The choroid plexuses secrete cerebrospinal fluid into the ventricles, accounting for most net fluid entry to the brain. Aquaporin, AQP1, allows water transfer across the apical surface of the choroid epithelium; another protein, perhaps GLUT1, is important on the basolateral surface. Read More

    The Effect of Supplemental Oxygen in Obesity Hypoventilation Syndrome.
    J Clin Sleep Med 2016 Oct 15;12(10):1379-1388. Epub 2016 Oct 15.
    Department of Medicine, Section of Pulmonary and Critical Care, University of Chicago, Chicago, IL.
    Study Objectives: Low flow supplemental oxygen is commonly prescribed to patients with obesity hypoventilation syndrome (OHS). However, there is a paucity of data regarding its efficacy and safety. The objective of this study was to assess the medium-term treatment efficacy of adding supplemental oxygen therapy to commonly prescribed treatment modalities in OHS. Read More

    Gitelman's syndrome presenting with hypocalcemic tetany and hypokalemic periodic paralysis.
    Saudi J Kidney Dis Transpl 2016 Sep-Oct;27(5):1026-1028
    Department of Nephrology, Sawai Man Singh Hospital, Jaipur, Rajasthan, India.
    Gitelman's syndrome is an autosomal recessive renal tubular disorder characterized by hypomagnesemia, hypokalemia, hypocalciuria, and metabolic alkalosis. Hypocalcemic tetany as a presentation of Gitelman's syndrome has rarely been reported in literature. We report a rare case of Gitelman's syndrome presenting with hypocalcemic tetany along with hypokalemic periodic paralysis. Read More

    [Disorders of the acid-base balance and the anion gap].
    Dtsch Med Wochenschr 2016 Oct 17;141(21):1549-1554. Epub 2016 Oct 17.
    The regulation of the acid-base balance and pH is critical for the organism. The most important buffer system is CO2 / HCO3(-). The kidney controls systemic bicarbonate and therefore the metabolic regulation and the lung is relevant for respiratory regulation by an effective CO2 elimination. Read More

    Acetazolamide Therapy for Metabolic Alkalosis in Pediatric Intensive Care Patients.
    Pediatr Crit Care Med 2016 Dec;17(12):e551-e558
    1Division of Neonatal Critical Care, Gregorio Marañón General University Hospital, Madrid, Spain.2Department of Pediatrics, Getafe University Hospital, Universidad Europea de Madrid, Research Network on Maternal and Child Health and Development, Getafe, Madrid, Spain.3Red SAMID, Spain.4Division of Pediatric Critical Care, Gregorio Marañon General University Hospital, Madrid, Spain.5Hospital Pharmacy Service, Gregorio Marañón General University Hospital, Madrid, Spain.
    Objective: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients.

    Design: Retrospective, observational study. Read More

    Analysis of Arterial Blood Gas Report in Chronic Kidney Diseases - Comparison between Bedside and Multistep Systematic Method.
    J Clin Diagn Res 2016 Aug 1;10(8):BC01-5. Epub 2016 Aug 1.
    Medical Officer in Charge-Government Blood Bank, Chandannagar SD Hospital , Government of West Bengal, India .
    Introduction: Acid Base Disorders (ABDs) are commonly encountered in critically ill Chronic Kidney Disease (CKD) patients. Timely and correct analysis of Arterial Blood Gases (ABG) is critical for the diagnosis, treatment and prediction of outcome of the patients.

    Aim: The aim was to explore type and prevalence of ABDs in 31 critically ill CKD patients from a tertiary care hospital in Maharashtra, to compare two methods of analysis- bedside and systematic approaches and to clinically correlate the nature of ABDs in these patients. Read More

    Dysfunctional breathing: a review of the literature and proposal for classification.
    Eur Respir Rev 2016 Sep;25(141):287-94
    Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
    Dysfunctional breathing is a term describing breathing disorders where chronic changes in breathing pattern result in dyspnoea and other symptoms in the absence or in excess of the magnitude of physiological respiratory or cardiac disease. We reviewed the literature and propose a classification system for the common dysfunctional breathing patterns described. The literature was searched using the terms: dysfunctional breathing, hyperventilation, Nijmegen questionnaire and thoraco-abdominal asynchrony. Read More

    Acid-base disturbances in acute poisoning and their association with survival.
    J Crit Care 2016 Oct 11;35:84-9. Epub 2016 May 11.
    Department of Nephrology, Loghman-Hakim Hospital, Shahid Beheshti University, Tehran, Iran.
    Purpose: The purpose was to investigate the association between acid-base disturbances and mortality in acute poisoning.

    Materials And Methods: We performed a retrospective cross-sectional exploratory study on all acutely poisoned patients older than 12 years who had been admitted to the main tertiary toxicology hospital in Tehran between March and August 2010.

    Results: Of a total of 1167 patients (median age=25 years, 50. Read More

    Blood Gas Analyzers.
    Top Companion Anim Med 2016 Mar 25;31(1):27-34. Epub 2016 May 25.
    Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:
    Acid-base and respiratory disturbances are common in sick and hospitalized veterinary patients; therefore, blood gas analyzers have become integral diagnostic and monitoring tools. This article will discuss uses of blood gas analyzers, types of samples that can be used, sample collection methods, potential sources of error, and potential alternatives to blood gas analyzers and their limitations. It will also discuss the types of analyzers that are available, logistical considerations that should be taken into account when purchasing an analyzer, and the basic principles of how these analyzers work. Read More

    Everest Physiology Pre-2008.
    Adv Exp Med Biol 2016;903:457-63
    Department of Medicine, University of California San Diego, 0623A, 9500, Gilman Drive, La Jolla, CA, 92093-0623, USA.
    When Edmund Hillary and Tenzing Norgay reached the summit of Mt. Everest in 1953, it was the culmination of many attempts beginning in 1921. Alexander Kellas had actually predicted as early as 1920 that the mountain could be climbed, but the extreme altitude of 8848 m with the consequent oxygen deprivation had foiled previous attempts. Read More

    Hypoxia and Its Acid-Base Consequences: From Mountains to Malignancy.
    Adv Exp Med Biol 2016;903:301-23
    Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
    Hypoxia, depending upon its magnitude and circumstances, evokes a spectrum of mild to severe acid-base changes ranging from alkalosis to acidosis, which can alter many responses to hypoxia at both non-genomic and genomic levels, in part via altered hypoxia-inducible factor (HIF) metabolism. Healthy people at high altitude and persons hyperventilating to non-hypoxic stimuli can become alkalotic and alkalemic with arterial pH acutely rising as high as 7.7. Read More

    The venous-arterial difference in CO2 should be interpreted with caution in case of respiratory alkalosis in healthy volunteers.
    J Clin Monit Comput 2016 Jun 10. Epub 2016 Jun 10.
    Service de Physiologie Clinique et de l'Exercice, Centre Hospitalier Universitaire de Saint Etienne, 42055, Saint Etienne, France.
    The venous-arterial difference in CO2 (ΔCO2) has been proposed as an index of the adequacy of tissue perfusion in shock states. We hypothesized that the variation in PaCO2 (hyper- or hypocapnia) could impact ΔCO2, partly through microcirculation adaptations. Fifteen healthy males volunteered to participate. Read More

    Splicing Defect in Mitochondrial Seryl-tRNA Synthetase Gene Causes Progressive Spastic Paresis Instead of HUPRA Syndrome.
    Hum Mutat 2016 Sep 27;37(9):884-8. Epub 2016 Jun 27.
    Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland.
    Mitochondrial aminoacyl-tRNA synthetases are an important group of disease genes typically underlying either a disorder affecting an isolated tissue or a distinct syndrome. Missense mutations in the mitochondrial seryl-tRNA synthetase gene, SARS2, have been identified in HUPRA syndrome (hyperuricemia, pulmonary hypertension, renal failure in infancy, and alkalosis). We report here a homozygous splicing mutation in SARS2 in a patient with progressive spastic paresis. Read More

    Hyperchloremia - Why and how.
    Nefrologia 2016 Jul-Aug;36(4):347-53. Epub 2016 Jun 3.
    Nephrology Section, Department of Medicine, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, United States. Electronic address:
    Hyperchloremia is a common electrolyte disorder that is associated with a diverse group of clinical conditions. The kidney plays an important role in the regulation of chloride concentration through a variety of transporters that are present along the nephron. Nevertheless, hyperchloremia can occur when water losses exceed sodium and chloride losses, when the capacity to handle excessive chloride is overwhelmed, or when the serum bicarbonate is low with a concomitant rise in chloride as occurs with a normal anion gap metabolic acidosis or respiratory alkalosis. Read More

    Characteristics of hyperthermia-induced hyperventilation in humans.
    Temperature (Austin) 2016 Jan-Mar;3(1):146-60. Epub 2016 Feb 18.
    Institute of Health and Sport Sciences, University of Tsukuba , Tsukuba City, Japan.
    In humans, hyperthermia leads to activation of a set of thermoregulatory responses that includes cutaneous vasodilation and sweating. Hyperthermia also increases ventilation in humans, as is observed in panting dogs, but the physiological significance and characteristics of the hyperventilatory response in humans remain unclear. The relative contribution of respiratory heat loss to total heat loss in a hot environment in humans is small, and this hyperventilation causes a concomitant reduction in arterial CO2 pressure (hypocapnia), which can cause cerebral hypoperfusion. Read More

    Acid-base balance, serum electrolytes and need for non-invasive ventilation in patients with hypercapnic acute exacerbation of chronic obstructive pulmonary disease admitted to an internal medicine ward.
    Multidiscip Respir Med 2016 25;11:23. Epub 2016 May 25.
    Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA.
    Background: Hypoventilation produces or worsens respiratory acidosis in patients with hypercapnia due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In these patients acid-base and hydroelectrolite balance are closely related. Aim of the present study was to evaluate acid-base and hydroelectrolite alterations in these subjects and the effect of non-invasive ventilation and pharmacological treatment. Read More

    Intraoperative Autotriggered Pressure Support Ventilation Resistant to Increased Flow Trigger Threshold.
    A A Case Rep 2016 Jul;7(1):9-12
    From the Department of Anesthesiology, Perioperative Medicine, and Pain Management, University of Miami, Miami, Florida.
    Oscillations from cardiac pulsations are normally transmitted to mediastinal structures without any consequence. Autotriggering (AT) of mechanical ventilation occurs when an inspiratory trigger, typically negative inspiratory flow in anesthesia ventilators, is met in the absence of patient effort. AT can lead to respiratory alkalosis, opioid overdose, prolonged mechanical ventilation, and lung hyperinflation. Read More

    Noninvasive inhaled nitric oxide for persistent pulmonary hypertension of the newborn: A single center experience.
    J Neonatal Perinatal Med 2016 May;9(2):211-5
    Alexander Center for Neonatology, Winnie Palmer Hospital for Women and Babies, Part of Orlando Health, Inc., Orlando, FL, USA.
    Introduction: Nitric oxide is a potent, selective pulmonary vasodilator that has been proven to decrease pulmonary vascular resistance and has been part of the treatment arsenal for persistent pulmonary hypertension of the newborn (PPHN). In 2009, the approach to the administration of inhaled nitric oxide (iNO) at Winnie Palmer Hospital for Women and Babies (WPH) changed to emphasize avoiding invasive ventilation while maintaining optimal ventilation to perfusion ratio, avoiding hyperventilation and alkalosis agents, and avoiding hyperoxemia and hyperoxia exposure. Our aim is to describe the outcomes of babies whose primary treatment for PPHN was noninvasive (NIV) iNO. Read More

    Anesteziol Reanimatol 2016 Jan-Feb;61(1):18-23
    Unlabelled: AIM OF RESEARCH: To estimate the cognitive status dynamics ofpatients during the early postoperative period after cardiac interventions and to reveal predictors of cognitive functions deterioration at this category of patients.

    Materials And Methods: 118 cardiac patients were tested of neurocognitive functions one days before operation, and then for the 2-3rd days after operation by means of the MMSE test, the FAB test, Shulte's test, a questionnaire of a depression of CES-D, the BATTERY OF FRONTAL DYSFUNCTION TEST. Data of the perioperation's period was analyzed. Read More

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