Effects of acid-base abnormalities on blood capacity of transporting CO(2): adverse effect of metabolic acidosis.

Abstract:

OBJECTIVE:To investigate the effects of some acid-base abnormalities on blood capacity of transporting CO(2). DESIGN:Prospective study. SETTING:General and Cardiosurgical ICUs of a University hospital. PATIENTS:Six groups of ten patients characterized by: metabolic alkalosis; respiratory alkalosis; absence of acid-base abnormalities; metabolic acidosis; uncompensated respiratory acidosis; and compensated respiratory acidosis. MEASUREMENTS AND RESULTS:The CO(2) dissociation curve, Haldane effect, and the ratio Ra-v between Ca-vCO(2) and Pa-vCO(2) were calculated from arterial and mixed-venous blood gas analyses. The CO(2) dissociation curve was shifted upwards by metabolic alkalosis and compensated respiratory acidosis and downwards by metabolic acidosis. The slope of the curve was unaffected, but CO(2) transport not due to Haldane effect was significantly lower in respiratory acidosis since the slope was less steep at higher PCO(2) values. In comparison with controls, patients affected by metabolic acidosis showed lower Haldane effect values (0.18+/-0.15 vs 0.59+/-0.26 ml of CO(2) per ml of arterial-mixed venous O(2) content difference; P <.05) and Ra-v values (0.43+/-0.10 vs 0.84+/-0.17 ml of CO(2) transported by 100 ml of blood per Torr of arterial-mixed venous PCO(2) gradient; P <.05). CONCLUSIONS:Our findings suggest that acid-base abnormalities, particularly metabolic acidosis, markedly affect blood capacity of transporting CO(2) and may worsen tissue hypercarbia associated with hypoperfusion. However, because of possible errors due to small measurements and the assumptions of the method, in the future definitive clarification will require the construction of original CO(2) dissociation curves for each acid-base abnormality.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Cavaliere F,Antonelli M,Arcangeli A,Conti G,Pennisi MA,Proietti R

doi

10.1007/s00134-002-1259-9

keywords:

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

609-15

issue

5

eissn

0342-4642

issn

1432-1238

journal_volume

28

pub_type

杂志文章
  • The ten pitfalls of lactate clearance in sepsis.

    abstract:: ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-018-5213-x

    authors: Hernandez G,Bellomo R,Bakker J

    更新日期:2019-01-01 00:00:00

  • How I treat septic shock.

    abstract:: ...

    journal_title:Intensive care medicine

    pub_type: 社论

    doi:10.1007/s00134-018-5401-8

    authors: Vincent JL

    更新日期:2018-12-01 00:00:00

  • Late-onset moderate to severe acute respiratory distress syndrome is associated with shorter survival and higher mortality: a two-stage association study.

    abstract:PURPOSE:To evaluate the association between acute respiratory distress syndrome (ARDS) onset time and prognosis. METHODS:Patients with moderate to severe ARDS (N = 876) were randomly assigned into derivation (N = 520) and validation (N = 356) datasets. Both 28-day and 60-day survival times after ARDS onset were analyz...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s00134-016-4638-3

    authors: Zhang R,Wang Z,Tejera P,Frank AJ,Wei Y,Su L,Zhu Z,Guo Y,Chen F,Bajwa EK,Thompson BT,Christiani DC

    更新日期:2017-03-01 00:00:00

  • Nine equivalents of nursing manpower use score (NEMS).

    abstract:OBJECTIVES:To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. DESIGN:Retrospective statistical analysis of a database and a prospective multicentre study. SETTING:Development in the database of the Foundation for ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050406

    authors: Reis Miranda D,Moreno R,Iapichino G

    更新日期:1997-07-01 00:00:00

  • Long-term mortality in patients with chronic obstructive pulmonary disease following extracorporeal membrane oxygenation for cardiac assist after cardiovascular surgery.

    abstract:PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-013-2931-y

    authors: Distelmaier K,Niessner A,Haider D,Lang IM,Heinz G,Maurer G,Koinig H,Steinlechner B,Goliasch G

    更新日期:2013-08-01 00:00:00

  • Do trials that report a neutral or negative treatment effect improve the care of critically ill patients? Yes.

    abstract:: ...

    journal_title:Intensive care medicine

    pub_type: 社论

    doi:10.1007/s00134-018-5129-5

    authors: Perner A,Finfer S

    更新日期:2018-11-01 00:00:00

  • Acute hemodynamic changes during lung recruitment in lavage and endotoxin-induced ALI.

    abstract:OBJECTIVE:To assess acute cardiorespiratory effects of recruitment manoeuvres in experimental acute lung injury. DESIGN:Experimental study in animal models of acute lung injury. SETTING:Experimental laboratory at a University Medical Centre. ANIMALS:Ten pigs with bronchoalveolar lavage and eight pigs with endotoxin-...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-004-2496-x

    authors: Odenstedt H,Aneman A,Kárason S,Stenqvist O,Lundin S

    更新日期:2005-01-01 00:00:00

  • Role of replacement fluids in the immediate complications of plasma exchange. French Registry Cooperative Group.

    abstract:OBJECTIVE:Comparison of side effects (fever shivering and/or allergic reactions, collapse, symptomatic hypocalcaemia) of the different substitution fluids used during therapeutical plasmapheresis. DESIGN:Multicentric retrospective comparative study designed to explore the side effects due to the replacements fluids (a...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s001340050595

    authors: Korach JM,Berger P,Giraud C,Le Perff-Desman C,Chillet P

    更新日期:1998-05-01 00:00:00

  • A model: systems management of life threatening injuries in children for the state of Maryland, USA.

    abstract::In the past two years several guidelines for suggested components of emergency medical systems for children have been suggested, and for the first time, specific standards of pediatric trauma care have also been formulated. The American Academy of Pediatrics new Provisional Committee on Emergency Medicine has been cha...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00260888

    authors: Haller JA,Beaver B

    更新日期:1989-01-01 00:00:00

  • Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis.

    abstract:OBJECTIVE:The evaluation of incidences and relating factors of severe persisting critical illness polyneuropathy (CIP) in survivors of multiple organ failure (MOF). DESIGN:Prospective study with an entry period of 24 months. Electrophysiological studies for the diagnosis of CIP were performed 1 or 2 days before the pa...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050471

    authors: Mohr M,Englisch L,Roth A,Burchardi H,Zielmann S

    更新日期:1997-11-01 00:00:00

  • ARDS and knowledge translation.

    abstract::Knowledge translation is an important step for translational research. In this issue of Intensive Care Medicine, a new mini-series of basic research-related reviews is published. Three invited reviews focus on the role of extracellular matrix in ventilator-induced lung injury and mechanotransduction. The major challen...

    journal_title:Intensive care medicine

    pub_type: 评论,社论

    doi:10.1007/s00134-007-0965-8

    authors: Liu M

    更新日期:2008-04-01 00:00:00

  • Remifentanil/midazolam versus fentanyl/midazolam for analgesia and sedation of mechanically ventilated neonates and young infants: a randomized controlled trial.

    abstract:PURPOSE:Common opioids for analgesia and sedation of mechanically ventilated infants may tend to accumulate and cause prolonged sedation with an unpredictable extubation time. Remifentanil is a promising option due to its unique pharmacokinetic properties, which seem to be valid in adults as well as in infants. METHOD...

    journal_title:Intensive care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s00134-012-2532-1

    authors: Welzing L,Oberthuer A,Junghaenel S,Harnischmacher U,Stützer H,Roth B

    更新日期:2012-06-01 00:00:00

  • Comparison of electrocardiograms recorded with standard leads and derived from the vectorcardiographic frank leads in high risk patients.

    abstract::Dynamic vectorcardiography (VCG) is increasingly employed for ischaemia monitoring with the use of a computerized method for recording and on-line analysis by the calculation of trend parameters. To elucidate how well the derived electrocardiogram (dECG), calculated from the VCG, compares with the simultaneously regis...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1007/s001340050455

    authors: Gannedahl PE,Ljungqvist OH,Lundin P,Edner M

    更新日期:1997-10-01 00:00:00

  • Attitudinal patterns determining decision-making in the treatment of the elderly: a comparison between physicians and nurses in Germany and Sweden.

    abstract:OBJECTIVE:Do-not-resuscitate orders (DNR orders) and advance directives (AD) have been developed and their use by patients is increasing. The objective of the study was to evaluate the compliance with patient's wishes and doctors' and nurses' agreement on decision-making in the treatment of elderly patients from a cros...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340000602

    authors: Richter J,Eisemann MR

    更新日期:2000-09-01 00:00:00

  • Three different mask physiotherapy regimens for prevention of post-operative pulmonary complications after heart and pulmonary surgery.

    abstract:OBJECTIVE:An investigation into the incidence of post-operative complications after thoracic surgery with 3 different physiotherapy masks. DESIGN:A prospective, consecutive, randomized comparison. SETTING:Department of Thoracic and Heart Surgery at a University Hospital. The treatments were performed by experienced a...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF01690551

    authors: Ingwersen UM,Larsen KR,Bertelsen MT,Kiil-Nielsen K,Laub M,Sandermann J,Bach K,Hansen H

    更新日期:1993-01-01 00:00:00

  • Lipid peroxidation and alpha-tocopherol during an acute respiratory failure after near drowning.

    abstract::We compare two patients admitted after near drowning. Both presented a severe metabolic acidosis, but only one of them developed an acute pulmonary edema with hypoxemia. An increase of lipid peroxides associated with a reduction of vitamin E concentration has been observed in this later patient. Lipid peroxidation, on...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00254776

    authors: Bertrand Y,Artoisenet A,Allard B,Barbier B,de Meulder A,Raynaert M,Mathieu P,Dumont E

    更新日期:1985-01-01 00:00:00

  • Ionized hypocalcemia during out-of-hospital cardiac arrest and cardiopulmonary resuscitation is not due to binding by lactate.

    abstract:OBJECTIVE:To determine the relationship between ionized calcium concentrations and blood lactate levels during cardiac arrest and cardiopulmonary resuscitation (CPR). DESIGN:A prospective cohort study. SETTING:Emergency department (ED) and general intensive care unit in a city hospital (tertiary care center). PATIEN...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340050493

    authors: Gando S,Igarashi M,Kameue T,Nanzaki S

    更新日期:1997-12-01 00:00:00

  • Effect of polymyxin B-immobilized fiber on bone resorption in patients with sepsis.

    abstract:OBJECTIVE:To analyze the effects of polymyxin B-immobilized fiber (PMX-F) on bone resorption in septic patients. DESIGN AND SETTING:Observational prospective study in intensive care units of a general hospital. PATIENTS AND PARTICIPANTS:25 patients with severe sepsis and 20 healthy controls. MEASUREMENTS AND RESULTS...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s00134-004-2357-7

    authors: Nakamura T,Kawagoe Y,Matsuda T,Koide H

    更新日期:2004-09-01 00:00:00

  • Patient-initiated, pressure-regulated, volume-controlled ventilation compared with intermittent mandatory ventilation in neonates: a prospective, randomised study.

    abstract:OBJECTIVE:To compare the effects of patient-initiated, pressure-regulated, volume-controlled ventilation (PRVC) with pressure-preset intermittent mandatory ventilation (IMV) in neonates with respiratory failure. DESIGN:Randomised, prospective study. SETTING:Intensive care unit (14 beds) in a 300-bed paediatric teachi...

    journal_title:Intensive care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/s001340050441

    authors: Piotrowski A,Sobala W,Kawczyński P

    更新日期:1997-09-01 00:00:00

  • Intermittent positive pressure breathing (IPPB) versus incentive spirometer (IS) therapy in the postoperative period.

    abstract::The increase of the inflationary lung volume created by a respiratory maneuver is critical for preventing postoperative alveolar collapse. We measured this volume as achieved with IPPB or incentive spirometry (IS) in 20 postoperative surgical patients. Using IPPB, with gas flow and peak airway pressures carefully adju...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01641120

    authors: Pfenninger J,Roth F

    更新日期:1977-12-01 00:00:00

  • Hypertensive crisis immediately after complete removal of phaeochromocytoma.

    abstract::A hypertensive crisis with an arterial blood pressure of 280/180 mmHg developed immediately after an apparently successful removal of a phaeochromocytoma. The blood pressure could not be lowered by phentolamine and not until the administration of dihydralazine and furosemide was the systemic pressure normalized. In ad...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF00315379

    authors: Johansson H,Brismar B,Hedenstierna G

    更新日期:1986-01-01 00:00:00

  • Delay of extubation in neonates and children after cardiac surgery: impact of ventilator-associated pneumonia.

    abstract:OBJECTIVE:This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children. METHODS:Cohort study in a pediatric intensive care unit of a t...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s001340051285

    authors: Fischer JE,Allen P,Fanconi S

    更新日期:2000-07-01 00:00:00

  • Clinical effects of adding fludrocortisone to a hydrocortisone-based shock protocol in hypotensive critically ill children.

    abstract:BACKGROUND:Adult studies evaluating corticosteroids have found varied efficacy. One study showing mortality benefit utilized fludrocortisone (FLU) and hydrocortisone (HC) (Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA 288:862-871, 2002). Use of...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-010-2090-3

    authors: Hebbar KB,Stockwell JA,Fortenberry JD

    更新日期:2011-03-01 00:00:00

  • A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age.

    abstract:OBJECTIVE:To present a concise history of tracheostomy and tracheal intubation for the approximately forty centuries from their earliest description around 2000 BC until the middle of the twentieth century, at which time a proliferation of advances marked the beginning of the modern era of anesthesiology. DATA SOURCES...

    journal_title:Intensive care medicine

    pub_type: 历史文章,杂志文章

    doi:10.1007/s00134-007-0931-5

    authors: Szmuk P,Ezri T,Evron S,Roth Y,Katz J

    更新日期:2008-02-01 00:00:00

  • Combined effects of NO inhalation and intravenous PGF2 alpha on pulmonary circulation and gas exchange in an ovine ARDS model.

    abstract:OBJECTIVES:Inhalation of nitric oxide (NO) selectively dilates pulmonary vessels in well-ventilated regions. Prostaglandin F2 alpha (PGF2 alpha) is a vasoconstrictor and is reported to enhance hypoxic pulmonary vasoconstriction. The objective of this study was to examine whether the combination of intravenous PGF2 alph...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01709742

    authors: Kobayashi H,Tanaka N,Winkler M,Zapol WM

    更新日期:1996-07-01 00:00:00

  • Adverse drug reactions and deliberate self-poisoning as cause of admission to the intensive care unit: a 1-year prospective observational cohort study.

    abstract:OBJECTIVE:The aim of the present study was (1) to determine the prevalence of intensive care unit (ICU) admissions due to an adverse drug reaction (ADR), and (2) to compare affected patients with patients admitted to the ICU for the treatment of deliberate self-poisoning using medical drugs. DESIGN:Prospective observa...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-008-1250-1

    authors: Schwake L,Wollenschläger I,Stremmel W,Encke J

    更新日期:2009-02-01 00:00:00

  • Influenza vaccination and 1-year risk of myocardial infarction, stroke, heart failure, pneumonia, and mortality among intensive care unit survivors aged 65 years or older: a nationwide population-based cohort study.

    abstract:PURPOSE:We examined whether influenza vaccination affects 1-year risk of myocardial infarction, stroke, heart failure, pneumonia, and death among intensive care unit (ICU) survivors aged ≥ 65 years. METHODS:Danish Intensive Care Database data on all elderly ( ≥ 65 years) patients hospitalized in Danish ICUs in the per...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-019-05648-4

    authors: Christiansen CF,Thomsen RW,Schmidt M,Pedersen L,Sørensen HT

    更新日期:2019-07-01 00:00:00

  • Transnasal puncture based on echographic sinusitis evidence in mechanically ventilated patients with suspicion of nosocomial maxillary sinusitis.

    abstract:OBJECTIVE:The aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis. DESIGN:prospective clinical investigation. SETTING:medical intensive care unit. PATIENTS:sixty patients ...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-006-0152-3

    authors: Vargas F,Bui HN,Boyer A,Bébear CM,Lacher-Fougére S,De-Barbeyrac BM,Salmi LR,Traissac L,Gbikpi-Benissan G,Gruson D,Hilbert G

    更新日期:2006-06-01 00:00:00

  • Discontinuation of prolonged infusions of dexmedetomidine in critically ill children with heart disease.

    abstract:PURPOSE:To describe changes in hemodynamic variables, sedation, and pain score after discontinuation of prolonged infusions of dexmedetomidine in a pediatric population of critically ill cardiac patients. METHODS:Retrospective case series of patients who received continuous infusions of dexmedetomidine for longer than...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/s00134-011-2441-8

    authors: Burbano NH,Otero AV,Berry DE,Orr RA,Munoz RA

    更新日期:2012-02-01 00:00:00

  • Hyperthermia complicating tricyclic antidepressant overdose.

    abstract::We observed a 51-year-old woman who was admitted for severe amitriptyline overdose. Besides major cardiovascular complications, the patient developed severe hyperpyrexia with a central body temperature of more than 43 degrees C for 5 h. The patient died on day 3 from cardiocirculatory collapse and arrhythmias. Hyperth...

    journal_title:Intensive care medicine

    pub_type: 杂志文章

    doi:10.1007/BF01712165

    authors: Hantson P,Benaissa M,Clemessy JL,Baud FJ

    更新日期:1996-05-01 00:00:00