Background: Permissive hypercapnia exerts a protective influence in tissue injury, possibly by attenuating free radical activity. Increased CO2 concentrations may decrease the production of phagocyte reactive oxygen intermediates (ROI). In this study, we used bronchoalveolar lavage (BAL) to determine whether isooxic permissive hypercapnia due to hypoventilation would influence neutrophil recruitment into alveolar spaces and ROI production of BAL phagocytes, as measured by luminol dependent chemiluminescence.
Material/methods: 27 Chinchilla rabbits randomized into three groups: control group (C; n=7), normocapnia (NC; n=10), and hypercapnia (HC; n=10) were anaesthetized with pentobarbitone and intubated. Bronchoalveolar lavage was obtained either after intubation (controls) or after mechanical ventilation lasting 240 minutes under normocapnia or permissive hypercapnia conditions. BAL cells were counted and luminol-dependent chemiluminescence estimations were performed.
Results: The BAL neutrophil count was significantly higher in the hypercapnia group than in normocapnia animals. The chemiluminescence of opsonized zymosan-stimulated cells was significantly higher in the normocapnia group than in the controls; the differences between the HC and NC animals, and between the HC and control animals, did not reach statistical significance.
Conclusions: In the mechanically ventilated rabbit under pentobarbitone anaesthesia, acute isooxic hypercapnia due to hypoventilation increases neutrophil BAL count, without direct impact on mixed BAL-cell chemiluminescence; moreover, conventional ventilation increases the chemiluminescence of opsonized zymosan-stimulated BAL cells
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Anesth Pain Med (Seoul)
January 2025
Department of Surgery, Faculty of Medicine, University of Medicine, Tirana, Albania.
Permissive strategies in the intensive care unit (PSICU) intentionally allow certain physiological parameters to deviate from traditionally strict control limits to mitigate the risks associated with overly aggressive interventions. These strategies have emerged in response to evidence that rigid adherence to normal physiological ranges may cause harm to critically ill patients, leading to iatrogenic complications or exacerbation of underlying conditions. This review discusses several permissive strategies, including those related to hypotension, hypercapnia, hypoxemia, and lower urinary output thresholds.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, AP-HP, Service de médecine intensive-réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France.
Ther Clin Risk Manag
November 2024
Department of Anesthesiology and Pain Medicine, the Affiliated Hospital of Jiaxing University, Jiaxing City, Zhejiang Province, People's Republic of China.
Cytokine
January 2025
Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080 Guangdong, China. Electronic address:
Background: Sepsis is an uncontrolled inflammatory response to infection and is closely associated with the occurrence of acute respiratory distress syndrome (ARDS). Low tidal volume lung ventilation and permissive hypercapnia is a recognized therapy for ARDS. However, whether permissive hypercapnia aggravates sepsis-associated encephalopathy (SAE) remains unclear.
View Article and Find Full Text PDFEur J Anaesthesiol
December 2024
From the Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China (BX, WZ).
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