The extracellular pH, PCO2, and [Cl-] at the surface of the brain cortex, expiratory PCO2 and arterial blood pressure were continuously recorded in anaesthetized and artificially ventilated cats. The observations from such a preparation were: 1. In response to a nearly step increase in end-tidal PCO2, the brain ECF pH, PCO2, [Cl-] and calculated [HCO-3] changed in the form of a nearly mono-exponential time function after a delay of 5-7 s. 2. The time constants of the changes in the extracellular pH, PCO2, [Cl-] and [HCO-3] were in the range of 30-40 s. 3. The extracellular [HCO-3] increased markedly at an initial rate of 4.22 mmol.1(-1) . min-1 after 36 s. 4. This increase occurred almost simultaneously with a decrease in the extracellular [Cl-]. An [HCO-3]-[Cl-] exchange ratio was determined which very closely approached one. It is concluded that the brain extracellular bicarbonate concentration in respiratory acidosis increases because the H+ formed from the hydrated CO2 reacts with the intracellular buffers of brain cells, mainly glial cells, and HCO-3 inside the cell is formed and exchanged for Cl- outside the cell similar to the HCO-3/Cl- exchange which occurs between red cells and blood plasma during CO2 loading. The described time constants of the anion exchange represent the wash in or wash out time of CO2 in a tissue containing intracellular buffer.
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Front Mol Biosci
January 2025
Research Department, Children's Cancer Hospital Egypt, Cairo, Egypt.
Introduction: COVID-19 severity and high in-hospital mortality are often associated with severe hypoxemia, hyperlactatemia, and acidosis, yet the key players driving this association remain unclear. It is generally assumed that organ damage causes toxic acidosis, but since neutrophil numbers in severe COVID-19 can exceed 80% of the total circulating leukocytes, we asked if metabolic acidosis mediated by the glycolytic neutrophils is associated with lung damage and impaired oxygen delivery in critically ill patients.
Methods: Based on prospective mortality outcome, critically ill COVID-19 patients were divided into ICU- survivors and ICU-non-survivors.
Intern Med
January 2025
Department of Respiratory Medicine, NHO Okayama Medical Center, Japan.
A 52-year-old Japanese man with a history of childhood asthma presented at our emergency department with progressive dyspnea. Despite subcutaneous adrenaline injections, salbutamol nebulization, and intravenous methylprednisolone, the carbon dioxide partial pressure (pCO) increased to 110 mmHg. The patient was intubated, and mechanical ventilation was initiated because of severe respiratory failure.
View Article and Find Full Text PDFPediatrics
January 2025
Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Context: Extubation failure (EF) is common in preterm neonates and may be associated with adverse outcomes.
Objective: To systematically review and meta-analyze the existing literature on predictors and outcomes of EF in preterm neonates.
Data Sources: MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase (OvidSP), CINAHL (EBSCOHost), and Cochrane Library (Wiley) from 1995 onward.
Ann Intensive Care
January 2025
Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, DMU CORREVE, Inserm UMR S_999, FHU SEPSIS, Groupe de Recherche Clinique CARMAS, Université Paris-Saclay, AP-HP, Le Kremlin-Bicêtre, France.
Background: Excessive tachycardia is associated with impaired hemodynamics and worse outcome in critically ill patients. Previous studies suggested beneficial effect of β-blockers administration in ICU patients, including those with septic shock. However, comparisons in ICU settings are lacking.
View Article and Find Full Text PDFPediatr Neonatol
December 2024
Department of Pediatrics, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street District 5, Ho Chi Minh City, 700000, Viet Nam; University Medical Center Ho Chi Minh City, 215 Hong Bang Street District 5, Ho Chi Minh City, 700000, Viet Nam; Neonatal Intensive Care Unit, Children's Hospital 2, 14 Ly Tu Trong Street District 1, Ho Chi Minh City, 700000, Viet Nam. Electronic address:
Background: Invasive mechanical ventilation in very-low-birth-weight infants (VLBWI) was associated with immediate and long-term complications. Nasal high-frequency oscillation (nHFO) has recently become a new non-invasive ventilation (NIV) mode for treating respiratory failure in VLBWI. This study aimed to investigate the safety and efficacy of nHFO as an alternative respiratory support to prevent intubation in VLBWI.
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