Document Detail


Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia.
MedLine Citation:
PMID:  19373455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Low tidal volume ventilation and permissive hypercapnia are required in patients with sepsis complicated by ARDS. The effects of hypercapnia on tissue oxidative metabolism in this setting are unknown. We therefore determined the effects of moderate hypercapnia on markers of systemic and splanchnic oxidative metabolism in an animal model of endotoxemia. METHODS: Anesthetized rats maintained at a PaCO(2) of 30, 40 or 60 mmHg were challenged with endotoxin. A control group (PaCO(2) 40 mmHg) received isotonic saline. Hemodynamic variables, arterial lactate, pyruvate, and ketone bodies were measured at baseline and after 4 h. Tissue adenosine triphosphate (ATP) and lactate were measured in the small intestine and the liver after 4 h. RESULTS: Endotoxin resulted in low cardiac output, increased lactate/pyruvate ratio and decreased ketone body ratio. These changes were not influenced by hypercapnia, but were more severe with hypocapnia. In the liver, ATP decreased and lactate increased independently from PaCO(2) after endotoxin. In contrast, the drop of ATP and the rise in lactate triggered by endotoxin in the intestine were prevented by hypercapnia. CONCLUSIONS: During endotoxemia in rats, moderate hypercapnia prevents the deterioration of tissue energetics in the intestine.
Authors:
Alex Gnaegi; François Feihl; Olivier Boulat; Bernard Waeber; Lucas Liaudet
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-17
Journal Detail:
Title:  Intensive care medicine     Volume:  35     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1297-304     Citation Subset:  IM    
Affiliation:
Division of Clinical Pathophysiology and Medical Teaching, Faculty of Biology and Medicine, University Hospital Center, CHUV-BH 08-621, 1011, Lausanne, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Carbon Dioxide / administration & dosage,  physiology
Endotoxemia / physiopathology*
Energy Metabolism / drug effects*,  physiology
Hypercapnia / metabolism*
Oxygen Consumption
Random Allocation
Rats
Rats, Wistar
Respiration, Artificial
Respiratory Distress Syndrome, Adult / physiopathology,  therapy
Sepsis / physiopathology
Splanchnic Circulation / drug effects*,  physiology
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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