Acute, short-term hypercapnia improves microvascular oxygenation of the colon in an animal model of sepsis

Stübs, Charlotte C.M.; Picker, O.; Schulz, Jan; Obermiller, Katja; Barthel, Franziska; Hahn, Anna-Maria; Bauer, Inge; Beck, Christopher

doi:10.1016/j.mvr.2013.07.008

Cited by 22 publications

(31 citation statements)

References 36 publications

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“…Despite some negative effects of hypercapnia on contractility we may expect an increase in cardiac output due to an increase in sympatoadrenal activity [34]. Furthermore, tissue perfusion is directly increased by hypercapnia and oxygen delivery into the tissues is enhanced by facilitated oxygen release owing to a right shift of the oxygen binding curve [35;36]. Our patients frequently had been treated with multiple cardiotoxic antineoplastic drugs prior to their episode of ARDS, therefore, it seems impossible to differentiate the impact of hypercapnia from a preexisting cardiac disease, ARDS or infection with this retrospective study design.…”

Section: Discussionmentioning

confidence: 99%

Permissive hypercapnia for severe acute respiratory distress syndrome in immunocompromised children: A single center experience

et al. 2017

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BackgroundControlled hypoventilation while accepting hypercapnia has been advocated to reduce ventilator-induced lung injury. The aim of the study was to analyze outcomes of a cohort of immunocompromised children with acute respiratory distress syndrome (ARDS) ventilated with a strategy of stepwise increasing PCO2 targets up to 140 mm Hg.MethodsRetrospective analysis of outcomes of a cohort of children with oncologic disease or after stem cell transplantation and severe respiratory failure in comparison with a historical control cohort.ResultsOut of 150 episodes of admission to the PICU 88 children underwent invasive mechanical ventilation for >24h (overall survival 75%). In a subgroup of 38 children with high ventilator requirements the PCO2 target ranges were increased stepwise. Fifteen children survived and were discharged from the PICU. Severe pulmonary hypertension was seen in two patients and no case of cerebral edema was observed. Long term outcome was available in 15 patients and 10 of these patients survived without adverse neurological sequelae. With introduction of this strategy survival of immunocompromised children undergoing mechanical ventilation for >24h increased to 48% compared to 32% prior to introduction (historical cohort).ConclusionsA ventilation strategy incorporating very high carbon dioxide levels to allow for low tidal volumes and limited inspiratory pressures is feasible in children. Even severe hypercapnia may be well tolerated. No severe side effects associated with hypercapnia were observed. This strategy could potentially increase survival in immunocompromised children with severe ARDS.

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Section: Discussionmentioning

confidence: 99%

Permissive hypercapnia for severe acute respiratory distress syndrome in immunocompromised children: A single center experience

et al. 2017

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“…Polymicrobial abdominal infection was induced by the implantation of a 14-G stent into the wall of the large intestine to promote faecal leakage into the abdominal cavity (colon ascendens stent peritonitis surgery (CASP)) as previously reported [18, 25].…”

Section: Methodsmentioning

confidence: 99%

“…As described previously [18, 25], we used a numeric score sheet (Clinical Score—see Table 1) to estimate the severity of sepsis (loss of body weight, appearance, spontaneous behaviour, provoked behaviour, breathing frequency, expiratory breathing sound, abdominal palpation, and condition of droppings). The animals were examined every 12 h. Animals scoring more than 10 points were euthanized.…”

Section: Methodsmentioning

confidence: 99%

Time-related changes in hepatic and colonic mitochondrial oxygen consumption after abdominal infection in rats

Herminghaus

Papenbrock

Eberhardt

et al. 2019

ICMx

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BackgroundEvidence suggests that early adaptive responses of hepatic mitochondria occur in experimentally induced sepsis. Little is known about both colonic mitochondrial function during abdominal infection and long-term changes in mitochondrial function under inflammatory conditions. We hypothesize that hepatic and colonic mitochondrial oxygen consumption changes time-dependently after sterile laparotomy and in the course of abdominal infection. The aim of the present study was to investigate the hepatic and colonic mitochondrial respiration after sterile laparotomy and abdominal infection over up to 96 h.MethodsAfter approval of the local Animal Care and Use Committee, 95 Wistar rats were randomized into 8 groups (n = 11–12): 1–4 sham (laparotomy only) and 5–8 colon ascendens stent peritonitis (CASP). Healthy, unoperated animals served as controls (n = 9). The mitochondrial respiration in colon and liver homogenates was assessed 24, 48, 72, and 96 h after surgery. Mitochondrial oxygen consumption was determined using a Clark-type electrode. State 2 (oxygen consumption in the presence of the substrates for complexes I and II) and state 3 respiration (ADP dependent) were assessed. The respiratory control ratio (RCR state 3/state 2) and ADP/O ratio (ADP added/oxygen consumed) were calculated for both complexes. Data are presented as means ± SD, two-way ANOVA followed by Tukey’s post hoc test.ResultsHepatic RCR was initially (after 24 h) elevated in both operated groups; after 48 h only, the septic group was elevated compared to controls. In CASP groups, the hepatic ADP/O ratio for complex I was elevated after 24 h (vs. controls) and after 48 h (vs. sham) but declined after 72 h (vs. controls). The ADP/O ratio for complex II stayed unchanged over the time period until 96 h.The colonic RCR and ADP/O did not change over time after sham or CASP operation.ConclusionHepatic, but not colonic, mitochondrial respiration is increased in the initial phase (until 48 h) and normalizes in the longer course of time (until 96 h) of abdominal infection.Electronic supplementary materialThe online version of this article (10.1186/s40635-018-0219-9) contains supplementary material, which is available to authorized users.

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“…Microvascular haemoglobin oxygen saturation (mHbSO 2 ) was measured with reflectance spectroscopy (O2C; LEA Medizintechnik GmbH, Giessen, Germany) on the right quadriceps muscle. 13 White light (450e1000 nm) was illuminated by a microprobe, and reflected light was analysed for the absorption spectra of oxygenated and deoxygenated haemoglobin in the tissue. As vessels with a diameter larger than 100 mm completely absorb the emitted light, 14 the mHbSO 2 results reflect the haemoglobin oxygenation mainly in postcapillary venules.…”

Section: Microcirculatory Measurementsmentioning

confidence: 99%

Reduction of vascular leakage by imatinib is associated with preserved microcirculatory perfusion and reduced renal injury markers in a rat model of cardiopulmonary bypass

Koning

Lange

Meurs

et al. 2018

British Journal of Anaesthesia

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Acute, short-term hypercapnia improves microvascular oxygenation of the colon in an animal model of sepsis

Cited by 22 publications

References 36 publications

Permissive hypercapnia for severe acute respiratory distress syndrome in immunocompromised children: A single center experience

Permissive hypercapnia for severe acute respiratory distress syndrome in immunocompromised children: A single center experience

Time-related changes in hepatic and colonic mitochondrial oxygen consumption after abdominal infection in rats

Reduction of vascular leakage by imatinib is associated with preserved microcirculatory perfusion and reduced renal injury markers in a rat model of cardiopulmonary bypass

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