Permissive range of hypercapnia for improved peripheral microcirculation and cardiac output in rabbits*

Komori, Makiko; Takada, Katsumi; Tomizawa, Yasuko; Nishiyama, Katsura; Kawamata, Miwako; Ozaki, Makoto

doi:10.1097/01.ccm.0000281445.77223.31

Cited by 56 publications

(41 citation statements)

References 30 publications

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“…These facts suggest that the researchers were motivated by something other than science. Despite these defects, the study conirmed that potentially lethal asphyxiation occurs suddenly at FICO 2 30% despite 70% oxygen supplementation [34] . In 2007, Dr. Eger et al produced a similar study entitled "Anesthetic Properties of Carbon Dioxide in the Rat" [11] .…”

Section: Research Inluence Of the Watersmentioning

confidence: 54%

“…This efect mimics general anesthesia, because it can be maintained in mammals for hours and is readily reversed anesthesia, but the margin of safety is narrow, and slightly higher CO 2 concentrations can precipitate cellular anaerobic respiration, lactic (metabolic) acidosis, fever, profuse perspiration, cyanosis, convulsions, brain damage, and death [10,33,34] . Anesthesia difers from asphyxiation in several ways.…”

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

“…Anesthesia simultaneously obscures the clinical warning signs of hypoxia (muscle weakness and disturbed mental function followed by unconsciousness) but these become problematic only when FICO 2 exceeds 10%. At FICO 2 above 30%m CO 2 asphyxiation manifests suddenly and unexpectedly in the form of metabolic acidosis, profuse perspiration, cyanosis, brain convulsions, and death [10,34] . CO 2 asphyxiation was mistakenly attributed to CO 2 toxicity in the previous century, when capnography and pulse oximetry were unknown, and defective machine designs enabled excessive CO 2 elevations.…”

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

“…Anesthesia abolishes the pulmonary discomfort and sufocation sensation that stimulates tachycardia and hypertension, whereupon the direct efects of mild hypercarbia reduce blood viscosity, optimize microcirculatory low, cardiac eiciency, cardiac output, tissue perfusion, tissue oxygenation, anesthetic induction, respiratory drive, organ function, opioid clearance, and prevent lung damage and opioid respiratory depression [34,35,[37][38][39][40][41][42] . Anesthesia simultaneously obscures the clinical warning signs of hypoxia (muscle weakness and disturbed mental function followed by unconsciousness) but these become problematic only when FICO 2 exceeds 10%.…”

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

“…During anesthesia, mild hypercarbia at least as high as 80 torr enhances microcirculatory low, reduces blood viscosity, improves cardiorespiratory function, increases tissue oxygenation, accelerates opioid clearance, ofsets opioid respiratory depression, prevents lung damage, and protects organ function [34][35][36][37] . In contrast, hyperventilation increases blood viscosity, undermines cardiorespiratory function, reduces opioid clearance, exaggerates opioid respiratory depression, decreases tissue perfusion, reduces tissue oxygenation, and compromises organ function.…”

Section: Hypoventilation Hyperventilation Opioids and Anesthesiamentioning

confidence: 99%

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Four Forgotten Giants of Anesthesia History

Coleman¹,

Internationals²

2016

JAS

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Introduction Does wisdom perhaps appear on the earth as a raven, which is inspired by the smell of carrion? --Friedrich NietzschePast is prologue. Carbon dioxide confusion has played a pivotal role in the evolution of modern anesthesia. Professional anesthesiology organizations have persistently neglected CO 2 management standards in favor of lesser issues [1][2][3][4] , so that the anesthesiology profession remains mired at the crossroads of revolutionary advance and ongoing self-destruction that can only be understood in historical context. Dr. Ralph Waters founded the profession on the basis of a practical new technique that introduced elective intubation and hyperventilation to abolish CO 2 toxicity disasters, but the harmful habit of hyperventilation has distorted anesthesia beliefs, habits, and practices; derailed research; halted professional advance; discouraged opioid treatment; abolished the therapeutic beneits of CO 2 ; exaggerated morbidity and mortality; and introduced a host of vexing clinical problems. It has indirectly fostered the iction that further improvements in anesthesia safety are impossible, which has undermined reimbursement, emasculated staf privileges, devastated morale, discouraged professional membership A , and rationalized the replacement of anesthesiologists by nurses.Meanwhile, the confusing chemistry, physiology, and pathology of carbon dioxide have yielded their secrets, modern anesthesia machines have eliminated the toxicity problem, modern agents have eliminated explosions, and modern monitoring AbstractThe anesthesiology profession may one day serve as a cautionary tale of how power, politics and privilege can perturb science and progress. Previous anesthesia practitioners possessed a superior understanding of physiology and pharmacology, but overenthusiastic CO 2 supplementation with inadequate monitors and machines caused asphyxiation disasters that were improperly attributed to CO 2 toxicity. Dr. Ralph Waters founded the anesthesiology profession on the basis of a practical new anesthetic technique that introduced elective intubation and hyperventilation to eliminate CO 2 toxicity, but mechanical hyperventilation dangerously depletes CO 2 tissue reserves and exaggerates morbidity and mortality. The beneits of CO 2 supplementation were forgotten, and consequent CO 2 confusion has derailed research, discouraged opioid treatment, damaged patient safety, and disrupted professional progress. Anesthesiologists can no longer claim to provide superior service, and hospital administrators are replacing them with nurses. Professional membership is in decline, and professional survival is in question. Modern machines have eliminated asphyxiation, and modern monitoring enables safe and beneicial hypercarbia that complements opioid treatment and minimizes surgical morbidity and mortality. CO 2 reform promises revolutionary advance but faces formidable opposition. [5] . The restoration of past principles using modern capnography, pulse oximetry, synthetic opioids, and improved inha...

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Section: Research Inluence Of the Watersmentioning

confidence: 54%

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

Section: Co 2 Asphyxiation Versus Anesthesiamentioning

confidence: 99%

Section: Hypoventilation Hyperventilation Opioids and Anesthesiamentioning

confidence: 99%

See 3 more Smart Citations

Four Forgotten Giants of Anesthesia History

Coleman¹,

Internationals²

2016

JAS

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Hyperthermia in a Chow Chow under general anaesthesia for magnetic resonance imaging

Jones

Robson

2022

Vet Record Case Reports

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A 5‐year 7‐month‐old, entire, male Chow Chow presented with paraparesis and ataxia due to a previously diagnosed T11–T12 spinal diverticulum. Due to the progression of clinical signs, magnetic resonance imaging was indicated to reassess the lesion. Preoperative rectal temperature was unable to be assessed due to temperament; however, it was likely the patient would be hyperthermic as it had been hyperthermic (40.6°C) under general anaesthesia 4 months earlier. Consequently, measures were taken to attempt to reduce body temperature before general anaesthesia. While under general anaesthesia for imaging, the patient was confirmed to be markedly hyperthermic. This report details the management of a patient with hyperthermia under general anaesthesia. The patient was gradually cooled before recovery from anaesthesia. Once recovered from anaesthesia and normothermic, the patient was discharged home the same day. Follow‐up confirmed no adverse effects.

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