Respiratory acidosis in adolescents with anorexia nervosa hospitalized for medical stabilization: A retrospective study

Kerem, Nogah C.; Riskin, Arieh; Averin, Elvira; Srugo, Isaac; Kugelman, Amir

doi:10.1002/eat.20911

Cited by 10 publications

(18 citation statements)

References 28 publications

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“…The findings in the current prospective study, of hypercapnia with a lower pH and a higher bicarbonate in adolescents with AN as compared with a control group, confirm the results of our recent retrospective study 21. However, to the best of our knowledge, hypercapnia in AN was not reported by others in the literature.…”

Section: Discussionsupporting

confidence: 89%

“…Repeated vomiting as a mean of purging might cause volume contraction and elevated levels of aldosterone, in addition to loss of acid from the stomach, and therefore present with metabolic alkalosis. In contrary to these two reasonable physiological phenomena and to the previous studies demonstrating normal blood gases in patients with AN,6, 9, 12 our retrospective study21 found that hypercapnia with mild acidosis and relative elevated bicarbonate levels are common in adolescents with recent onset AN admitted for medical stabilization. As there is no “overcompensation” for pH correction, it meant that the origin for the mild acidosis was respiratory, and not metabolic.…”

Section: Introductioncontrasting

confidence: 99%

“…Most studies that assessed the effects of AN on the respiratory system included women beyond the adolescence period or had mixed populations of adolescents and young adults6, 8–10, 12, 15, 20 and were performed in a “stable” or chronic stage of the disease 6, 8, 9, 15. Our current study, as well as our recent report,21 differs from the mentioned studies as it included only adolescents, with a relatively recent onset of AN and with ongoing weight loss in the 2 months prior to their admission. Thus, our adolescent population was at a unique stage of relatively high metabolic demands and probably was not yet at an adaptation phase of reduced oxygen consumption, pCO 2 production, and energetic output as demonstrated in the chronic phase of AN 15.…”

Section: Discussionmentioning

confidence: 99%

“…Sample size calculations for the primary outcome (hypercapnia in AN as compared with control group on admission and improvement of hypercapnia during hospitalization) were based on our retrospective study 21. In that study, there was hypecapnia in AN patients on admission (53.8 ± 4.6 mm Hg) that improved significantly ( p < 0.001) toward discharge (48.0 ± 6.1 mm Hg).…”

Section: Methodsmentioning

confidence: 99%

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Direct asymmetric N‐specific reaction of nitrosobenzene with aldehydes catalyzed by a chiral primary amine‐based organocatalyst

Qin

et al. 2011

Chirality

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Nitroso compounds have two reactive nitrogen and oxygen atoms. It is interesting and important to perform a nitrogen or oxygen selective reaction with interesting substrates. These atom specific reactions are crucial to specifically synthesis of specific compounds. An enantioselective N-specific reaction of nitrosobenzene with unmodified aldehydes was successfully achieved catalyzed first by a variety of primary amine-based organocatalysts with higher yield and enantioselectivity. The bulkier substituted groups of the organocatalyst and two hydrogen bonds from the organocatalyst and the oxygen atom of nitrosobenzene make the reaction preferentially N-specific and predominantly afford R products.

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Section: Discussionsupporting

confidence: 89%

Section: Introductioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Direct asymmetric N‐specific reaction of nitrosobenzene with aldehydes catalyzed by a chiral primary amine‐based organocatalyst

Qin

et al. 2011

Chirality

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“…One study examined respiratory acidosis in a retrospective cohort of 45 adolescents26 and found that respiratory acidosis improves after 10 days with bed rest and refeeding. However, as there was no comparison group, it is unclear whether the improvement was due to refeeding rather than bed rest.…”

Section: Resultsmentioning

confidence: 99%

What is the evidence for using bed rest as part of hospital treatment of severe anorexia nervosa?

Ibrahim

Cutinha

Ayton

2019

Evid Based Mental Health

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Bed rest is commonly used on medical and paediatric wards as part of nursing management of the physically compromised patient with severe anorexia nervosa. The aim of this study was to review the evidence base of bed rest as an intervention in the management of severe anorexia nervosa. We searched MEDLINE, PubMed, Embase, PsychInfo, CINAHL, HMIC, AMED, HBE, BNI and guidelines written in English until April 2018 using the following terms: bed rest and anorexia nervosa. After exclusion of duplicates, three guidelines and eight articles were included. The papers were methodologically heterogeneous, and therefore, quantitative summary was not possible. There have been no randomised controlled trials to compare the benefits and harms of bed rest as the focus of intervention in the treatment of anorexia nervosa. Several papers showed that patients have a strong preference for less restrictive approaches. These are also less intensive in nursing time. Negative physical consequences were described in a number of studies: these included lower heart rate, impaired bone turn over and increased risk of infection. We found no evidence to support bed rest in hospital treatment of anorexia nervosa. The risks associated with bed rest are significant and include both physical and psychological harm, and these can be avoided by early mobilisation. Given the established complications of bed rest in other critically ill patient populations, it is difficult to recommend the enforcement of bed rest for patients with anorexia nervosa. Future research should focus on safe early mobilisation, which would reduce complications and improve patient satisfaction.

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Momentary physiological indices related to eating disorders: A systematic and methodological review

Ralph‐Nearman,

Osborn,

Chang

et al. 2024

Euro Eating Disorders Rev

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Eating disorders (ED) are serious psychiatric illnesses, with no everyday support to intervene on the high rates of relapse. Understanding physiological indices that can be measured by wearable sensor technologies may provide new momentary interventions for individuals with ED. This systematic review, searching large databases, synthesises studies investigating peripheral physiological (PP) indices commonly included in wearable wristbands (heart rate [HR], heart rate variability [HRV], electrodermal activity [EDA], peripheral skin temperature [PST], and acceleration) in ED. Inclusion criteria included: (a) full peer‐reviewed empirical articles in English; (b) human participants with active ED; and (c) containing one of five wearable physiological measures. Kmet risk of bias was assessed. Ninety‐four studies were included (Anorexia nervosa [AN; N = 4418], bulimia nervosa [BN; N = 916], binge eating disorder [BED; N = 1604], other specified feeding and eating disorders [OSFED; N = 424], and transdiagnostic [N = 47]). Participants with AN displayed lower HR and EDA and higher HRV compared to healthy individuals. Those with BN showed higher HRV, and lower EDA and PST compared to healthy individuals. Other ED and Transdiagnostic samples showed mixed results. PP differences are indicated through various assessments in ED, which may suggest diagnostic associations, although more studies are needed to validate observed patterns. Results suggest important therapeutic potential for PP in ED, and larger studies including diverse participants and diagnostic groups are needed to fully uncover their role in ED.

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Respiratory acidosis in adolescents with anorexia nervosa hospitalized for medical stabilization: A retrospective study

Abstract: Mild respiratory acidosis is common in adolescents with recently diagnosed AN, hospitalized for medical stabilization. Respiratory acidosis improves with bed rest and refeeding. The clinical significance of these findings should be further evaluated.

Cited by 10 publications

References 28 publications

Direct asymmetric N‐specific reaction of nitrosobenzene with aldehydes catalyzed by a chiral primary amine‐based organocatalyst

Direct asymmetric N‐specific reaction of nitrosobenzene with aldehydes catalyzed by a chiral primary amine‐based organocatalyst

What is the evidence for using bed rest as part of hospital treatment of severe anorexia nervosa?

Momentary physiological indices related to eating disorders: A systematic and methodological review

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