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PubMed1979

[The effects of Pavulon (pancuronium bromide) on maternal circulation and metabolism as well as on fetal metabolism and postnatal condition at Caesarean section (author's transl)].

The effects of pancuronium bromide (Pavulon) on maternal circulation and metabolism as well as on fetal metabolism and postnatal conditions were studied in 13 women in late pregnancy (between gestational weeks 33 and 40) requiring Caesarean section in general anaesthesia. A comparison with results of 50 spontaneous deliveries without analgetics was performed. The average dosage of 4 mg did not effect the maternal blood pressure, fetal muscle tonus and cardiorespiratory adaption of the newborn. According to general anaesthesia we found in acid-base status a pH decrease with respiratory acidosis in comparison with spontaneous deliveries without anaesthetics, but pH and pCO2 were normalized 30 min after delivery. On the contrary, the oxygen tension were higher as at delivery as 30 min after delivery by Caesarean section. Although 1 minute Apgar score was lower than after spontaneous delivery the heart rate and frequency of ventilation were normal in every time and in the following minutes Apgar score was 7 to 10, too. An effect of pancuronium bromide to maternal or fetal carbohydrate metabolism could not be found. The less side effects on maternal cardiovascular system and the missing influence in postnatal condition recommand pancuronium bromide as a suitable relaxant in obstetrical anaesthesia, too.

Acidosis↗
PubMed1985

Unusual response following use of succinylcholine in a horse anesthetized with halothane.

A syndrome similar to malignant hyperthermia developed in a 545-kg Quarter Horse while anesthetized with halothane for cataract removal. Succinylcholine administration caused prolonged, severe muscle fasciculations followed by tachycardia, and an elevated blood pressure. Later, while the horse was still under anesthesia, its body temperature rose 2 degrees C, and respiratory acidosis developed. Myositis developed after surgery, but the horse recovered.

Anesthesia, General↗
PubMed1985

Effects of volatile anesthetics or fentanyl on hepatic function in cirrhotic rats.

Halothane, enflurane, isoflurane, and fentanyl were examined for their potential to exacerbate liver dysfunction in rats with preexisting cirrhosis. Male Wistar rats given sodium phenobarbital for 2 weeks are assigned randomly to two groups. One group (cirrhotic) was exposed by inhalation to carbon tetrachloride (CCl4) in air at weekly intervals for 12 weeks to induce cirrhosis. The other group (noncirrhotic) was handled similarly but received air only. Five weeks after the last exposure to CCl4, cirrhotic and noncirrhotic rats were given three hours of 1 MAC halothane, enflurane, or isoflurane in 50% oxygen, or 350 micrograms fentanyl per kg of body weight and 50% oxygen, or 50% oxygen only. Blood gas tensions and blood glucose levels were measured before, during, and at the end of exposure. Forty-eight hours after exposure, serum chemistries were measured in each rat for comparison with preexposure values. Rats were then killed by CO2 overdose, and liver, kidney, and testis were prepared for microscopic examination. Enflurane, isoflurane, and halothane, but not fentanyl, produced mild respiratory acidosis and no change in serum glucose levels. All anesthetics resulted in a mild but similar degree of acute liver dysfunction as indicated by small increases in SGOT or SGPT in both cirrhotic and noncirrhotic rats. Liver histology revealed mild to moderate portal cirrhosis with fibrosis and well-developed micronodules in rats exposed to CCl4, but no superimposed acute hepatocellular damage was noted. It is concluded that all the anesthetics used in this study were associated with the same minimal degree of postanesthetic hepatic dysfunction and that the dysfunction was similar in both cirrhotic and noncirrhotic rats.

Alanine Transaminase↗
PubMed1975

[Blood acid-base changes produced by variations of water oxygenation in the crab Carcinus maenas (author's transl)].

10 Blood acid-base changes were studied at 17 degrees C in immersed crabs (Carcinus maenas) exposed to hypoxic and hyperoxic conditions, by measuring the pH and the CO2 partial pressure, PbCO2, and by calculating the bicarbonate concentration. 20 Hyperoxia first induces a marked respiratory acidosis with a rise of PbCO2. This acidosis is compensated thereafter by a non-ventilatory increase of the blood buffer base concentration. These results are discussed in relation to the general problems concerning the control of the blood acid-base balance in aquatic animals.

Acid-Base Equilibrium↗
PubMed1979

Progesterone in obese patients with respiratory failure.

Two obese patients with acute respiratory failure are described. Both required mechanical ventilation to reverse the respiratory acidosis. On recovery, the major abnormality was failure of ventilatory response to inhaled carbon dioxide. After oral progesterone (100 mg/day and 20 mg/day, respectively) the slope of the carbon dioxide response line increased from 0,02 to 1,14 I min-1 mmHg-1 and from 0,04 to 1,14 I min-1 mmHg-1, respectively. This was associated with sustained clinical remission in 1 patient.

Carbon Dioxide↗
PubMed1979

Distribution of cardiac output in anaesthetised horses.

The radioactive microsphere method was used to determine the distribution of cardiac output in six anaesthetised ponies. Simultaneous measurements of cardiac output allowed calculation of the tissue perfusions (ml/min/100 g). Allowing for the fact that measurements were carried out on animals under halothane anaesthesia and which had respiratory acidosis, the results were comparable with published values for other species.

Anesthesia, Inhalation↗
PubMed1979

Effects on man of 30-day exposure to a PICO2 of 14 torr (2 %): application to exposure limits.

Pulmonary function, acid-base balance, renal electrolyte excretion, hematology, biorhythms and psychomotor test results were studied in six men during 30 days of exposure to a PICO2 of 14 torr (FICO2 = 0.02) with pre- and postexposure periods on air. Alveolar and arterial PCO2 increased and remained constant throughout the CO2 exposure (delta PACO2 = delta PACO2 = 2.5 torr); the rise in expiratory minute volume (delta VE = 60%) was related to the increased tidal volume. Oxygen uptake and carbon dioxide output increased about 10% because of the ventilatory work overload. Physiological dead space increased 8% without an alveolar-arterial PCO2 difference. Respiratory acidosis was mild (delta pH approximately or equal to 0.01) and the renal response was slight. There was no variation in plasma electrolytes, except a slight decrease in potassium. Red blood cell count decreased, showing a confinement effect. Adaptation to exercise was slightly impaired. Results of electrobiological and psychomotor tests and biorhythm evaluations showed no variation; application of these findings to CO2 exposure limits is discussed.

Acid-Base Equilibrium↗
PubMed1977

Status asthmaticus. A nine-year experience.

A retrospective analysis of 811 patients admitted to the hospital for status asthmaticus over a nine-year period was performed. Eight patients died, and 19 required mechanical ventilation. All persons who died of status asthmaticus were in the group that required mechanical ventilation. In 12 of the patients who received ventilation, no definite cause for the acute exacerbation could be identified, although initial arterial blood gas analyses showed profound hypoxemia, hypercapnia, and acute respiratory acidosis. Seventy-eight major complications occurred during mechanical ventilation. Pneumothorax, endotracheal tube malfunction, alveolar hypoventilation on the ventilator, and pneumonia were associated with decreased survival. Mucous plugging of the airways was found in all autopsied patients. Mechanical ventilation in status asthmaticus is a life-support system associated with substantial morbidity and should be instituted only when it becomes evident that maximal medical therapy will not be efficacious.

Adolescent↗
PubMed1975

[The effects of flunitrazepam (rohypnol) on respiration (author's transl)].

The effects of flunitrazepam (0.03 mg/kg administered intravenously over a two-minute period) was investigated in 11 healthy volunteers with normal pulmonary function. Spirometer tracings were recorded continuously by the Siregnost FD 40 and blood gas measurements were performed by the Harnoncourt AVL gas analyzer. Flunitrazepam produced a characteristic cyclical hypoventilation/hyperventilation pattern lasting 15 min., followed by quiet sleeping rhythms. The duration of action was 20 min. There was a significant fall in PCO2, whilst the CO2 tension showed a significant rise. Changes in pH were in accordance with respiratory acidosis. Apnoea did not occur after the administration of flunitrazepam.

Anti-Anxiety Agents↗
PubMed1983

[Relations between acid-base equilibrium and body temperature. Physiological concepts and practical applications].

In 1975 H. Rahn put forward a new concept of hydrogen ions regulation which explains acid-base regulation in relation to body temperature and applies to all animal species. At the root of this concept is the finding that maintenance of intracellular neutrality is governed by water dissociation and regulated by imidazole-rich protein buffers. The pH of the extracellular fluid, which receives acid by-products of cell activity, is kept higher than that of the intracellular fluid (relative alkalinity). The difference between extracellular pH and neutrality is constant for each species and ranges from 0.6 to 0.8 pH units. It is unaffected by changes in temperature, and the total CO2 content of extracellular fluid remains constant. The authors were able to confirm the value of this new concept in man by experimental studies of in vitro and in vivo blood of patients undergoing aorto-coronary bypass under controlled hypothermia. They draw the following practical conclusions: (1) in subjects under moderate or deep hypothermia for surgical purposes, the acid-base status can be controlled and the extracellular pH adjusted by ensuring intracellular neutrality; this is done by keeping PCO 2 at such a level that the arterial blood pH measured at 37 degrees C remains around 7.40; (2) the problem of correcting acid-base values (pH-PCO 2) according to body temperature is solved simply by using pH and PCO 2 values measured at 37 degrees C and interpreting them, as usual, in terms of metabolic or respiratory acidosis or alkalosis.

Acid-Base Equilibrium↗
PubMed1983

[Pulmonary edema caused by heroin. Hemodynamic study of 2 cases].

The authors report two cases of heroin induced pulmonary edema. In both cases the severity of respiratory failure, attested by a deep hypoxemia (paO2 28 and 32 mmHg) and a metabolic and respiratory acidosis (pH 7.07 and 7.14) imposed an artificial ventilation with positive end expiratory pressure (PEEP). Hemodynamic study revealed a noncardiogenic edema. In both cases, a cardiac insufficiency was also present : in the first case it's etiology remained unclear, in the second it was a complication of hyperkalemia.

Acidosis↗
PubMed1983

Effects of hypercapnia and hyperoxia on metabolism during exercise.

It has been postulated that the respiratory acidosis associated with hyperoxia (HO) may mediate some of the metabolic effects that are traditionally attributed to the elevation in PaO2. Five subjects performed 30 min of steady-state exercise (65% VO2max) on eight occasions while inspiring either 21 or 60% O2 in combination with 0, 2, 4, or 6% CO2. Statistical significance was accepted if P less than 0.05. The four HO tests were associated with increased VO2 and lower R and blood lactate. However, when compared to the four normoxic tests, all of the hypercapnic (HC) conditions (independent of the inspired O2 percent) had statistically lower blood lactate. Hypercapnia was associated with lower R values and increased blood H+. Regression analysis demonstrated relationships between H+ and R, as well as between H+ and blood lactate. These findings are independent of whether 21 or 60% O2 was inspired, and support the hypothesis that acidosis, not PO2, mediates the effects related to HO.

Bicarbonates↗
PubMed1983

Almitrine bismesylate in congenital central hypoventilation.

We have carried out sequential studies of respiration and sleep state, from two weeks to two years of age in a girl with congenital central hypoventilation. When awake her minute ventilation (VE) and blood gases are normal, and when asleep she shows hypoventilation, with progressive hypoxia, hypercarbia and respiratory acidosis, most marked in NREM sleep. There has been no consistent change in VE (expressed as ml/kg/min) with age, awake or asleep, and she remains ventilator dependent when asleep. Growth and development are normal. We report a trial of almitrine bismesylate at the age of 21 months. A dose of 1.5 mg/kg/day orally for eight days produced minimal changes in VE, but when given 2.6 mg/kg/day for a further seven days there was a significant increase in VE in both NREM (27% increase) and in REM sleep (30% increase). These changes were accompanied by substantial improvements in blood gases, with PaCO2 less than 50 mmHg and PaO2 greater than 60 mmHg throughout a four hour study period asleep, off the ventilator, in air. After stopping almitrine bismesylate VE and blood gas values returned to pretreatment values. Almitrine bismesylate may be of value as an alternative to artificial ventilation in this condition.

Almitrine↗
PubMed1984

[Pathogenesis and treatment of infection].

The decrease in the microbicidal activity of peripheral blood neutrophils against autohemocultures was demonstrated with special reference to 16 patients with sepsis. This fact is discussed in the light of the data on respiratory acidosis, anemization, and blood iron reduction in sepsis.

Adult↗
PubMed1981

[A clinical study of co2-elimination using a modified bain-system (author's transl)].

Of three groups of anaesthetized and intubated patients (n = 7) under controlled ventilation two received fresh gas flows of 70 ml/kg . min, 100 ml/kg . min and 130 ml/kg . min either in increasing or in decreasing amounts via a Bain circuit, while the third group was ventilated via a conventional semi-closed anaesthesia circuit. Blood gas analyses and cardiovascular parameters were recorded. In one patient temperatures and relative humidities of in- and expired gases were obtained by psychrometry. A modification of the Bain system afforded control of respiratory minute volumes and airway pressures. CO2-elimination proved to be adequate at a fresh gas flow of 130 ml/kg. min. At 100 ml/kg. min it was acceptable still, however pH values were outside normal range. With 70 ml/kg . min mean capillary pCO2 values (42.6 mmHg and 43.2 mmHg) and mean pH values (7.32 and 7.33) in the two respective groups proved a respiratory acidosis. Capillary pO2 was above 100 mmHg in all groups. Temperature and relative humidity of inspired gases were 24 degrees C and 40 per cent, 23 degrees C and 25 per cent, 22 degrees C and 3 per cent at fresh gas flows of 70, 100 and 130 ml/kg . min respectively.

Adult↗
PubMed1981

Effects of segmental subarachnoid analgesia on arterial blood pressure, gas tensions, and pH in adult conscious cows.

Arterial blood pressure, blood gas tensions (PaCO2, PaO2), and pH (pHa) were determined in 16 adult, nonpregnant Holstein cows (620 +/- 54 kg) given subarachnoid injection of a 5% procaine hydrochloride solution at the T13-L1 intervertebral space. Analgesia, as determined by response to superficial and deep muscular pinpricks at the L1 dermatome, was delayed (onset) 7 to 15 minutes, and it lasted (duration) 28 to 83 minutes. Thoracolumbar analgesia extending between spinal cord segments T9 and L4 on 1 or both sides of the spine produced significant (P less than 0.05) increases in heart rate and decreases in respiratory rate, but otherwise had no effect (P less than 0.05) on systolic, diastolic, and mean arterial blood pressures, PaCO2, PaO2, and pHa. Similarly, no significant changes (P less than 0.05) of physiologic variables were observed in a control group of 5 cows given a subarachnoidal injection of 0.9% sodium chloride solution at 1 hour before procaine hydrochloride was injected. It was concluded that the unsedated, healthy cow tolerates segmental subarachnoid analgesia between spinal segments T9 and L4 well and that this analgesia is not adversely affected by hypoxemia, respiratory acidosis, or hypotension.

Anesthesia, Spinal↗
PubMed1982

[Haemodynamic and cardiac and respiratory changes during enflurane-monoanaesthesia in the Göttingen minipig (author's transl)].

Two groups of 10 Göttingen minipigs each were anaesthetized with enflurane in a mixture of O2 and N2O for 90 minutes. One group breathed spontaneously. In the other controlled respiration was used following relaxation with succinylcholine-chloride. Control values of ECG, blood pressure, aortic blood flow, arterial oxygen and carbon dioxide tensions, arterial pH, the maximum rate of rise of the left ventricular pressure (max. dp/dt) were recorded from all animals. Anaesthesia was induced with enflurane using a face mask. On reaching the stage of deep surgical anaesthesia the pigs were quickly intubated and anaesthesia was maintained for up to 90 minutes. Max. dp/dt, blood gas tensions and pH were measured again 60 minutes after induction of anaesthesia. A third arterial blood sample was taken in the 100th minute at the end of the experiment. Enflurane produced a negative chronotropic and inotropic effect on the heart muscle. Blood pressure decreased by 40% and cardiac output by 32%. Total peripheral resistance was reduced in the 20th minute by 28% but returned to the control level towards the end of the experiment. We observed a few disturbances of cardiac rhythm and conduction. The spontaneously breathing group developed a respiratory acidosis. Within 10 minutes of discontinuing enflurane administration all parameters returned to the control levels. An obvious overdose of enflurane caused transitory convulsions in two animals. Similar symptoms are well known in humans. We prefer enflurane in the minipig since, in contrast to other inhalation anaesthetics, almost none is metabolised. This is especially important in cases of repeated anaesthesia in the same animal.

Anesthesia, Inhalation↗