Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia.

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Serval ID
serval:BIB_FBEEF977BEB8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia.
Journal
Intensive care medicine
Author(s)
Gnaegi A., Feihl F., Boulat O., Waeber B., Liaudet L.
ISSN
1432-1238[electronic]
Publication state
Published
Issued date
2009
Volume
35
Number
7
Pages
1297-1304
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
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.
Keywords
Animals, Carbon Dioxide/administration & dosage, Carbon Dioxide/physiology, Endotoxemia/physiopathology, Energy Metabolism/drug effects, Energy Metabolism/physiology, Hypercapnia/metabolism, Oxygen Consumption, Random Allocation, Rats, Rats, Wistar, Respiration, Artificial, Respiratory Distress Syndrome, Adult/physiopathology, Respiratory Distress Syndrome, Adult/therapy, Sepsis/physiopathology, Splanchnic Circulation/drug effects, Splanchnic Circulation/physiology
Pubmed
Web of science
Open Access
Yes
Create date
21/12/2009 13:36
Last modification date
01/10/2019 7:20
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