scholarly journals Hypercapnia: An Aggravating Factor in Asthma

2020 ◽  
Vol 9 (10) ◽  
pp. 3207
Author(s):  
Masahiko Shigemura ◽  
Tetsuya Homma ◽  
Jacob I Sznajder
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Innate Immune System ◽  
Skeletal Muscles ◽  
Innate Immune ◽  
Respiratory Disorder ◽  
Small Minority ◽  
Alveolar Hypoventilation ◽  
Carbon Dioxide Co2

Asthma is a common chronic respiratory disorder with relatively good outcomes in the majority of patients with appropriate maintenance therapy. However, in a small minority, patients can experience severe asthma with respiratory failure and hypercapnia, necessitating intensive care unit admission. Hypercapnia occurs due to alveolar hypoventilation and insufficient removal of carbon dioxide (CO2) from the blood. Although mild hypercapnia is generally well tolerated in patients with asthma, there is accumulating evidence that elevated levels of CO2 can act as a gaso-signaling molecule, triggering deleterious effects in various organs such as the lung, skeletal muscles and the innate immune system. Here, we review recent advances on pathophysiological response to hypercapnia and discuss potential detrimental effects of hypercapnia in patients with asthma.

scholarly journals Lack of effect of glutamine administration to boost the innate immune system response in trauma patients in the intensive care unit

Critical Care ◽  
2010 ◽  
Vol 14 (6) ◽  
pp. R233 ◽  
Author(s):  
Jon Pérez-Bárcena ◽  
Catalina Crespí ◽  
Verónica Regueiro ◽  
Pedro Marsé ◽  
Joan M Raurich ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Immune System ◽  
Innate Immune System ◽  
Innate Immune ◽  
System Response ◽  
Trauma Patients ◽  
Immune System Response

Feasıbılıty of Transcutaneous Method for Carbon Dıoxıde Monıtorıng in an Intensive Care Unıt

2022 ◽  
Vol 18 ◽  
Author(s):  
Nazlıhan Boyacı ◽  
Sariyya Mammadova ◽  
Nurgül Naurizbay ◽  
Merve Güleryüz ◽  
Kamil İnci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Partial Pressure ◽  
Blood Gas ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Randomized Controlled Studies ◽  
Significant Difference

Background: Transcutaneous partial pressure of carbon dioxide (PtCO2) monitorization provides a continuous and non-invasive measurement of partial pressure of carbon dioxide (pCO2). In addition, peripheral oxygen saturation (SpO2) can also be measured and followed by this method. However, data regarding the correlation between PtCO2 and arterial pCO2 (PaCO2) measurements acquired from peripheric arterial blood gas is controversial. Objective: We aimed to determine the reliability of PtCO2 with PaCO2 based on its advantages, like non-invasiveness and continuous applicability. Methods: Thirty-five adult patients with hypercapnic respiratory failure admitted to our tertiary medical intensive care unit (ICU) were included. Then we compared PtCO2 and PaCO2 and both SpO2 measurements simultaneously. Thirty measurements from the deltoid zone and 26 measurements from the cheek zone were applied. Results: PtCO2 could not be measured from the deltoid region in 5 (14%) patients. SpO2 and pulse rate could not be detected at 8 (26.7%) of the deltoid zone measurements. Correlation coefficients between PtCO2 and PaCO2 from deltoid and the cheek region were r: 0,915 and r: 0,946 (p = 0,0001). In comparison with the Bland-Altman test, difference in deltoid measurements was -1,38 ± 1,18 mmHg (p = 0.252) and in cheek measurements it was -5,12 ± 0,92 mmHg (p = 0,0001). There was no statistically significant difference between SpO2 measurements in each region. Conclusion: Our results suggest that PtCO2 and SpO2 measurements from the deltoid region are reliable compared to the arterial blood gas analysis in hypercapnic ICU patients. More randomized controlled studies investigating the effects of different measurement areas, hemodynamic parameters, and hemoglobin levels are needed.

Detection of Inadvertent Airway Intubation During Gastric Tube Insertion: Capnography Versus a Colorimetric Carbon Dioxide Detector

2006 ◽  
Vol 15 (2) ◽  
pp. 188-195 ◽  
Author(s):  
Suzanne M. Burns ◽  
Richard Carpenter ◽  
Cheri Blevins ◽  
Sharon Bragg ◽  
Mary Marshall ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Mental Status ◽  
Gastric Tube ◽  
Medical Intensive Care Unit ◽  
Tube Placement ◽  
Tube Type ◽  
Gastric Tubes ◽  
Medical Intensive Care

• Background In the medical intensive care unit at the University of Virginia Health System, capnography is used to detect end-tidal carbon dioxide to protect patients from inadvertent airway cannulation during placement of gastric tubes. • Objectives To compare the method in which capnography is used with a method in which a colorimetric carbon dioxide detector is used and to determine what variables affect accurate placement of gastric tubes. • Methods A prospective convenience sample of 195 gastric tube insertions was studied in 130 adult patients in a medical intensive care unit. Standard insertions of gastric tubes (done with capnography) were simultaneously monitored by using a disposable colorimetric device, with a color change indicating the presence of carbon dioxide. • ResultsInsertion variables included tube type (60% Salem sump tubes, 40% soft-bore feeding tubes), route of insertion (71% oral, 29% nasal), mechanical ventilation (81%), and decreased mental status (72%). Carbon dioxide was successfully detected with the colorimetric indicator (within seconds) in all insertions in which carbon dioxide was detected by capnography. When carbon dioxide was detected (27% of insertions), the tubes were withdrawn and reinserted. Carbon dioxide detection during tube placement was significantly associated with nasal insertions (P = .03) and spontaneously breathing/nonintubated status (P=.01) but not with mental status or tube type. • Conclusions A colorimetric device is as accurate as capnography for detecting carbon dioxide during placement of gastric tubes.

scholarly journals An Evaluation of Five Carbon Dioxide Analysers for use in the Operating Theatre and Intensive Care Unit

1987 ◽  
Vol 15 (2) ◽  
pp. 212-216 ◽  
Author(s):  
D. G. Selby ◽  
A. H. Ilsley ◽  
W. B. Runciman
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Water Vapour ◽  
Operating Theatre ◽  
Main Stream ◽  
Time Stability ◽  
Side Stream ◽  
Stream Sampling ◽  
Available Carbon

Five commercially available carbon dioxide analysers were assessed with respect to accuracy, response time, stability, the effect of water vapour and the effect of rebreathing. Two side-stream sampling analysers (Datex Normocap and Engstrom Eliza) and one main-stream sampling analyser (Hewlett-Packard Capnoshot) were found to be satisfactory for use both in the operating theatre and intensive care unit. The Instrumentation Laboratory (IL) 200, a side-stream monitor, performed satisfactorily but neither it nor the Siemens Sirecust 404, a main-stream monitor, has the facility to compensate for the presence of nitrous oxide. The Siemens analyser, in the form tested, could not be recommended for clinical use, as it was less accurate than the other monitors, could not detect rebreathing, and was subject to fluctuations when used with gas mixtures saturated with water vapour.

Imaging of the Vena Cava in the Intensive Care Unit Prior to Vena Cava Filter Insertion: Carbon Dioxide as an Alternative to Iodinated Contrast

2008 ◽  
Vol 74 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Thomas M. Schmelzer ◽  
A. Britton Christmas ◽  
David G. Jacobs ◽  
B. Todd Heniford ◽  
Ronald F. Sing
Keyword(s):  
Carbon Dioxide ◽  
Blood Pressure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Contrast Agent ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Iodinated Contrast ◽  
Venous Oxygen Saturation ◽  
Filter Insertion

This study evaluates the safety and effectiveness of carbon dioxide (CO2) as a contrast agent in patients in the intensive care unit undergoing vena cava filter (VCF) insertion. We prospectively evaluated patients in the intensive care unit undergoing bedside VCF insertion using CO2 cavagraphy. Blood pressure, pulse rate, mixed venous oxygen saturation, and intracranial pressure were monitored before, during, and after the CO2 injection. Fifty patients in the intensive care unit (mean age 48.2 ± 16.5 years) were included in the study. Five patients had decreases in blood pressure, which resolved without intervention. Two patients required iodinated contrast as a result of inadequate CO2 imaging. All patients had successful insertion of VCF. The use of CO2 as a contrast agent is a safe and highly effective alternative for vena cava imaging and can be considered the first-line contrast agent for all critically ill patients requiring VCF placement.

Mainstream End-tidal Carbon Dioxide Monitoring in the Neonatal Intensive Care Unit

PEDIATRICS ◽  
1998 ◽  
Vol 101 (4) ◽  
pp. 648-653 ◽  
Author(s):  
Henry J. Rozycki ◽  
Gregory D. Sysyn ◽  
M. Kathy Marshall ◽  
Raymond Malloy ◽  
Thomas E. Wiswell
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
End Tidal Carbon Dioxide ◽  
Carbon Dioxide Monitoring ◽  
End Tidal
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