respiratory alkalosis
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Author(s):  
Michael M. Tymko ◽  
Christopher K. Willie ◽  
Connor A. Howe ◽  
Ryan L. Hoiland ◽  
Rachel Stone ◽  
...  

High-altitude exposure results in a hyperventilatory-induced respiratory alkalosis followed by renal compensation (bicarbonaturia) to return arterial blood pH(a) toward sea-level values. However, acid-base balance has not been comprehensively examined in both lowlanders and indigenous populations - where the latter are thought to be fully adapted to high-altitude. The purpose of this investigation was to compare acid-base balance between acclimatizing lowlanders, and Andean and Sherpa highlanders at various altitudes (~3,800, ~4,300, and ~5,000 m). We compiled data collected across five independent high-altitude expeditions and report the following novel findings: 1) at 3,800 m, Andeans (n=7) had elevated pHa compared to Sherpas (n=12; P<0.01), but not to lowlanders (n=16; nine days acclimatized; P=0.09); 2) at 4,300 m, lowlanders (n=16; 21 days acclimatized) had elevated pHa compared to Andeans (n=32) and Sherpas (n=11; both P<0.01), and Andeans had elevated pHa compared to Sherpas (P=0.01); and 3) at 5,000 m, lowlanders (n=16; 14 days acclimatized) had higher pHa compared to both Andeans (n=66) and Sherpas (n=18; P<0.01, and P=0.03, respectively), and Andean and Sherpa highlanders had similar blood pHa (P=0.65). These novel data characterize acid-base balance acclimatization and adaptation to various altitudes in lowlanders and indigenous highlanders.


eLife ◽  
2022 ◽  
Vol 11 ◽  
Author(s):  
Kathryn A Salvati ◽  
George MPR Souza ◽  
Adam C Lu ◽  
Matthew L Ritger ◽  
Patrice Guyenet ◽  
...  

Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable hyperventilation to powerfully activate absence seizure-generating circuits remain entirely unknown. By utilizing gas exchange manipulations and optogenetics in the WAG/Rij rat, an established rodent model of absence epilepsy, we demonstrate that absence seizures are highly sensitive to arterial carbon dioxide, suggesting that seizure-generating circuits are sensitive to pH. Moreover, hyperventilation consistently activated neurons within the intralaminar nuclei of the thalamus, a structure implicated in seizure generation. We show that intralaminar thalamus also contains pH-sensitive neurons. Collectively, these observations suggest that hyperventilation activates pH-sensitive neurons of the intralaminar nuclei to provoke absence seizures.


Critical Care ◽  
2021 ◽  
pp. 36-37
Author(s):  
Steven Mensack

2021 ◽  
Vol 66 ◽  
pp. 1-5
Author(s):  
Paul Brussee ◽  
Jelle Zwaag ◽  
Lucas van Eijk ◽  
Johannes G. van der Hoeven ◽  
Miriam A. Moviat ◽  
...  

2021 ◽  
Vol 4 (4) ◽  
pp. 291
Author(s):  
Sri Rejeki ◽  
Achmad Sulichan ◽  
Fitri Nuroini

Pain is a physiological condition that is generally experienced by almost all mothers in labor or pain during menstruation (dysmenorrhea). Pain causes tachycardia in the mother, increased oxygen consumption, lactic (lactic) acid production, hyperventilation with a risk of respiratory alkalosis, and increased skeletal muscle tension. Regiosarcal Counter Pressure is an effective therapy to reduce pain due to uterine contractions. Based on research that has been done, Regiosarcal counter-pressure therapy can reduce pain levels and has also been shown to slightly reduce prostaglandin (PGE-2) levels in an insignificant amount. Changes in PGE-2 are suspected to have an impact on the stimulant hormone Interleukin-6 (IL-6). This study aims to determine the levels of IL-6 and prostaglandins in the first stage of labor. The research method used quasi-experimental, with inclusion criteria of first-stage labor, no pelvic abnormalities and other abnormalities that hindered the process of vaginal delivery, primiparas, singleton pregnancies, the location of the head did not receive painkillers. The results obtained 25 respondents with an average age of 23.72 (± 2.89) years, the average concentration of IL-6 before therapy was 185.159 (± 3.76) pg/ml and the mean after therapy was 180.782 (± 22.05) pg. /ml, the mean concentration of PGE2 before treatment was 223.521 (± 72.73) pg/ml and the mean after treatment was 179.873 (± 110.61) pg/ml. Administration of regiosacral counter-pressure therapy did not significantly reduce the levels of the hormone IL-6 and prostaglandins in women who experienced uterine contractions.


2021 ◽  
Vol 8 (4) ◽  
pp. 568-571
Author(s):  
Paapa Dasari ◽  
Sonal Garg

Menarche, the beginning of menstrual function occurs as a result of complex interaction between the hypothalamus, pituitary and ovarian hormones and is an important event in any girl’s life as it signifies the beginning of fertility. Rarely some diseases like migraine, epilepsy, inherited bleeding disorders can manifest at menarche and cause significant anxiety to the parents and the adolescent girl. A 13-year-old girl presented with convulsions following 8 days of excessive bleeding at the time of menarche. She had altered sensorium, severe anaemia with Respiratory alkalosis and needed ICU Care. She needed multiple transfusions of blood and blood products. She showed features of sepsis on haemogram at admission later manifested respiratory findings. Her bleeding per vaginum did not respond to antifibrinolytics and progesterones and stopped only after evacuation of contents on day 5 under GA. No organism could be isolated and she recovered on Day 6 of higher broad spectrum antibiotics. Her parents were counselled to watch for occurrence of seizures in later life as this catastrophe may signify onset of epilepsy in later life.


2021 ◽  
Vol 15 (10) ◽  
pp. e01535
Author(s):  
Dustin Hang ◽  
Zafar Iqbal ◽  
Sylvia Y. Dolinski

2021 ◽  
pp. 1753495X2110378
Author(s):  
Brady Thomson ◽  
Ragani Velusamy ◽  
Annabel Martin

Physiological hyperventilation and dyspnoea in pregnancy are well-established phenomena and commonly lead to a chronic respiratory alkalosis with compensatory renal excretion of bicarbonate. However, the underlying mechanism of dyspnoea during normal pregnancy remains largely undefined. Increasing progesterone levels are a primary factor leading to increased respiratory drive to ensure the rising metabolic demands of the pregnancy are met. Dyspnoea symptoms typically begin in the first or second trimester, are mild, and do not interfere with activities of daily living. We report the case of a 35-year-old female with severe physiological hyperventilation of pregnancy presenting with profound dyspnoea, tachypnoea, and presyncope from 18 weeks of gestation until delivery. Subsequent investigations revealed no identifiable underlying pathology. There remain limited reports of such severe physiological hyperventilation of pregnancy. This case highlights interesting questions regarding the respiratory physiology of pregnancy and underlying mechanisms.


2021 ◽  
Vol 3 ◽  
Author(s):  
Tom Citherlet ◽  
Fabienne Crettaz von Roten ◽  
Bengt Kayser ◽  
Kenny Guex

The Wim Hof breathing method (WHBM) combines periods of hyperventilation (HV) followed by voluntary breath-holds (BH) at low lung volume. It has been increasingly adopted by coaches and their athletes to improve performance, but there was no published research on its effects. We determined the feasibility of implementing a single WHBM session before repeated sprinting performance and evaluated any acute ergogenic effects. Fifteen amateur runners performed a single WHBM session prior to a Repeated Ability Sprint Test (RAST) in comparison to voluntary HV or spontaneous breathing (SB) (control) in a randomized cross-over design. Gas exchange, heart rate, and finger pulse oxygen saturation (SpO2) were monitored. Despite large physiological effects in the SpO2 and expired carbon dioxide (VCO2) levels of both HV and WHBM, no significant positive or negative condition effects were found on RAST peak power, average power, or fatigue index. Finger SpO2 dropped to 60 ± 12% at the end of the BHs. Upon the last HV in the WHBM and HV conditions, end-tidal CO2 partial pressure (PETCO2) values were 19 ± 3 and 17 ± 3 mmHg, indicative of respiratory alkalosis with estimated arterial pH increases of +0.171 and of +0.181, respectively. Upon completion of RAST, 8 min cumulated expired carbon dioxide volumes in the WHBM and HV were greater than in SB, suggesting lingering carbon dioxide stores depletion. These findings indicate that despite large physiological effects, a single WHBM session does not improve anaerobic performance in repeated sprinting exercise.


2021 ◽  
Author(s):  
Kathryn Salvati ◽  
George M.P.R. Souza ◽  
Adam C Lu ◽  
Matthew L Ritger ◽  
Patrice Guyenet ◽  
...  

Hyperventilation reliably provokes seizures in patients diagnosed with absence epilepsy. Despite this predictable patient response, the mechanisms that enable hyperventilation to powerfully activate absence seizure-generating circuits remain entirely unknown. Using the WAG/Rij rat, an established rodent model of absence epilepsy, we demonstrate that absence seizures are highly sensitive to arterial carbon dioxide, suggesting that seizure-generating circuits are sensitive to pH. Moreover, hyperventilation consistently activated neurons within the intralaminar nuclei of the thalamus, a structure implicated in seizure generation. We show that intralaminar thalamus also contains pH-sensitive neurons. Collectively, these observations suggest that hyperventilation activates pH-sensitive neurons of the intralaminar nuclei to provoke absence seizures.


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