171 resultados para HYPERCAPNIA


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Pós-graduação em Bases Gerais da Cirurgia - FMB

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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The volume-controlled mechanical ventilation and spontaneous ventilation, through haemogasometric, cardiovascular and spirometry variables were evaluated. Twenty-eight rabbits were distributed into two groups: GIVC (isoflurane and volume-controlled ventilation), GIVE (isoflurane and spontaneous ventilation), GSVC (sevoflurane and volume-controlled ventilation) and GSVE (sevoflurane and spontaneous ventilation). Induction was performed by mask with isoflurane (GIVE and GIVC) or sevoflurane (GSVE and GSVC) at 1.5 MAC in 100% oxygen. To maintain anesthesia, MAC was reset to 1. In GIVC and GSVC groups, rocuronium was administered at a dose of 0.6 mg/kg followed by its continuous infusion (0.6 mg/kg/h). In GSVE and GIVE, 0.9% NaCl was administered instead of rocuronium. Controlled ventilation was started by adjusting the capnometry in order to obtain values between 35 and 45 mmHg. Parameters were measured 60 minutes after induction of anesthesia (M0), 15 minutes after the bolus of rocuronium or 0.9% NaCl (M15) and every fifteen minutes (M30, M45 and M60). Hypercapnia and acidosis was evident in GIVC, GSVC and GSVE. We concluded that the volume-controlled mechanical ventilation was not able to maintain normocapnia in rabbits, producing acidosis in them, especially when using sevoflurane. The use of isoflurane showed greater stability than the sevoflurane anesthetic in the species studied.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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It is well known that breathing introduces rhythmical oscillations in the heart rate and arterial pressure levels. Sympathetic oscillations coupled to the respiratory activity have been suggested as an important homeostatic mechanism optimizing tissue perfusion and blood gas uptake/delivery. This respiratory-sympathetic coupling is strengthened in conditions of blood gas challenges (hypoxia and hypercapnia) as a result of the synchronized activation of brainstem respiratory and sympathetic neurons, culminating with the emergence of entrained cardiovascular and respiratory reflex responses. Studies have proposed that the ventrolateral region of the medulla oblongata is a major site of synaptic interaction between respiratory and sympathetic neurons. However, other brainstem regions also play a relevant role in the patterning of respiratory and sympathetic motor outputs. Recent findings suggest that the neurons of the nucleus of the solitary tract (NTS), in the dorsal medulla, are essential for the processing and coordination of respiratory and sympathetic responses to hypoxia. The NTS is the first synaptic station of the cardiorespiratory afferent inputs, including peripheral chemoreceptors, baroreceptors and pulmonary stretch receptors. The synaptic profile of the NTS neurons receiving the excitatory drive from afferent inputs is complex and involves distinct neurotransmitters, including glutamate, ATP and acetylcholine. In the present review we discuss the role of the NTS circuitry in coordinating sympathetic and respiratory reflex responses. We also analyze the neuroplasticity of NTS neurons and their contribution for the development of cardiorespiratory dysfunctions, as observed in neurogenic hypertension, obstructive sleep apnea and metabolic disorders.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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In female rats, a single injection of estradiol valerate (EV) results in effects that are similar to those observed in women with polycystic ovary syndrome (PCOS). We hypothesized that EV-induced PCOS affects breathing control based on evidence showing an influence of sex hormones on ventilation. To test this hypothesis, we studied the effects of EV treatment on the ventilation of female rats in air, in 7% CO2 and in 7% O2, at 30, 45 and 60 days after EV injection. The group examined 30 days after EV treatment showed a 61% reduction in the hypercapnic ventilatory response compared to the control group. Basal ventilation, hypoxic ventilatory response, and body temperature were not affected. These results, suggest that the hormonal changes observed in PCOS may result in a temporary inhibition of the central chemoreflex but do not influence basal ventilation or the hypoxic peripheral chemoreflex.

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Obstructive Sleep Apnea Syndrome (OSAS) is characterized by snoring and / or repetitive pauses in breathing during sleep associated with hypoxemia and hypercapnia. Affects approximately 1-3% of children, especially preschoolers. There is an association of OSAS with negative impact on neurocognitive development. However, there are few studies using protocols to assess cognition and behavioral disorders in children with OSAS. The objective of this study was to analyze the major studies related to the topic within the last two decades. The main studies published between 1995 to 2011 were identified through MEDLINE and LILACS databases. We selected the most relevant for OSAS in children, neurocognitive effects and association between obstructive disorders / OSAS in the target population (children). It was concluded that the studies analyzed showed that there is strong evidence regarding the overlapping of OSAS in children with neurocognitive disorders and that treatment of OSAS has positive impact on neurocognitive development.