Hypercapnic Conditions Research Articles

The effect of carbon dioxide on growth and energy metabolism in pikeperch (Sander lucioperca)

Pikeperch (Sander lucioperca) is a popular fish for human consumption and decreasing wild catches increase the demand for aquaculture production. Limited knowledge of the species' requirements under intense recirculating aquaculture system (RAS) culture conditions has motivated this study to focus on the effect of elevated carbon dioxide (CO2) levels on pikeperch metabolism. The trial was conducted in a recirculating aquaculture respirometer system with pikeperch (average body weight 251.9g) and three hypercapnia regimes over 58 feeding days. Food grade CO2 gas was gradually added to the medium (15mgL−1) and high (30mgL−1) treatments while no gas was added to the low treatment (hence 4mgL−1). Fish were fed daily for 10min with a commercial diet (ALLER Metabolica). O2, T, pH, CO2 were measured individually for each tank and logged every 2h to calculate oxygen consumption rates of each treatment. Total Ammonia-Nitrogen was measured monthly for individual tanks and used to calculate TAN excretion. Results showed a linear decrease of 6% in final body weight with increasing CO2 levels between the low and the high CO2 treatment. Feed intake was linearly increased after four weeks of the experiment from 0.97±0.07% in the low CO2 treatment to 0.86±0.03% in the high CO2 treatment but the effect faded after eight weeks, indicating a habituation to the hypercapnia conditions. High levels of CO2 were associated with reductions in haematocrit and metabolic oxygen consumption. The results suggest that adult pikeperch can survive carbon dioxide concentrations of up to 30mgL−1 when other water quality parameters are in acceptable levels but will be affected in metabolism already at moderate CO2 levels of 15mgL−1.

Spatial distribution of flow and oxygenation in the cerebral venous drainage system.

To investigate the venous oxygenation and flow in the brain, and determine how they might change under challenged states. Eight healthy human subjects (24-37 years) were studied. T2 -relaxation under spin tagging (TRUST) magnetic resonance imaging (MRI) and phase-contrast MRI were performed to measure venous oxygenation and venous blood flow, respectively, in the superior sagittal sinus (SSS), the straight sinus (SS), and the internal jugular veins (IJVs). Venous oxygenation was assessed at room air (0.03%CO2 , 21%O2 ) and under hyperoxia (O%CO2 , 95%O2 , and 5%N2 ) conditions. Venous blood flow was assessed at room air and under hypercapnia (5%CO2 , 21%O2 , and 74%N2 ) conditions. Whole-brain blood flow was also measured at the four feeding arteries of the brain using phase-contrast MRI. The changes in venous oxygenation and blood flow from room air to hyperoxia or hypercapnia conditions were tested using paired t-tests. Venous oxygenation in the SSS, the SS, and the IJVs was 61 ± 4%, 64 ± 4%, and 62 ± 4%, respectively, at room air, and increased to 70 ± 3% (P < 0.01 compared to room air), 71 ± 5% (P = 0.59), and 68 ± 5% (P < 0.05) under hyperoxic condition. The SSS, SS, and IJV drained 46 ± 9%, 16 ± 4%, and 79 ± 1% of whole-brain blood flow, respectively, and this flow distribution did not change under hypercapnic condition (P > 0.5). The results found in this study provide insight into the venous oxygenation and venous flow distribution and its heterogeneity among different venous structures. 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1091-1098.

Perturbation treadmill training improves clinical rating of the motor symptoms gait and postural stability, and sensor-based gait parameters in Parkinson’s disease

Although deep neuromuscular block (post-tetanic-count 1-2 twitches) improves surgical conditions during laparoscopic retroperitoneal surgery compared with standard block (train-of-four 1-2 twitches), the quality of surgical conditions varies widely, often related to diaphragmatic contractions. Hypocapnia may improve surgical conditions. Therefore we studied the effect of changes in arterial carbon dioxide concentrations on surgical conditions in patients undergoing laparoscopic surgery under general anaesthesia and deep neuromuscular block.Forty patients undergoing elective laparoscopic surgery for prostatectomy or nephrectomy received propofol/remifentanil anaesthesia and deep neuromuscular block with rocuronium. Patients were randomized to surgery under hypocapnic or hypercapnic conditions. During surgery, the surgical conditions were evaluated using the 5-point Leiden-Surgical Rating Scale (L-SRS) ranging from 1 (extremely poor conditions) to 5 (optimal conditions) by the surgeon, who was blinded to group.Mean (sd) arterial carbon dioxide concentrations were 4.5 (0.6) [range: 3.8–5.6] kPa under hypocapnic and 6.9 (0.6) [6.1–8.1] kPa under hypercapnic conditions. The L-SRS did not differ between groups: 4.84 (0.4) [4-5] in hypocapnia and 4.77 (0.4) [3.9–5] in hypercapnia. Ninety-nine percent of ratings were good or excellent irrespective of treatment.Deep neuromuscular block provides good to optimal surgical conditions in laparoscopic retroperitoneal urological surgery, independent of the level of arterial PCO2.NCT01968447.

Hypercapnic Conditions After Experimental Blunt Chest Trauma Increase Efferocytosis of Alveolar Macrophages and Reduce Local Inflammation.

Blunt chest trauma induces severe local and systemic inflammatory alterations and an accumulation of apoptotic polymorphonuclear granulocytes (aPMN) in the lungs, frequently followed by bacterial infection. Alveolar macrophages (AM) represent one of the main actors for their clearance. However, little is known regarding regulatory and influencing factors of AM efferocytic and phagocytic activities. In this context, we investigated the influence of impaired gas exchange on AM activity.Male rats underwent blunt chest trauma or sham procedure and aPMN or Escherichia coli (E. coli) were instilled. Subsequently, the efferocytic and phagocytic activities were assessed by analyzing AM obtained from bronchoalveolar lavage fluids at three time points. To determine whether efferocytic and phagocytic activities of AM are affected by shifting gas concentrations, AM were subjected in vitro to hypoxic and hypercapnic conditions.Trauma significantly upregulated the capacity of AM to ingest E. coli starting 24 h after trauma, whereas the aPMN uptake rate remained virtually unchanged. In vitro, AM reacted to hypercapnic conditions by enhanced efferocytosis associated with increased release of anti-inflammatory cytokines. Additionally, phagocytosis and the pro-inflammatory reaction of AM after trauma appeared to be impaired. In contrast, hypoxic conditions displayed no regulatory effect on AM.In conclusion, blunt chest trauma enhances phagocytic activity of AM. On the other hand, hypercapnic conditions in the lungs may significantly contribute to the clearance of aPMN. The application of CO2 in clinical settings must be properly assessed, with the benefits of CO2 balanced against the detrimental effects of impaired bacterial clearance.

The development of contemporary European sea bass larvae (Dicentrarchus labrax) is not affected by projected ocean acidification scenarios

Ocean acidification is a recognized consequence of anthropogenic carbon dioxide (CO2) emission in the atmosphere. Despite its threat to marine ecosystems, little is presently known about the capacity for fish to respond efficiently to this acidification. In adult fish, acid–base regulatory capacities are believed to be relatively competent to respond to hypercapnic conditions. However, fish in early life stage could be particularly sensitive to environmental factors as organs and important physiological functions become progressively operational during this period. In this study, the response of European sea bass (Dicentrarchus labrax) larvae reared under three ocean acidification scenarios, i.e., control (present condition, P_{{{text{CO}}_{2} }} = 590 µatm, pH total = 7.9), low acidification (intermediate IPCC scenario, P_{{{text{CO}}_{2} }} = 980 µatm, pH total = 7.7), and high acidification (most severe IPCC scenario, P_{{{text{CO}}_{2} }} = 1520 µatm, pH total = 7.5) were compared across multiple levels of biological organizations. From 2 to 45 days-post-hatching, the chronic exposure to the different scenarios had limited influence on the survival and growth of the larvae (in the low acidification condition only) and had no apparent effect on the digestive developmental processes. The high acidification condition induced both faster mineralization and reduction in skeletal deformities. Global (microarray) and targeted (qPCR) analysis of transcript levels in whole larvae did not reveal any significant changes in gene expression across tested acidification conditions. Overall, this study suggests that contemporary sea bass larvae are already capable of coping with projected acidification conditions without having to mobilize specific defense mechanisms.

Reduced vessel tone leads to vasodilation and decreased cerebral rigidity

Magnetic Resonance Elastography (MRE) measures elastic shear wave propagation in vivo to infer biomechanical properties non-invasively [Muthupillai, et al. (1995) Science;269:1854-1857.]. Models predict that tissue stiffness is influenced by changes of vascular properties [Parker, et al. (2016) PhysMedBiol;61:4890-4903.]. Cerebral blood supply is closely regulated by diameter changes of blood vessels. We here investigated the influence of vasodilation on cerebral brain stiffness with MRE. A healthy C57BL/6 mouse was anesthetized with isoflurane mixed in 100% O2. Vasodilation was induced by a hypercapnic challenge (isoflurane mixed in 95% O2 + 5% CO2). Brain stiffness was measured with a 3D spin-echo MRE sequence in a 7T animal MRI scanner under normocapnic and hypercapnic conditions. Vibration frequency was 1 kHz. Wave length and wave speed was observed to decrease significantly under hypercapnic conditions across the whole brain when compared to baseline. These changes correspond to a decrease in tissue rigidity. We conclude, therefore, that vasodilation via reducing vessel tone leads to a significant decrease in brain rigidity. Therefore, potential changes in cerebral blood flow due to physiological or pathological conditions should be considered when studying brain rigidity.

Carbon dioxide sensing in an obligate insect-fungus symbiosis: CO2 preferences of leaf-cutting ants to rear their mutualistic fungus.

Defense against biotic or abiotic stresses is one of the benefits of living in symbiosis. Leaf-cutting ants, which live in an obligate mutualism with a fungus, attenuate thermal and desiccation stress of their partner through behavioral responses, by choosing suitable places for fungus-rearing across the soil profile. The underground environment also presents hypoxic (low oxygen) and hypercapnic (high carbon dioxide) conditions, which can negatively influence the symbiont. Here, we investigated whether workers of the leaf-cutting ant Acromyrmex lundii use the CO2 concentration as an orientation cue when selecting a place to locate their fungus garden, and whether they show preferences for specific CO2 concentrations. We also evaluated whether levels preferred by workers for fungus-rearing differ from those selected for themselves. In the laboratory, CO2 preferences were assessed in binary choices between chambers with different CO2 concentrations, by quantifying number of workers in each chamber and amount of relocated fungus. Leaf-cutting ants used the CO2 concentration as a spatial cue when selecting places for fungus-rearing. A. lundii preferred intermediate CO2 levels, between 1 and 3%, as they would encounter at soil depths where their nest chambers are located. In addition, workers avoided both atmospheric and high CO2 levels as they would occur outside the nest and at deeper soil layers, respectively. In order to prevent fungus desiccation, however, workers relocated fungus to high CO2 levels, which were otherwise avoided. Workers’ CO2 preferences for themselves showed no clear-cut pattern. We suggest that workers avoid both atmospheric and high CO2 concentrations not because they are detrimental for themselves, but because of their consequences for the symbiotic partner. Whether the preferred CO2 concentrations are beneficial for symbiont growth remains to be investigated, as well as whether the observed preferences for fungus-rearing influences the ants’ decisions where to excavate new chambers across the soil profile.

Depletion of rostral ventrolateral medullary catecholaminergic neurons impairs the hypoxic ventilatory response in conscious rats

The stimuli that commonly activate the catecholaminergic C1 neurons (nociception, hypotension, and hypoxia) also increase breathing. Pharmacogenetic evidence suggests that catecholaminergic neurons regulate breathing. Therefore, we evaluated whether the loss of C1 cells affects cardiorespiratory control during resting, hypoxic (8% O2) and hypercapnic (7% CO2) conditions. A bilateral injection of the immunotoxin anti-dopamine β-hydroxylase-saporin (anti-DβH-SAP; 2.4ng/100nl) or saline was performed in adult male Wistar rats (270–300g, N=5–8/group). Histology revealed a 60–75% loss of C1 neurons in anti-DβH-SAP-treated rats, but no significant changes or C1 cell loss was observed in sham-treated rats or those with off-target injection sites. Bilateral depletion of C1 neurons did not alter cardiorespiratory variables during rest and hypercapnia (7% CO2), but it did affect the response to hypoxia. Specifically, the increase in ventilation, the number of sighs, and the tachycardia were reduced, but unexpectedly, the mean arterial pressure increased during hypoxia (8% O2). The present study indicates that C1 neurons contribute to cardiorespiratory control during hypoxia rather than at rest or during hypercapnia.

Intertidal pool fish Girella laevifrons (Kyphosidae) shown strong physiological homeostasis but shy personality: The cost of living in hypercapnic habitats

Tide pools habitats are naturally exposed to a high degree of environmental variability. The consequences of living in these extreme habitats are not well established. In particular, little it is known about of the effects of hypercanic seawater (i.e. high pCO2 levels) on marine vertebrates such as intertidal pool fish. The aim of this study was to evaluate the effects of increased pCO2 on the physiology and behavior in juveniles of the intertidal pool fish Girella laevifrons. Two nominal pCO2 concentrations (400 and 1600μatm) were used. We found that exposure to hypercapnic conditions did not affect oxygen consumption and absorption efficiency. However, the lateralization and boldness behavior was significantly disrupted in high pCO2 conditions. In general, a predator-risk cost of boldness is assumed, thus the increased occurrence of shy personality in juvenile fishes may result in a change in the balance of this biological interaction, with significant ecological consequences.

Evolutionary adaptation of the sensitivity of connexin26 hemichannels to CO2.

CO2 readily combines with H2O to form and H+. Because an increase of only 100 nM in the concentration of H+ (a decrease of 0.1 unit of pH) in blood can prove fatal, the regulated excretion of CO2 during breathing is an essential life-preserving process. In rodents and humans, this vital process is mediated in part via the direct sensing of CO2 via connexin26 (Cx26). CO2 binds to hemichannels of Cx26 causing them to open and allow release of the neurotransmitter ATP. If Cx26 were to be a universal and important CO2 sensor across all homeothermic animals, then a simple hypothesis would posit that it should exhibit evolutionary adaptation in animals with different homeostatic set points for the regulation of partial pressure of arterial CO2 (PaCO2). In humans and rats, PaCO2 is regulated around a set point of 40 mmHg. By contrast, birds are able to maintain cerebral blood flow and breathing at much lower levels of PaCO2. Fossorial mammals, such as the mole rat, live exclusively underground in burrows that are both hypoxic and hypercapnic and can thrive under very hypercapnic conditions. We have therefore compared the CO2 sensitivity of Cx26 from human, chicken, rat and mole rat (Heterocephalus glaber). We find that both the affinity and cooperativity of CO2 binding to Cx26 have been subjected to evolutionary adaption in a manner consistent with the homeostatic requirements of these four species. This is analogous to the evolutionary adaptation of haemoglobin to the needs of O2 transport across the animal kingdom and supports the hypothesis that Cx26 is an important and universal CO2 sensor in homeotherms.

Notoginsenoside R&amp;lt;sub&amp;gt;1&amp;lt;/sub&amp;gt; Attenuates Hypoxia and Hypercapnia-Induced Vasoconstriction &amp;lt;i&amp;gt;In Vitro&amp;lt;/i&amp;gt; by Reducing the Expression of p38

Notoginsenoside R1, the main active ingredient of Panax notoginseng saponins (PNS), has been proposed to play fatal roles in the development of hypoxic hypercapnia-induced pulmonary vasoconstriction (HHPV). Subsequently, pulmonary arterial smooth muscle cells (PASMCs) lead to pulmonary vascular system remodeling and chronic pulmonary disease in the development of HHPV. Despite considerable studies have contributed to pulmonary disease, the mechanism of how Notoginsenoside R1 affects HHPV remains unclear. In this view, we will discuss the effect of notoginsenoside R1 by investigating the expression of p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway in PASMCs under hypoxia and hypercapnia condition. The third order PASMCs of Sprague Dawley (SD) rats were cultured with various concentrations (8, 40, 100 mg/L, respectively) of Notoginsenoside R1. Our data showed that the protein and mRNA expression levels of p-38 MAPK were higher in hypoxic hypercapnia group compared with hypoxic DMSO and normoxia control groups (p 1 treatment groups, the level of p-p38 MAPK protein and p38 MAPK mRNA were significantly decreased with different degrees (p 1 treatment may contribute to attenuate HHPV via decreasing the protein and mRNA expression levels of p-38 MAPK.

O2 binding and CO2 sensitivity in hemoglobins of subterranean African mole rats

Inhabiting deep and sealed subterranean burrows, mole rats exhibit a remarkable suite of specializations, including eusociality (living in colonies with single breeding queens), extraordinary longevity, cancer immunity and poikilothermy, and extreme tolerance of hypoxia and hypercapnia. With little information available on adjustments in haemoglobin (Hb) function that may mitigate the impact of exogenous and endogenous constraints on the uptake and internal transport of O2, we measured haematological characteristics, as well as Hb-O2 binding affinity and sensitivity to pH (Bohr effect), CO2, temperature and 2,3-diphosphoglycerate (DPG, the major allosteric modulator of Hb-O2 affinity in red blood cells) in four social and two solitary species of African mole rats (family Bathyergidae) originating from different biomes and soil types across Central and Southern Africa. We found no consistent patterns in haematocrit (Hct) and blood and red cell DPG and Hb concentrations or in intrinsic Hb-O2 affinity and its sensitivity to pH and DPG that correlate with burrowing, sociality and soil type. However, the results reveal low specific (pH independent) effects of CO2 on Hb-O2 affinity compared with humans that predictably safeguard pulmonary loading under hypoxic and hypercapnic burrow conditions. The O2 binding characteristics are discussed in relation to available information on the primary structure of Hbs from adult and developmental stages of mammals subjected to hypoxia and hypercapnia and the molecular mechanisms underlying functional variation in rodent Hbs.

Reveglucosidase alfa (BMN 701), an IGF2-Tagged rhAcid α-Glucosidase, Improves Respiratory Functional Parameters in a Murine Model of Pompe Disease.

Pompe disease is a rare neuromuscular disorder caused by an acid α-glucosidase (GAA) deficiency resulting in glycogen accumulation in muscle, leading to myopathy and respiratory weakness. Reveglucosidase alfa (BMN 701) is an insulin-like growth factor 2-tagged recombinant human acid GAA (rhGAA) that enhances rhGAA cellular uptake via a glycosylation-independent insulin-like growth factor 2 binding region of the cation-independent mannose-6-phosphate receptor (CI-MPR). The studies presented here evaluated the effects of Reveglucosidase alfa treatment on glycogen clearance in muscle relative to rhGAA, as well as changes in respiratory function and glycogen clearance in respiratory-related tissue in a Pompe mouse model (GAAtm1Rabn/J). In a comparison of glycogen clearance in muscle with Reveglucosidase alfa and rhGAA, Reveglucosidase alfa was more effective than rhGAA with 2.8-4.7 lower EC50 values, probably owing to increased cellular uptake. The effect of weekly intravenous administration of Reveglucosidase alfa on respiratory function was monitored in Pompe and wild-type mice using whole body plethysmography. Over 12 weeks of 20-mg/kg Reveglucosidase alfa treatment in Pompe mice, peak inspiratory flow (PIF) and peak expiratory flow (PEF) stabilized with no compensation in respiratory rate and inspiratory time during hypercapnic and recovery conditions compared with vehicle-treated Pompe mice. Dose-related decreases in glycogen levels in both ambulatory and respiratory muscles generally correlated to changes in respiratory function. Improvement of murine PIF and PEF were similar in magnitude to increases in maximal inspiratory and expiratory pressure observed clinically in late onset Pompe patients treated with Reveglucosidase alfa (Byrne et al., manuscript in preparation).

ВЛИЯНИЕ СРЕДСТВ ГИПЕРКАПНИЧЕСКОЙ ГИПОКСИИ НА ФУНКЦИОНАЛЬНУЮ И СПЕЦИАЛЬНУЮ ФИЗИЧЕСКУЮ ПОДГОТОВЛЕННОСТЬ ЮНЫХ ДЗЮДОИСТОВ

Aim was to assess the efficiency of Karbonik respiratory trainer developed by professor Kulikov in 15-16-year-old judokas’ training. Materials and Methods. The study involved two groups of first- and second-category judokas. Each group included 10 athletes of approximately the same physical fitness level. Training of the experimental group used hypoxic hypercapnic gas mixture formed by the above mentioned respiratory trainer. Response of the functional systems to the training program was assessed based on the changes in hypoxic index, timed inspiratory and expiratory capacities, lung capacity, and heart rate; as well as tests reflecting the levels of special physical fitness and sport performance. Results. It was revealed that regular respiratory training via additional volume of dead air breath provided by Karbonik respiratory trainer system contributed to adaptation of a young judoka’s body to hypoxia and hypercapnia, which, in its turn, resulted in improvement of special physical fitness and sport performance. Conclusion. The respiratory trainer due to additional dead space volume creates the conditions of moderate hypoxia and hypercapnia which have a combined positive effect on the increase of special physical fitness and sport performance in young judokas.

Impact of age on cerebrovascular dilation versus reactivity to hypercapnia

This study quantified the effect of age on cerebrovascular reactivity and cerebrovascular conductance while accounting for differences in grey matter volume in younger (YA: n = 12; 24 ± 4 years, six females) and older adults (OA: n = 10; 66 ± 7 years; five females). Cerebral blood flow velocity (CBFV; transcranial Doppler) in the middle cerebral artery (MCA), MCA cross-sectional area (CSA), intracranial volumes (magnetic resonance imaging), and mean arterial pressure (MAP; Finometer), were measured under normocapnic and hypercapnic (6% carbon dioxide) conditions. Cerebral blood flow (CBF) was quantified from CBFV and MCA CSA and normalized to grey matter volume. Grey matter volume was 719 ± 98 mL in YA and 622 ± 50 mL in OA (P = 0.009). Cerebrovascular reactivity (%ΔCBF/ΔPETCO2) was not different between YA and OA. In contrast, cerebrovascular conductance (CBF/MAP) in response to hypercapnia was reduced in OA (P = 0.02). Of note, MAP increased more with hypercapnia in OA compared with YA. Therefore, the central hemodynamic response to hypercapnia compensated for a diminished dilatory response downstream from the MCA so that the CBF response to hypercapnia per unit of brain mass was not affected by age. This impairment was not detected by traditional measures of cerebrovascular reactivity.

Ginsenoside Rg1 attenuates hypoxia and hypercapnia-induced vasoconstriction in isolated rat pulmonary arterial rings by reducing the expression of p38.

Pulmonary arterial hypertension (PAH) is a fatal disease characterized by increased pulmonary arteriolar resistance. Pulmonary vasoconstriction has been proved to play a significant role in PAH. We previously reported that Panax notoginseng saponins (PNS) might attenuate hypoxia and hypercapnia-induced pulmonary vasoconstriction (HHPV). In the present study, our specific objective was to investigate the role of ginsenoside Rg1, a major component of PNS, in this process and the possible underlying mechanism. The second order pulmonary rings isolated from the Sprague-Dawley rats were treated with different dosage of ginsenoside Rg1 at 8, 40, or 100 mg/L respectively, both before and during the conditions of hypoxia and hypercapnia. Contractile force changes of the rings were detected. Furthermore, SB203580, the selective inhibitor for p38 activation was applied to the rings. Pulmonary arterial smooth muscle cells (PASMCs) were cultured under hypoxic and hypercapnic conditions, and ginsenoside Rg1 was administered to detect the changes induced by p38. Under the hypoxic and hypercapnic conditions, we observed a biphasic pulmonary artery contractile response to the second pulmonary artery rings. It is hypothesized that the observed attenuation of vasoconstriction and the production of vasodilation could have been induced by ginsenoside Rg1. This effect was significantly reinforced by SB203580 (P<0.05 or P<0.01). The expression of p38 in the PASMCs under hypoxic and hypercapnic conditions was significantly activated (P<0.05 or P<0.01) and the observed activation was attenuated by ginsenoside Rg1 (P<0.05 or P<0.01). Our findings strongly support the significant role of ginsenoside Rg1 in the inhibition of hypoxia and hypercapnia-induced vasoconstriction by the p38 pathway.

Influence of variations in arterial PCO2 on surgical conditions during laparoscopic retroperitoneal surgery

BackgroundAlthough deep neuromuscular block (post-tetanic-count 1-2 twitches) improves surgical conditions during laparoscopic retroperitoneal surgery compared with standard block (train-of-four 1-2 twitches), the quality of surgical conditions varies widely, often related to diaphragmatic contractions. Hypocapnia may improve surgical conditions. Therefore we studied the effect of changes in arterial carbon dioxide concentrations on surgical conditions in patients undergoing laparoscopic surgery under general anaesthesia and deep neuromuscular block. MethodsForty patients undergoing elective laparoscopic surgery for prostatectomy or nephrectomy received propofol/remifentanil anaesthesia and deep neuromuscular block with rocuronium. Patients were randomized to surgery under hypocapnic or hypercapnic conditions. During surgery, the surgical conditions were evaluated using the 5-point Leiden-Surgical Rating Scale (L-SRS) ranging from 1 (extremely poor conditions) to 5 (optimal conditions) by the surgeon, who was blinded to group. ResultsMean (sd) arterial carbon dioxide concentrations were 4.5 (0.6) [range: 3.8–5.6] kPa under hypocapnic and 6.9 (0.6) [6.1–8.1] kPa under hypercapnic conditions. The L-SRS did not differ between groups: 4.84 (0.4) [4-5] in hypocapnia and 4.77 (0.4) [3.9–5] in hypercapnia. Ninety-nine percent of ratings were good or excellent irrespective of treatment. ConclusionsDeep neuromuscular block provides good to optimal surgical conditions in laparoscopic retroperitoneal urological surgery, independent of the level of arterial PCO2. Clinical trial registrationNCT01968447.

The venous–arterial difference in CO2 should be interpreted with caution in case of respiratory alkalosis in healthy volunteers

The venous-arterial difference in CO2 (ΔCO2) has been proposed as an index of the adequacy of tissue perfusion in shock states. We hypothesized that the variation in PaCO2 (hyper- or hypocapnia) could impact ΔCO2, partly through microcirculation adaptations. Fifteen healthy males volunteered to participate. For hypocapnia condition (hCO2), the subjects were asked to hyperventilate, while they were asked to breathe a gas mixture containing 8% CO2 for hypercapnia condition (HCO2). The 2 conditions were randomly assigned. Blood gases were measured at baseline before each condition, and after 5-7min of either hCO2 or HCO2 condition. Microcirculation was assessed by the muscle reoxygenation slope measured with near infrared spectroscopy following a vascular occlusion test and by skin circulation with in vivo reflectance confocal microscopy. ΔCO2 was significantly increased with hCO2 while it tended to decrease with HCO2 (non-significant). HCO2 induced a moderate increase of the resaturation slope of NIRS oxygenation. Skin microcirculatory blood flow significantly dropped with hCO2, while it remained unchanged with hypercapnia. Our results warrant cautious interpretation of ΔCO2 as an indicator of tissue perfusion during respiratory alkalosis.

Hypercapnia slows down proliferation and apoptosis of human bone marrow promyeloblasts.

Stem cells are being applied in increasingly diverse fields of research and therapy; as such, growing and culturing them in scalable quantities would be a huge advantage for all concerned. Gas mixtures containing 5% CO2 are a typical concentration for the in vitro culturing of cells. The effect of varying the CO2 concentration on promyeloblast KG-1a cells was investigated in this paper. KG-1a cells are characterized by high expression of CD34 surface antigen, which is an important clinical surface marker for human hematopoietic stem cells (HSCs) transplantation. KG-1a cells were cultured in three CO2 concentrations (1, 5 and 15%). Cells were batch-cultured and analyzed daily for viability, size, morphology, proliferation, and apoptosis using flow cytometry. No considerable differences were noted in KG-1a cell morphological properties at all three CO2 levels as they retained their myeloblast appearance. Calculated population doubling time increased with an increase in CO2 concentration. Enhanced cell proliferation was seen in cells cultured in hypercapnic conditions, in contrast to significantly decreased proliferation in hypocapnic populations. Flow cytometry analysis revealed that apoptosis was significantly (p=0.0032) delayed in hypercapnic cultures, in parallel to accelerated apoptosis in hypocapnic ones. These results, which to the best of our knowledge are novel, suggest that elevated levels of CO2 are favored for the enhanced proliferation of bone marrow (BM) progenitor cells such as HSCs.

Behavioral, Ventilatory and Thermoregulatory Responses to Hypercapnia and Hypoxia in the Wistar Audiogenic Rat (WAR) Strain.

IntroductionWe investigated the behavioral, respiratory, and thermoregulatory responses elicited by acute exposure to both hypercapnic and hypoxic environments in Wistar audiogenic rats (WARs). The WAR strain represents a genetic animal model of epilepsy.MethodsBehavioral analyses were performed using neuroethological methods, and flowcharts were constructed to illustrate behavioral findings. The body plethysmography method was used to obtain pulmonary ventilation (VE) measurements, and body temperature (Tb) measurements were taken via temperature sensors implanted in the abdominal cavities of the animals.ResultsNo significant difference was observed between the WAR and Wistar control group with respect to the thermoregulatory response elicited by exposure to both acute hypercapnia and acute hypoxia (p>0.05). However, we found that the VE of WARs was attenuated relative to that of Wistar control animals during exposure to both hypercapnic (WAR: 133 ± 11% vs. Wistar: 243 ± 23%, p<0.01) and hypoxic conditions (WAR: 138 ± 8% vs. Wistar: 177 ± 8%; p<0.01). In addition, we noted that this ventilatory attenuation was followed by alterations in the behavioral responses of these animals.ConclusionsOur results indicate that WARs, a genetic model of epilepsy, have important alterations in their ability to compensate for changes in levels of various arterial blood gasses. WARs present an attenuated ventilatory response to an increased PaCO2 or decreased PaO2, coupled to behavioral changes, which make them a suitable model to further study respiratory risks associated to epilepsy.