Partial Pressure Of CO2 Levels Research Articles

The Correlation between Intra-Arterial Partial Pressure of CO2 (PaCO2) and Post-Operative Nausea, Vomiting (PONV) and Pain in Patients Undergoing Laparoscopic Cholecystectomy

Background: Postoperative nausea and vomiting is a common complication after surgery that no single theory has been expressed as to the cause of this complication so far. The aim of this study was to determine the relationship between PaCO2 and nausea, vomiting and pain after laparoscopic cholecystectomy.
 Methods: In this cross-sectional study, 88 patients in Alzahra hospital, underwent laparoscopic cholecystectomy were selected and the level of pre and postoperative PaCO2, as well as duration of postoperative nausea, incidence of vomiting, and severity of postoperative pain was assessed. The correlation between PaCO2, HCO3 and PH with these postoperative complications were evaluated. The patients’ data were analyzed by using Chi-square, t-test, Pearson correlation, Paired t-test and Repeated Measure ANOVA tests. P value < 0.05 was considered statistically significant.
 Results: The correlation between duration of nausea and PaCO2 levels before and after surgery was 0.05 and 0.04, respectively, which was not statistically significant (p value = 0.63 and p value = 0.72, respectively). In addition, the correlation between PaCO2 level and severity of postoperative pain was 0.2 (p value = 0.07), which was not statistically significant.
 Conclusion: The findings of the present study showed that PaCO2 level has not statistically significant effect on duration of postoperative nausea, incidence of vomiting, and severity of postoperative pain.

Assessment of sidestream end-tidal capnography in ventilated infants on the neonatal unit.

Continuous monitoring of carbon dioxide (CO2 ) levels can be achieved by capnography. Our aims were to compare the performance of a sidestream capnograph with a low dead space and sampling rate to a mainstream device and evaluate whether its results correlated with arterial/capillary CO2 levels in infants with different respiratory disease severities. End-tidal carbon dioxide (EtCO2 ) results by sidestream and mainstream capnography would correlate, but the divergence of EtCO2 and CO2 results would occur in more severe lung disease. Prospective cohort study. Fifty infants with a median (interquartile range) gestational age of 31.1 (27.1-37.4) weeks and birth weight of 1.37 (0.76-2.95) kg. Concurrent measurements of EtCO2 in ventilated infants were made using a new Microstream sidestream device and a mainstream capnograph (gold standard). Results from both devices were compared with arterial or capillary CO2 levels. The ratio of dead space to tidal volume (Vd/Vt) was calculated to assess respiratory disease severity. The mean difference between the concurrent measurements of EtCO2 was -0.54 ± 0.67 kPa (95% agreement levels - 1.86 to 0.77 kPa), the correlation between the two was r = .85 (P < .001). Sidestream capnography results correlated better with partial pressure of CO2 (PCO2 ) levels in infants with less (Vd/Vt < 0.35; r2 = .66, P < .001) rather than more severe (Vd/Vt > 0.35; r2 = .33, P = .01) lung disease. The sidestream capnography performed similarly to the mainstream capnography. The poorer correlation of EtCO2 to PCO2 levels in infants with severe respiratory disease should highlight to clinicians increased ventilation-perfusion mismatch.

Extracorporeal carbon dioxide removal requirements for ultraprotective mechanical ventilation: Mathematical model predictions

Extracorporeal carbon dioxide (CO2) removal (ECCO2R) facilitates the use of low tidal volumes during protective or ultraprotective mechanical ventilation when managing patients with acute respiratory distress syndrome (ARDS); however, the rate of ECCO2R required to avoid hypercapnia remains unclear. We calculated ECCO2R rate requirements to maintain arterial partial pressure of CO2 (PaCO2) at clinically desirable levels in mechanically ventilated ARDS patients using a six‐compartment mathematical model of CO2 and oxygen (O2) biochemistry and whole‐body transport with the inclusion of an ECCO2R device for extracorporeal veno‐venous removal of CO2. The model assumes steady state conditions. Model compartments were lung capillary blood, arterial blood, venous blood, post‐ECCO2R venous blood, interstitial fluid and tissue cells, with CO2 and O2 distribution within each compartment; biochemistry included equilibrium among bicarbonate and non‐bicarbonate buffers and CO2 and O2 binding to hemoglobin to elucidate Bohr and Haldane effects. O2 consumption and CO2 production rates were assumed proportional to predicted body weight (PBW) and adjusted to achieve reported arterial partial pressure of O2 and a PaCO2 level of 46 mmHg at a tidal volume of 7.6 mL/kg PBW in the absence of an ECCO2R device based on average data from LUNG SAFE. Model calculations showed that ECCO2R rates required to achieve mild permissive hypercapnia (PaCO2 of 46 mmHg) at a ventilation frequency or respiratory rate of 20.8/min during mechanical ventilation increased when tidal volumes decreased from 7.6 to 3 mL/kg PBW. Higher ECCO2R rates were required to achieve normocapnia (PaCO2 of 40 mmHg). Model calculations also showed that required ECCO2R rates were lower when ventilation frequencies were increased from 20.8/min to 26/min. The current mathematical model predicts that ECCO2R rates resulting in clinically desirable PaCO2 levels at tidal volumes of 5‐6 mL/kg PBW can likely be achieved in mechanically ventilated ARDS patients with current technologies; use of ultraprotective tidal volumes (3‐4 mL/kg PBW) may be challenging unless high mechanical ventilation frequencies are used.

The effect of air pollution on diurnal variation of performance in anaerobic tests, cardiovascular and hematological parameters, and blood gases on soccer players following the Yo–Yo Intermittent Recovery Test Level-1

ABSTRACTThis study aimed to investigate the effect of air pollution on diurnal variation of performance in anaerobic tests, cardiovascular and hematological parameters, and blood gases on soccer players following the Yo–Yo Intermittent Recovery Test Level-1 (YYIRT1). In a randomized order, 11 healthy soccer players (mean age: 21.8 [range: 20–24] years; height: 178.00 [range: 1.64–1.83] cm; body mass index [BMI]: 23.57 [range: 20.45–28.03] kg.m−2) performed a YYIRT1 at two different times of day (TOD) (08:00 h and 18:00 h) in two areas (i.e. polluted (PA) and non-polluted (NPA)) with a recovery period of ≥ 72 h in between, to determine the maximal oxygen uptake (VO2max). In each test session: resting oral temperature is measured, anaerobic performances (pre- and post-YYIRT1) were performed, cardiovascular parameters and blood samples were collected at: rest, 3 min and 60 min after the YYIRT1, to assess blood gases and hematological parameters. Our results showed that, agility performance, VO2max, red blood cells (RBC), hemoglobin (Hb), pH, and bicarbonate levels (HCO3−) decrease significantly (p < 0.001) following the YYIRT1 in PA compared to NPA. Likewise, the heart rate (HR), systolic blood pressure (SBP), platelets (PLT), white blood cells (WBC), neutrophiles (NEUT), lymphocytes (LYM), and partial pressure of CO2 levels (PvCO2) were significantly higher (p < 0.001) in PA. This effect was slightly accentuated at 18:00 h for some parameters (i.e. Agility, HCO3−, HR, PvCO2, RBC, SBP). However, performances of sprint and Sargent jump test (SJT), oral temperature, rate of perceived exertion scales (RPE), partial pressure of O2 (PvO2), diastolic blood pressure (DBP), and monocytes (MON) were not affected by pollution (p > 0.05). In conclusion, pollution seems to be critical for health stability and performance in response to YYIRT1 especially in the evening and the winter season. Therefore, coaches and athletes should draw attention to the potential importance of land use planning in their training sessions and competitions in the morning in polluted area to minimize the risk of pollution exposure.

Low Hesperian PCO2 constrained from in situ mineralogical analysis at Gale Crater, Mars

Carbon dioxide is an essential atmospheric component in martian climate models that attempt to reconcile a faint young sun with planetwide evidence of liquid water in the Noachian and Early Hesperian. In this study, we use mineral and contextual sedimentary environmental data measured by the Mars Science Laboratory (MSL) Rover Curiosity to estimate the atmospheric partial pressure of CO2 (PCO2) coinciding with a long-lived lake system in Gale Crater at ∼3.5 Ga. A reaction-transport model that simulates mineralogy observed within the Sheepbed member at Yellowknife Bay (YKB), by coupling mineral equilibria with carbonate precipitation kinetics and rates of sedimentation, indicates atmospheric PCO2 levels in the 10s mbar range. At such low PCO2 levels, existing climate models are unable to warm Hesperian Mars anywhere near the freezing point of water, and other gases are required to raise atmospheric pressure to prevent lake waters from being lost to the atmosphere. Thus, either lacustrine features of Gale formed in a cold environment by a mechanism yet to be determined, or the climate models still lack an essential component that would serve to elevate surface temperatures, at least locally, on Hesperian Mars. Our results also impose restrictions on the potential role of atmospheric CO2 in inferred warmer conditions and valley network formation of the late Noachian.

Validation of the i-STAT system for the analysis of blood parameters in fish.

Portable clinical analysers, such as the i-STAT system, are increasingly being used for blood analysis in animal ecology and physiology because of their portability and easy operation. Although originally conceived for clinical application and to replace robust but lengthy techniques, researchers have extended the use of the i-STAT system outside of humans and even to poikilothermic fish, with only limited validation. The present study analysed a range of blood parameters [pH, haematocrit (Hct), haemoglobin (Hb), HCO3 (-), partial pressure of CO2 (PCO2), partial pressure of O2 (PO2), Hb saturation (sO2) and Na(+) concentration] in a model teleost fish (rainbow trout, Oncorhynchus mykiss) using the i-STAT system (CG8+ cartridges) and established laboratory techniques. This methodological comparison was performed at two temperatures (10 and 20°C), two haematocrits (low and high) and three PCO2 levels (0.5, 1.0 and 1.5%). Our results indicate that pH was measured accurately with the i-STAT system over a physiological pH range and using the i-STAT temperature correction. Haematocrit was consistently underestimated by the i-STAT, while the measurements of Na(+), PCO2, HCO3 (-) and PO2 were variably inaccurate over the range of values typically found in fish. The algorithm that the i-STAT uses to calculate sO2 did not yield meaningful results on rainbow trout blood. Application of conversion factors to correct i-STAT measurements is not recommended, due to significant effects of temperature, Hct and PCO2 on the measurement errors and complex interactions may exist. In conclusion, the i-STAT system can easily generate fast results from rainbow trout whole blood, but many are inaccurate values.

Short-term acute hypercapnia affects cellular responses to trace metals in the hard clams Mercenaria mercenaria

Estuarine and coastal habitats experience large fluctuations of environmental factors such as temperature, salinity, partial pressure of CO2 (PCO2) and pH; they also serve as the natural sinks for trace metals. Benthic filter-feeding organisms such as bivalves are exposed to the elevated concentrations of metals in estuarine water and sediments that can strongly affect their physiology. The effects of metals on estuarine organisms may be exacerbated by other environmental factors. Thus, a decrease in pH caused by high PCO2 (hypercapnia) can modulate the effects of trace metals by affecting metal bioavailability, accumulation or binding. To better understand the cellular mechanisms of interactions between PCO2 and trace metals in marine bivalves, we exposed isolated mantle cells of the hard clams (Mercenaria mercenaria) to different levels of PCO2 (0.05, 1.52 and 3.01kPa) and two major trace metal pollutants – cadmium (Cd) and copper (Cu). Elevated PCO2 resulted in a decrease in intracellular pH (pHi) of the isolated mantle cells from 7.8 to 7.4. Elevated PCO2 significantly but differently affected the trace metal accumulation by the cells. Cd uptake was suppressed at elevated PCO2 levels while Cu accumulation has greatly accelerated under hypercapnic conditions. Interestingly, at higher extracellular Cd levels, labile intracellular Cd2+ concentration remained the same, while intracellular levels of free Zn2+ increased suggesting that Cd2+ substitutes bound Zn2+ in these cells. In contrast, Cu exposure did not affect intracellular Zn2+ but led to a profound increase in the intracellular levels of labile Cu2+ and Fe2+. An increase in the extracellular concentrations of Cd and Cu led to the elevated production of reactive oxygen species under the normocapnic conditions (0.05kPa PCO2); surprisingly, this effect was mitigated in hypercapnia (1.52 and 3.01kPa). Overall, our data reveal complex and metal-specific interactions between the cellular effects of trace metals and PCO2 in clams and indicate that variations in environmental PCO2 may modulate the biological effects of trace metals in marine organisms.

Hidden acidosis: an explanation of acid–base and lactate changes occurring in umbilical cord blood after delayed sampling

To explore the 'hidden acidosis' phenomenon, in which there is a washout of acid metabolites from peripheral tissues in both vaginal and abdominal deliveries, by investigating temporal umbilical cord blood acid-base and lactate changes after delayed blood sampling. Prospective comparative study. University hospital. Umbilical cord blood from 124 newborns. Arterial and venous cord blood was sampled immediately after birth (T₀), and at 45 seconds (T₄₅), from unclamped cords with intact pulsations taken from 66 neonates born vaginally and 58 neonates born via planned caesarean section at 36-42 weeks of gestation. Non-parametric tests were used for statistical comparisons, with P < 0.05 considered significant. Temporal changes (T₀-T₄₅) in umbilical cord blood pH, the partial pressure of CO₂ (PCO₂) and O₂ (PO₂), and in the concentrations of lactate, haematocrit (Hct), and haemoglobin (Hb). In both groups all arterial parameters, except for PCO₂ in the group delivered by caesarean section, changed significantly (pH decreased and the other variables increased). There were corresponding changes in venous acid-base parameters. When temporal arterial changes were compared between the two groups, the decrease in pH and increase in PCO₂ were more pronounced in the group delivered vaginally. Neonates born vaginally had significantly lower pH and higher lactate, Hct, and Hb concentrations at T₀ and T₄₅ in both the artery and the vein. At T₄₅, arterial PCO₂ and PO₂ levels in the group delivered vaginally were also significantly higher. Delayed umbilical cord sampling affected the acid-base balance and haematological parameters after both vaginal and caesarean deliveries, although the effect was more marked in the group delivered vaginally. The hidden acidosis phenomenon explains this change towards acidaemia and lactaemia. Arterial haemoconcentration was not the explanation of the acid-base drift.

The influence of varying inspired fractions of O2 and CO2 on the development of involuntary breathing movements during maximal apnoea

The growing urge to breathe that occurs during breath-holding results in development of involuntary breathing movements (IBMs). The present study determined whether IBMs are initiated at critical levels of hypercapnia and/or hypoxia during maximal apnoea. Arterial blood gasses at the onset of IBM were monitored during maximal voluntary breath-holds. Eleven healthy men performed breath holds after breathing air, hyperoxic–normocapnia, hypoxic–normocapnia, and normoxic–hypercapnia. Pre-breathing of the gas mixtures facilitated the IBM onset, reducing the time-to-onset for ∼46% (hyperoxic condition) and for ∼80% (hypoxic condition) compared to the normoxic air breathing time. A strong correlation (R=0.83, P=0.002) between arterial partial pressure of CO2 (PaCO2) at IBM onset after pre-breathing hyperoxic and hypercapnic gas mixtures was observed, suggesting the existence of a possible IBM PaCO2 threshold level of ∼6.5±0.5kPa. No clear “threshold” was observed for partial pressure of arterial O2 (PaO2). However, we observed that IBM onset was influenced, in part, by an interaction between PaO2 and PaCO2 levels during maximal apnoea. This study demonstrated the complex interaction between arterial blood-gases and the physiological response to maximal breath holding.

Evidence for the submarine weathering of silicate minerals in Black Sea sediments: Possible implications for the marine Li and B cycles

The role of sediment diagenesis in the marine cycles of Li and B is poorly understood. Because Li and B are easily mobilized during burial and are consumed in authigenic clay mineral formation, their abundance in marine pore waters varies considerably. Exchange with the overlying ocean through diffusive fluxes should thus be common. Nevertheless, only a minor Li sink associated with the low‐temperature alteration of volcanic ash has been observed. We describe a low‐temperature diagenetic environment in the Black Sea dominated by the alteration of detrital plagioclase feldspars. Fluids expelled from the Odessa mud volcano in the Sorokin Trough originate from shallow (≈100–400 m deep) sediments which are poor in volcanic materials but rich in anorthite. These fluids are depleted in Na+, K+, Li+, B, and 18O and enriched in Ca2+ and Sr2+, indicating that anorthite is dissolving and authigenic clays are forming. Using a simple chemical model, we calculate the pH and the partial pressure of CO2 (PCO2) in fluids associated with this alteration process. Our results show that the pH of these fluids is up to 1.5 pH units lower than in most deep marine sediments and that PCO2 levels are up to several hundred times higher than in the atmosphere. These conditions are similar to those which favor the weathering of silicate minerals in subaerial soil environments. We propose that in Black Sea sediments enhanced organic matter preservation favors CO2 production through methanogenesis and results in a low pore water pH, compared to most deep sea sediments. As a result, silicate mineral weathering, which is a sluggish process in most marine diagenetic environments, proceeds rapidly in Black Sea sediments. There is a potential for organic matter‐rich continental shelf environments to host this type of diagenesis. Should such environments be widespread, this new Li and B sink could help balance the marine Li and Li isotope budgets but would imply an apparent imbalance in the B cycle.

Ionic regulation and nitrogenous excretion in rainbow trout exposed to buffered and unbuffered freshwater of pH 10.5.

Rainbow trout exposed to unbuffered water of pH 10.5 initially showed significant increases in blood pH, plasma cortisol and glucose, partial pressure of NH3 (PNH3), NH4+, and HCO3- values as well as loss of plasma Cl-, reduced partial pressure of CO2 (PCO2), and inhibition of total ammonia excretion rate. After the first day, fish resisted further change, and new levels were established (for blood pH and plasma PCO2 and PNH3 levels) or imbalances corrected, either partially (for total ammonia excretion) or completely (for plasma Cl-, HCO3-, cortisol, and glucose values). During the 7-d exposure, 80% of fish in unbuffered water survived, but in buffered water (0.75 mmol L(-1) glycine-buffered KOH at pH 10.5), survival was only 50% after 3 d, and ion regulatory failure was evident. Fish in buffered and unbuffered alkaline waters had similar total ammonia excretion rates, which suggests that glycine-buffered KOH was not sufficient to significantly reduce gill boundary layer acidification. After 7 d in unbuffered alkaline water, 30% of total ammonia excretion was linked with an amiloride-sensitive (0.1 mmol L(-1)) Na+ uptake mechanism. Treatment of alkaline-exposed trout with waterborne acetazolamide (1.5 mmol L(-1)) indicated that gill boundary layer H+ production, through hydration of CO2, had a role in excretion of total ammonia. Exposure to 4-acetamino-4'-isothiocyantostilbene-2,2'-disulphonic acid (SITS; 0.1 mmol L(-1)) following 24-h exposure to unbuffered alkaline water resulted in increased plasma HCO3- and lowered plasma Cl- concentrations, indicating the role of branchial Cl-/HCO3- exchange in regaining Cl- lost and eliminating the HCO3- accumulated during exposure to alkaline water.