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Mobilizing Carbon Dioxide Stores. An Experimental Study.

Lorenzo Giosa1, Mattia Busana1, Matteo Bonifazi1

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|August 20, 2020
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Summary
This summary is machine-generated.

Mobilizing carbon dioxide (CO2) from body stores over 48 hours without reaching a steady state supports intermittent extracorporeal CO2 removal (ECCO2R) in chronic hypercapnia patients.

Keywords:
CO2acid–base balancechronic obstructive pulmonary diseaseextracorporeal CO2 removalstores

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Area of Science:

  • Physiology
  • Respiratory Medicine
  • Critical Care

Background:

  • Understanding carbon dioxide (CO2) stores mobilization is crucial for managing chronic hypercapnia.
  • Intermittent extracorporeal CO2 removal (ECCO2R) is a potential therapeutic strategy for these patients.

Purpose of the Study:

  • To investigate the dynamics of CO2 stores in a porcine model.
  • To assess the physiological rationale for intermittent ECCO2R.

Main Methods:

  • Fifteen pigs were randomized into four groups: hyperventilation, hypoventilation, hypoventilation followed by normoventilation, and hypoventilation followed by ECCO2R.
  • Ventilation parameters and CO2 stores were monitored over 48 hours.
  • A 50% reduction in minute ventilation was applied to all pigs at 48 hours.

Main Results:

  • CO2 stores decreased significantly with hyperventilation and ECCO2R, while they increased with hypoventilation.
  • In the second 24-hour period, CO2 stores decreased in both the hypoventilation-normoventilation and hypoventilation-ECCO2R groups.
  • The rise in PaCO2 after a 50% minute ventilation reduction was inversely related to prior CO2 stores mobilization.

Conclusions:

  • CO2 stores can be mobilized over 48 hours without achieving a steady state.
  • This dynamic mobilization provides a physiological basis for employing intermittent ECCO2R in patients with chronic hypercapnia.
  • The degree of CO2 stores mobilization influences the acute response to reduced ventilation.