Role of Respiratory Drive in Hyperoxia-Induced Hypercapnia in Ready-to-Wean Subjects With COPD.
BACKGROUND: Hyperoxia-induced hypercapnia in subjects with COPD is mainly explained by alterations in the ventilation/perfusion ratio. However, it is unclear why respiratory drive does not prevent CO2 retention. Some authors have highlighted the importance of respiratory drive in CO2 increases durin...
| Publicado en: | Respiratory Care Vol. 60; no. 3; pp. 328 - 335 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Mar2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=101303115&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 101303115 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Mar2015 vid: 60 iid: 3 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 101303115 101303115 101303115 10.4187/respcare.03270 101303115 ppf: 328 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Role of Respiratory Drive in Hyperoxia-Induced Hypercapnia in Ready-to-Wean Subjects With COPD. aug: au: Rialp, Gemma Raurich, Joan M. Llompart-Pou, Juan A Ayestarán, Ignacio affil: Intensive Care Unit, Hospital Son Llàtzer, Palma de Mallorca, Spain sug: subj: Hypercapnia Ventilator Weaning Pulmonary Disease, Chronic Obstructive Hyperoxia Human Prospective Studies Male Female Middle Age Aged Wilcoxon Signed Rank Test Matched-Pair Analysis Pearson's Correlation Coefficient Analysis of Variance Intraclass Correlation Coefficient Descriptive Statistics Data Analysis Software Scales Confidence Intervals Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Hyperoxia-induced hypercapnia in subjects with COPD is mainly explained by alterations in the ventilation/perfusion ratio. However, it is unclear why respiratory drive does not prevent CO2 retention. Some authors have highlighted the importance of respiratory drive in CO2 increases during hyperoxia. The aim of the study was to examine the effects of hyperoxia on respiratory drive in subjects with COPD. METHODS: Fourteen intubated, ready-to-wean subjects with COPD were studied during normoxia and hyperoxia. A CO2 response test was then performed with the rebreathing method to measure the hypercapnic drive response, defined as the ratio of change in airway-occlusion pressure 0.1 s after the start of inspiratory flow (ΔP0.1) to change in PaCO2 (ΔPaCO2), and the hypercapnic ventilatory response, defined as the ratio of change in minute volume (ΔV̇E) to ΔPaCO2. RESULTS: Hyperoxia produced a significant increase in PaCO2 (55 ± 9 vs 58 ± 10 mm Hg, P = .02) and a decrease in pH (7.41 ± 0.05 vs 7.38 ± 0.05, P = .01) compared with normoxia, with a non-significant decrease in V̇E (9.9 ± 2.9 vs 9.1 ± 2.3 L/min, P = .16) and no changes in P0.1 (2.85 ± 1.40 vs 2.82 ± 1.16 cm H2O, P ± .97) The correlation between hyperoxia-induced changes in V̇E and PaCO2 was r2 = 0.38 (P = .02). Median ΔP0.1/ΔPaCO2 and ΔV̇E/ΔPaCO2 did not show significant differences between normoxia and hyperoxia: 0.22 (0.12– 0.49) cm H2O/mm Hg versus 0.25 (0.14 – 0.34) cm H2O/mm Hg (P = .30) and 0.37 (0.12–0.54) L/min/mm Hg versus 0.35 (0.12–0.96) L/min/mm Hg (P = .20), respectively. CONCLUSIONS: In ready-to-wean subjects with COPD exacerbations, hyperoxia is followed by an increase in PaCO2, but it does not significantly modify the respiratory drive or the ventilatory response to hypercapnia. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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