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Intensive Care Medicine

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01-07-2009 | Experimental

Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia

Authors: Alex Gnaegi, François Feihl, Olivier Boulat, Bernard Waeber, Lucas Liaudet

Published in: Intensive Care Medicine | Issue 7/2009

Abstract

Purpose

Low tidal volume ventilation and permissive hypercapnia are required in patients with sepsis complicated by ARDS. The effects of hypercapnia on tissue oxidative metabolism in this setting are unknown. We therefore determined the effects of moderate hypercapnia on markers of systemic and splanchnic oxidative metabolism in an animal model of endotoxemia.

Methods

Anesthetized rats maintained at a PaCO₂ of 30, 40 or 60 mmHg were challenged with endotoxin. A control group (PaCO₂ 40 mmHg) received isotonic saline. Hemodynamic variables, arterial lactate, pyruvate, and ketone bodies were measured at baseline and after 4 h. Tissue adenosine triphosphate (ATP) and lactate were measured in the small intestine and the liver after 4 h.

Results

Endotoxin resulted in low cardiac output, increased lactate/pyruvate ratio and decreased ketone body ratio. These changes were not influenced by hypercapnia, but were more severe with hypocapnia. In the liver, ATP decreased and lactate increased independently from PaCO₂ after endotoxin. In contrast, the drop of ATP and the rise in lactate triggered by endotoxin in the intestine were prevented by hypercapnia.

Conclusions

During endotoxemia in rats, moderate hypercapnia prevents the deterioration of tissue energetics in the intestine.

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Title: Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia
Authors: Alex Gnaegi
François Feihl
Olivier Boulat
Bernard Waeber
Lucas Liaudet
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1488-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Moderate hypercapnia exerts beneficial effects on splanchnic energy metabolism during endotoxemia

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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