Acid–base patterns in acute severe asthma

Raimondi, G; González, Silvia; Zaltsman, Jorge; Menga, Guillermo; Adrogué, Horacio J.

doi:10.3109/02770903.2013.834506

Cited by 14 publications

(6 citation statements)

References 33 publications

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“…While blood gas disturbances have been demonstrated in patients with an acute asthma exacerbation, with respiratory alkalosis present predominantly in patients with mild airway obstruction (29), few studies evaluated its presence in a stable state of disease, that is, outside the remits of an acute exacerbation (16). The prevalence of hypocapnia in 40% of the patients with asthma in a stable state of disease in the current study is higher compared to the few earlier studies addressing this issue.…”

Section: Discussioncontrasting

confidence: 57%

Prevalence of hyperventilation in patients with asthma

Deenstra¹,

Helvoort²,

Djamin

et al. 2021

Journal of Asthma

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Objective: Asthma is frequently accompanied by dysfunctional breathing of which hyperventilation has been recognized as a subtype. The prevalence of hyperventilation in stable asthma has been scantily studied using blood gas analysis. Hence, a reliable estimate of its prevalence is lacking. It is unknown whether the Nijmegen Questionnaire (NQ) is a useful screening tool for hyperventilation in asthma. Therefore, the primary aim of this study was to determine the prevalence of hyperventilation in a large sample of patients with asthma in a stable state of disease. Secondary aims were to compare the clinical characteristics between patients with and without hyperventilation, and, to examine the concurrent validity of the NQ to detect hypocapnia in patients with asthma. Methods: A real-world, observational, multicenter study was conducted. Capillary blood gas analysis was performed in adults with a confirmed diagnosis of stable asthma. A subset of patients completed the NQ. Results: A blood gas analysis was obtained in 1006 patients. In 17% of the patients an acute hyperventilation was found, and in another 23% a chronic hyperventilation was uncovered. Patients with a chronic hyperventilation blood gas were more often female, were younger and had a better spirometric outcomes. The NQ appeared not to correlate with PCO2. Conclusion: Hyperventilation is common in patients with stable asthma. Chronic hyperventilation is more often found in females of younger age and with the best spirometric outcomes compared to patients without hyperventilation. The NQ is not a suitable screening tool for the presence of hyperventilation in stable asthmatics.

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Section: Discussioncontrasting

confidence: 57%

Prevalence of hyperventilation in patients with asthma

Deenstra¹,

Helvoort²,

Djamin

et al. 2021

Journal of Asthma

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“…LA concentrations vary widely with metabolic activity and tissue perfusion, and correlate with clinical features. For example, LA or lactate levels are linked to outcomes or severity in cancer [22][23][24][25], sepsis [26], pulmonary embolism [27], and asthma [2,28,29]. But more than just a marker of glucose metabolism, LA is functionally important.…”

Section: Introductionmentioning

confidence: 99%

Lactic acid suppresses IgE-mediated mast cell function in vitro and in vivo

Abebayehu

Spence

Caslin

et al. 2019

Cellular Immunology

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Mast cells have functional plasticity affected by their tissue microenvironment, which greatly impacts their inflammatory responses. Because lactic acid (LA) is abundant in inflamed tissues and tumors, we investigated how it affects mast cell function. Using IgE-mediated activation as a model system, we found that LA suppressed inflammatory cytokine production and degranulation in mouse peritoneal mast cells, data that were confirmed with human skin mast cells. In mouse peritoneal mast cells, LA-mediated cytokine suppression was dependent on pH-and monocarboxylic transporter-1 expression. Additionally, LA reduced IgE-induced Syk, Btk, and ERK phosphorylation, key signals eliciting inflammation. In vivo, LA injection reduced IgEmediated hypothermia in mice undergoing passive systemic anaphylaxis. Our data suggest that LA may serve as a feedback inhibitor that limits mast cell-mediated inflammation.

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“…It has also been reported that the absence of pulsus paradoxus makes the presence of hypercapnia unlikely, although it is noted that clinical signs and symptoms during acute severe asthma often are not correlated with the severity of the functional impairment [19]. Raimondi et al performed a case series study exploring acid-base patterns in patients admitted for acute severe asthma, in correlation with forced expiratory volume in 1 s (FEV 1 ) values [8]. Airway obstruction severity did not seem to correlate significantly with PaO 2 values, a finding also reported in several other studies in the past [18,20,21] and thought to be due to V A /Q mismatch not being connected to air flow rates; moreover, treatment with β-agonists may lead to further widening of V A /Q mismatch.…”

Section: Respiratory Acidosismentioning

confidence: 99%

Acid-Base Disturbances in Patients with Asthma: A Literature Review and Comments on Their Pathophysiology

Vasileiadis

Alevrakis

Ampelioti

et al. 2019

JCM

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Asthma is a common illness throughout the world that affects the respiratory system function, i.e., a system whose operational adequacy determines the respiratory gases exchange. It is therefore expected that acute severe asthma will be associated with respiratory acid-base disorders. In addition, the resulting hypoxemia along with the circulatory compromise due to heart–lung interactions can reduce tissue oxygenation, with a particular impact on respiratory muscles that have increased energy needs due to the increased workload. Thus, anaerobic metabolism may ensue, leading to lactic acidosis. Additionally, chronic hypocapnia in asthma can cause a compensatory drop in plasma bicarbonate concentration, resulting in non-anion gap acidosis. Indeed, studies have shown that in acute severe asthma, metabolic acid-base disorders may occur, i.e., high anion gap or non-anion gap metabolic acidosis. This review briefly presents studies that have investigated acid-base disorders in asthma, with comments on their underlying pathophysiology.

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Acid–base patterns in acute severe asthma

Cited by 14 publications

References 33 publications

Prevalence of hyperventilation in patients with asthma

Prevalence of hyperventilation in patients with asthma

Lactic acid suppresses IgE-mediated mast cell function in vitro and in vivo

Acid-Base Disturbances in Patients with Asthma: A Literature Review and Comments on Their Pathophysiology

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