Respiratory Acid-Base Disorders: Respiratory Acidosis and Respiratory Alkalosis

Tinawi, Mohammad

doi:10.26502/acbr.50170157

Cited by 6 publications

(6 citation statements)

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“…17 In the initial phase of C. maculatum toxicity, rapid breathing and tachypnea lead to hypocapnia and respiratory alkalosis, but in the late phase, with the onset of respiratory muscle weakness, respiratory acidosis predominates. 18 In this study, as shown in Table 1, the patient with moderate symptoms has compensated for respiratory alkalosis, whereas the patient with severe symptoms in the emergency room has compensated for respiratory acidosis. After intubation and ICU admission, acid-base abnormalities were resolved.…”

Section: Discussionmentioning

confidence: 68%

Mild‐to‐severe poisoning due to Coniummaculatum as toxic herb: A case series

Boskabadi

Askari

Zakariaei

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 68%

Mild‐to‐severe poisoning due to Coniummaculatum as toxic herb: A case series

Boskabadi

Askari

Zakariaei

et al. 2021

Clinical Case Reports

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“…Similarly, blood CO 2 was increased during and a month following exposure to wildfires in captive bottlenose dolphins housed in the San Diego Bay (Venn-Watson et al, 2013). Elevated CO 2 may result from slow, shallow breathing, increased CO 2 production, and alveolar hypoventilation, and can indicate a primary compensation for metabolic alkalosis or respiratory acidosis (Centor, 1990;Epstein and Singh, 2001;Tinawi, 2021). In the present study, RR was increased, not decreased, in response to elevated PM 2.5 and THI, suggesting that elevated blood CO 2 was not attributable to a drop in RR.…”

Section: Blood Comentioning

confidence: 99%

Effects of wildfire smoke exposure on innate immunity, metabolism, and milk production in lactating dairy cows

Anderson

Rezamand

Skibiel

2022

Journal of Dairy Science

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Wildfires are particularly prevalent in the Western United States, home to more than 2 million dairy cows that produce more than 25% of the nation's milk. Wildfires emit fine particulate matter (PM 2.5 ) in smoke, which is a known air toxin and is thought to contribute to morbidity in humans by inducing inflammation. The physiological responses of dairy cows to wildfire PM 2.5 are unknown. Herein we assessed the immune, metabolic, and production responses of lactating Holstein cows to wildfire PM 2.5 inhalation. Cows (primiparous, n = 7; multiparous, n = 6) were monitored across the wildfire season from July to September 2020. Cows were housed in freestall pens and thus were exposed to ambient air quality. Air temperature, relative humidity, and PM 2.5 were obtained from a monitoring station 5.7 km from the farm. Animals were considered to be exposed to wildfire PM 2.5 if daily average PM 2.5 exceeded 35 µg/m 3 and wildfire and wind trajectory mapping showed that the PM 2.5 derived from active wildfires. Based on these conditions, cows were exposed to wildfire PM 2.5 for 7 consecutive days in mid-September. Milk yield was recorded daily and milk components analysis conducted before, during, and after exposure. Blood was taken from the jugular vein before, during, and after exposure and assayed for hematology, blood chemistry, and blood metabolites. Statistical analysis was conducted using mixed models including PM 2.5 , temperature-humidity index (THI), parity (primiparous or multiparous), and their interactions as fixed effects and cow as a random effect. Separate models included lags up to 7 d to identify delayed and persistent effects from wildfire PM 2.5 exposure. Exposure to elevated PM 2.5 from wildfire smoke resulted in lower milk yield during exposure and for 7 d after last exposure and higher blood CO 2 concentration, which persisted for 1 d following exposure. We observed a positive PM 2.5 by THI interaction for eosinophil and basophil count and a negative PM 2.5 by THI interaction for red blood cell count and hemoglobin concentration after a 3-d lag.Neutrophil count was also lower with a combination of higher THI and PM 2.5 . We found no discernable effect of PM 2.5 on haptoglobin concentration. Effects of PM 2.5 and THI on metabolism were contingent on day of exposure. On lag d 0, blood urea nitrogen (BUN) was reduced with higher combined THI and PM 2.5 , but on subsequent lag days, THI and PM 2.5 had a positive interaction on BUN. Conversely, THI and PM 2.5 had a positive interacting effect on nonesterified fatty acids (NEFA) on lag d 0 but subsequently caused a reduction in circulating NEFA concentration. Our results suggest that exposure to high wildfire-derived PM 2.5 , alone or in concert with elevated THI, alters systemic metabolism, milk production, and the innate immune system.

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“…6 Studi lain menyatakan kematian pada pasien dengan pH >7,60 ditemukan sebanyak 48,5%. 7 Studi di Wuhan menemukan analisis gas darah pasien yang meninggal akibat COVID-19 dengan tekanan parsial karbon dioksida (PaCO 2 )<35 mmHg sebanyak 52,9%. 8 Hal ini menandakan bahwa hipoksemia menyebabkan pergeseran kurva disosiasi oxyhemoglobin ke kiri yang mengakibatkan ketersediaan oksigen dalam jaringan berkurang dan menghambat pergerakan napas.…”

Section: Pendahuluanunclassified

“…8 Hal ini menandakan bahwa hipoksemia menyebabkan pergeseran kurva disosiasi oxyhemoglobin ke kiri yang mengakibatkan ketersediaan oksigen dalam jaringan berkurang dan menghambat pergerakan napas. 7 Analisis gas darah merupakan pemeriksaan rutin yang penting dilakukan untuk evaluasi keseimbangan asam basa, efektivitas pertukaran gas dan mengetahui kontrol respirasi volunter. Gangguan keseimbangan asam basa dapat memperburuk keadaan suatu penyakit, mengancam nyawa bahkan dapat berujung dengan kematian.…”

Section: Pendahuluanunclassified

“…17 Alkalosis respiratorik merupakan keadaan alkalemia (pH >7,45) yang disebabkan oleh penurunan PaCO 2 <35 mmHg sebagai akibat dari hiperventilasi alveolar yang bergantung pada produksi CO 2 (hipokapnea primer). Alkalosis respiratorik termasuk gangguan asam basa terbanyak kedua (29%) yang ditemukan pada pasien yang dirawat 7 Pada penelitian yang dilakukan di Rumah Sakit Tongji, Wuhan, China, dari 799 pasien yang dirawat dengan kriteria COVID-19 derajat berat hingga kritis, didapatkan pasien dengan komplikasi alkalosis (28%) sebanyak 40% meninggal. Dispnea merupakan keluhan terbanyak saat onset pertama (62%) yang kemudian memberat menjadi ARDS (100%), gagal napas tipe I (51%), hingga pasien meninggal.…”

Section: Pembahasanunclassified

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Tinjauan Pustaka: Alkalosis Respiratorik pada COVID-19: Sleeping with the "Silent Devil."

Dewi¹,

Panji²

2022

jap

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Dewasa ini krisis pertumbuhan penyakit coronavirus disease (COVID-19) telah menekan sistem kesehatan secara global bahkan lebih dari sebelumnya, menyebabkan kebutuhan peningkatan kapasitas unit perawatan intensif dalam menangani jumlah pasien kritis yang meningkat secara tajam. Gagal napas pada COVID-19 diperburuk oleh keadaan hipoksemia dan dapat memburuk menjadi acute respiratory distress syndrome (ARDS) yang segera membutuhkan terapi suplementasi oksigen. Menilai kebutuhan memulai terapi oksigen dapat dilakukan salah satunya dengan analisis gas darah untuk mengevaluasi gangguan asam basa terutama pada perjalanan awal COVID-19 simtomatis berat. Silent hypoxemia sebagai gejala COVID-19 yang mematikan merupakan sebuah tantangan dalam kegawatdaruratan COVID-19. Hipoksemia berat akibat hiperventilasi tanpa gangguan pernapasan akan menunjukkan gambaran hasil analisis gas darah berupa alkalosis respiratorik sebagai upaya kompensasi penurunan kadar PaCO 2 untuk meningkatkan saturasi. Pergeseran kurva disosiasi ke kiri menyebabkan peningkatan afinitas Hb-O 2 untuk memfasilitasi kebutuhan oksigen. Maka dari itu, tenaga kesehatan harus memperhatikan bukan hanya keadaan umum pasien melainkan juga laju pernapasan dan melihat tanda hiperventilasi untuk mengetahui gangguan asam basa melalui analisis gas darah agar dapat mencegah komplikasi alkalosis respiratorik.

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Respiratory Acid-Base Disorders: Respiratory Acidosis and Respiratory Alkalosis

Cited by 6 publications

References 0 publications

Mild‐to‐severe poisoning due to Coniummaculatum as toxic herb: A case series

Mild‐to‐severe poisoning due to Coniummaculatum as toxic herb: A case series

Effects of wildfire smoke exposure on innate immunity, metabolism, and milk production in lactating dairy cows

Tinjauan Pustaka: Alkalosis Respiratorik pada COVID-19: Sleeping with the "Silent Devil."

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