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慢性呼吸性酸碱平衡紊乱对急性二氧化碳滴定曲线的影响。

Influence of chronic respiratory acid-base disorders on acute CO2 titration curve.

作者信息

Adrogué H J, Madias N E

出版信息

J Appl Physiol (1985). 1985 Apr;58(4):1231-8. doi: 10.1152/jappl.1985.58.4.1231.

Abstract

We have recently shown that background presence of chronic metabolic acid-base disorder markedly alters in vivo acute CO2 titration curve. These studies were carried out to assess the influence of chronic respiratory acid-base disorders on response to acute hypercapnia and to explore whether the chronic level of plasma pH is the factor responsible for alterations in the CO2 titration curve. We compared whole-body responses to acute hypercapnia of dogs with preexisting chronic respiratory alkalosis (n = 8) with that of normal animals (n = 4) and animals with chronic respiratory acidosis (n = 13). Chronic respiratory alkalosis and acidosis, as well as the acute CO2 titrations, were produced in unanesthetized dogs within a large environmental chamber. For comparison with our data on chronic metabolic acidosis and alkalosis, plasma bicarbonate levels, which are secondarily altered in chronic respiratory acid-base disorders, were used as an index of chronic acid-base status of the animals. Results indicate that, as with chronic metabolic acid-base disorders, a larger increment in plasma bicarbonate occurs during acute hypercapnia when steady-state plasma bicarbonate is low (respiratory alkalosis) than when it is high (respiratory acidosis). Yet, in further analogy with the metabolic studies, plasma hydrogen ion concentration is better defended at higher plasma bicarbonate levels in accordance with mathematical relationships defined by the Henderson-Hasselbalch equation. Combined results demonstrate that the influence of chronic acid-base status on whole-body response to acute hypercapnia is independent of initial plasma pH.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们最近发现,慢性代谢性酸碱紊乱的背景存在会显著改变体内急性二氧化碳滴定曲线。开展这些研究是为了评估慢性呼吸性酸碱紊乱对急性高碳酸血症反应的影响,并探究血浆pH的慢性水平是否是导致二氧化碳滴定曲线改变的因素。我们比较了预先存在慢性呼吸性碱中毒的犬(n = 8)、正常动物(n = 4)和慢性呼吸性酸中毒的动物(n = 13)对急性高碳酸血症的全身反应。慢性呼吸性碱中毒和酸中毒以及急性二氧化碳滴定均在大型环境舱内的未麻醉犬身上产生。为了与我们关于慢性代谢性酸中毒和碱中毒的数据进行比较,将在慢性呼吸性酸碱紊乱中继发改变的血浆碳酸氢盐水平用作动物慢性酸碱状态的指标。结果表明,与慢性代谢性酸碱紊乱一样,在急性高碳酸血症期间,稳态血浆碳酸氢盐水平低(呼吸性碱中毒)时血浆碳酸氢盐的增量大于水平高时(呼吸性酸中毒)。然而,与代谢研究进一步相似的是,根据亨德森 - 哈塞尔巴尔赫方程定义的数学关系,在较高血浆碳酸氢盐水平时血浆氢离子浓度能得到更好的维持。综合结果表明,慢性酸碱状态对全身急性高碳酸血症反应的影响与初始血浆pH无关。(摘要截短于250字)

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