Influence of bicarbonate on ventilatory drive in healthy subjects

Eline Mos-Oppersma, Jonne Doorduin, J.G. van der Hoeven, Peter Veltink, Leo M.A. Heunks

Research output: Contribution to journalMeeting AbstractOther research output

Abstract

Background Acute hypoventilation results in CO2 retention and respiratory acidosis. Bicarbonate retention aims to restore pH level. However, after institution of mechanical ventilation metabolic alkalosis may develop, which could impair respiratory drive. Aim To investigate whether increased plasma bicarbonate reduces ventilatory drive and minute ventilation. Methods We enrolled 11 healthy volunteers. At baseline (t0), arterial blood gas (ABG) analysis and a hypercapnic ventilatory response (HCVR) test were performed while flow, diaphragm electrical activity (EAdi), and partial pressure of in- and expiratory CO2 were measured. 100 ml 8.4% sodium bicarbonate was administered for 10 times with 8 h interval. Subsequently, measurements were repeated (t1). Ratio between difference in start and end of minute ventilation (VE) and end-tidal CO2 pressure (PetCO2) was calculated. Results Bicarbonate levels increased from 25.2±2.2 mmol/L to 29.2±1.9 mmol/L. There was no difference in ΔVE/ΔPetCO2 between t0 (6.1±2.5 L·min-1/kPa) and t1 (6.3±2.6 L·min-1/kPa, p=0.76). Figure 1 shows mean EAdi and VE for each step of increasing inspiratory CO2. Akaike index on intra-individual fits showed a significant effect of bicarbonate on EAdi and a small effect on VE. Conclusion Increasing arterial bicarbonate reduces ventilatory drive in healthy subjects. The clinical importance is that it could be helpful to reduce plasma bicarbonate in selected difficult to wean patients.
Original languageEnglish
Article numberPA5025
JournalEuropean respiratory journal
Volume48
Issue numbersuppl 60
DOIs
Publication statusPublished - 2016

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Bicarbonates
Healthy Volunteers
Ventilation
Respiratory Acidosis
Hypoventilation
Alkalosis
Blood Gas Analysis
Sodium Bicarbonate
Partial Pressure
Diaphragm
Artificial Respiration
Pressure

Cite this

Mos-Oppersma, Eline ; Doorduin, Jonne ; van der Hoeven, J.G. ; Veltink, Peter ; Heunks, Leo M.A. / Influence of bicarbonate on ventilatory drive in healthy subjects. In: European respiratory journal. 2016 ; Vol. 48, No. suppl 60.
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title = "Influence of bicarbonate on ventilatory drive in healthy subjects",
abstract = "Background Acute hypoventilation results in CO2 retention and respiratory acidosis. Bicarbonate retention aims to restore pH level. However, after institution of mechanical ventilation metabolic alkalosis may develop, which could impair respiratory drive. Aim To investigate whether increased plasma bicarbonate reduces ventilatory drive and minute ventilation. Methods We enrolled 11 healthy volunteers. At baseline (t0), arterial blood gas (ABG) analysis and a hypercapnic ventilatory response (HCVR) test were performed while flow, diaphragm electrical activity (EAdi), and partial pressure of in- and expiratory CO2 were measured. 100 ml 8.4{\%} sodium bicarbonate was administered for 10 times with 8 h interval. Subsequently, measurements were repeated (t1). Ratio between difference in start and end of minute ventilation (VE) and end-tidal CO2 pressure (PetCO2) was calculated. Results Bicarbonate levels increased from 25.2±2.2 mmol/L to 29.2±1.9 mmol/L. There was no difference in ΔVE/ΔPetCO2 between t0 (6.1±2.5 L·min-1/kPa) and t1 (6.3±2.6 L·min-1/kPa, p=0.76). Figure 1 shows mean EAdi and VE for each step of increasing inspiratory CO2. Akaike index on intra-individual fits showed a significant effect of bicarbonate on EAdi and a small effect on VE. Conclusion Increasing arterial bicarbonate reduces ventilatory drive in healthy subjects. The clinical importance is that it could be helpful to reduce plasma bicarbonate in selected difficult to wean patients.",
author = "Eline Mos-Oppersma and Jonne Doorduin and {van der Hoeven}, J.G. and Peter Veltink and Heunks, {Leo M.A.}",
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Influence of bicarbonate on ventilatory drive in healthy subjects. / Mos-Oppersma, Eline ; Doorduin, Jonne; van der Hoeven, J.G.; Veltink, Peter; Heunks, Leo M.A.

In: European respiratory journal, Vol. 48, No. suppl 60, PA5025, 2016.

Research output: Contribution to journalMeeting AbstractOther research output

TY - JOUR

T1 - Influence of bicarbonate on ventilatory drive in healthy subjects

AU - Mos-Oppersma, Eline

AU - Doorduin, Jonne

AU - van der Hoeven, J.G.

AU - Veltink, Peter

AU - Heunks, Leo M.A.

N1 - ERS International Congress 2016 abstracts

PY - 2016

Y1 - 2016

N2 - Background Acute hypoventilation results in CO2 retention and respiratory acidosis. Bicarbonate retention aims to restore pH level. However, after institution of mechanical ventilation metabolic alkalosis may develop, which could impair respiratory drive. Aim To investigate whether increased plasma bicarbonate reduces ventilatory drive and minute ventilation. Methods We enrolled 11 healthy volunteers. At baseline (t0), arterial blood gas (ABG) analysis and a hypercapnic ventilatory response (HCVR) test were performed while flow, diaphragm electrical activity (EAdi), and partial pressure of in- and expiratory CO2 were measured. 100 ml 8.4% sodium bicarbonate was administered for 10 times with 8 h interval. Subsequently, measurements were repeated (t1). Ratio between difference in start and end of minute ventilation (VE) and end-tidal CO2 pressure (PetCO2) was calculated. Results Bicarbonate levels increased from 25.2±2.2 mmol/L to 29.2±1.9 mmol/L. There was no difference in ΔVE/ΔPetCO2 between t0 (6.1±2.5 L·min-1/kPa) and t1 (6.3±2.6 L·min-1/kPa, p=0.76). Figure 1 shows mean EAdi and VE for each step of increasing inspiratory CO2. Akaike index on intra-individual fits showed a significant effect of bicarbonate on EAdi and a small effect on VE. Conclusion Increasing arterial bicarbonate reduces ventilatory drive in healthy subjects. The clinical importance is that it could be helpful to reduce plasma bicarbonate in selected difficult to wean patients.

AB - Background Acute hypoventilation results in CO2 retention and respiratory acidosis. Bicarbonate retention aims to restore pH level. However, after institution of mechanical ventilation metabolic alkalosis may develop, which could impair respiratory drive. Aim To investigate whether increased plasma bicarbonate reduces ventilatory drive and minute ventilation. Methods We enrolled 11 healthy volunteers. At baseline (t0), arterial blood gas (ABG) analysis and a hypercapnic ventilatory response (HCVR) test were performed while flow, diaphragm electrical activity (EAdi), and partial pressure of in- and expiratory CO2 were measured. 100 ml 8.4% sodium bicarbonate was administered for 10 times with 8 h interval. Subsequently, measurements were repeated (t1). Ratio between difference in start and end of minute ventilation (VE) and end-tidal CO2 pressure (PetCO2) was calculated. Results Bicarbonate levels increased from 25.2±2.2 mmol/L to 29.2±1.9 mmol/L. There was no difference in ΔVE/ΔPetCO2 between t0 (6.1±2.5 L·min-1/kPa) and t1 (6.3±2.6 L·min-1/kPa, p=0.76). Figure 1 shows mean EAdi and VE for each step of increasing inspiratory CO2. Akaike index on intra-individual fits showed a significant effect of bicarbonate on EAdi and a small effect on VE. Conclusion Increasing arterial bicarbonate reduces ventilatory drive in healthy subjects. The clinical importance is that it could be helpful to reduce plasma bicarbonate in selected difficult to wean patients.

U2 - 10.1183/13993003.congress-2016.PA5025

DO - 10.1183/13993003.congress-2016.PA5025

M3 - Meeting Abstract

VL - 48

JO - European respiratory journal

JF - European respiratory journal

SN - 0903-1936

IS - suppl 60

M1 - PA5025

ER -