The effect of metabolic alkalosis on the ventilatory response in healthy subjects

E. Oppersma; J. Doorduin; J.G. van der Hoeven; P.H. Veltink; H.W.H. van Hees; L.M.A. Heunks

doi:10.1016/j.resp.2018.01.002

The effect of metabolic alkalosis on the ventilatory response in healthy subjects

E. Oppersma, J. Doorduin, J.G. van der Hoeven, P.H. Veltink, H.W.H. van Hees, L.M.A. Heunks^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation.

Methods: In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days.

Results: Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO2 pressure during the HCVR test, RR, Vt, Pdi, EAdi and VE increased. The clinical ratio ΔVE/ΔPetCO2 remained unchanged, but Pdi, EAdi and VE were significantly lower after bicarbonate administration for similar levels of inspired CO2.

Conclusion: This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO2.

Original language	English
Pages (from-to)	47-53
Number of pages	7
Journal	Respiratory Physiology and Neurobiology
Volume	249
DOIs	https://doi.org/10.1016/j.resp.2018.01.002
Publication status	Published - Feb 2018

Keywords

UT-Hybrid-D
Neural respiratory drive
Posthypercapnic alkalosis
Pulnonary function test
Physiology

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title = "The effect of metabolic alkalosis on the ventilatory response in healthy subjects",

abstract = "Background: Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation.Methods: In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days.Results: Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO2 pressure during the HCVR test, RR, Vt, Pdi, EAdi and VE increased. The clinical ratio ΔVE/ΔPetCO2 remained unchanged, but Pdi, EAdi and VE were significantly lower after bicarbonate administration for similar levels of inspired CO2.Conclusion: This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO2.",

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author = "E. Oppersma and J. Doorduin and {van der Hoeven}, J.G. and P.H. Veltink and {van Hees}, H.W.H. and L.M.A. Heunks",

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AU - Oppersma, E.

AU - Doorduin, J.

AU - van der Hoeven, J.G.

AU - Veltink, P.H.

AU - van Hees, H.W.H.

AU - Heunks, L.M.A.

N1 - Elssevier deal

PY - 2018/2

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N2 - Background: Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation.Methods: In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days.Results: Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO2 pressure during the HCVR test, RR, Vt, Pdi, EAdi and VE increased. The clinical ratio ΔVE/ΔPetCO2 remained unchanged, but Pdi, EAdi and VE were significantly lower after bicarbonate administration for similar levels of inspired CO2.Conclusion: This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO2.

AB - Background: Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation.Methods: In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days.Results: Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO2 pressure during the HCVR test, RR, Vt, Pdi, EAdi and VE increased. The clinical ratio ΔVE/ΔPetCO2 remained unchanged, but Pdi, EAdi and VE were significantly lower after bicarbonate administration for similar levels of inspired CO2.Conclusion: This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO2.

KW - UT-Hybrid-D

KW - Neural respiratory drive

KW - Posthypercapnic alkalosis

KW - Pulnonary function test

KW - Physiology

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DO - 10.1016/j.resp.2018.01.002

M3 - Article

VL - 249

SP - 47

EP - 53

JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

SN - 1569-9048

ER -

The effect of metabolic alkalosis on the ventilatory response in healthy subjects

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