Effect of variations in blood hydrogen ion concentration on pulmonary gas exchange of artificially ventilated dogs

Effect of changes in ionized calcium concentration in arterial blood and metabolic acidosis on the arterial partial pressure of oxygen in dogs

OBJECTIVE

To evaluate the effects of metabolic acidosis and changes in ionized calcium (Ca2+) concentration on PaO2 in dogs.

ANIMALS

33 anesthetized dogs receiving assisted ventilation.

PROCEDURE

Normal acid-base status was maintained in 8 dogs (group I), and metabolic acidosis was induced in 25 dogs. For 60 minutes, normocalcemia was maintained in group I and 10 other dogs (group II), and 10 dogs were allowed to become hypercalcemic (group III); hypocalcemia was then induced in groups I and II. Groups II and IV (5 dogs) were treated identically except that, at 90 minutes, the latter underwent parathyroidectomy. At intervals, variables including PaO2, Ca2+ concentration, arterial blood pH (pHa), and systolic blood pressure were assessed.

RESULTS

In group II, PaO2 increased from baseline value (96 +/- 2 mm Hg) within 10 minutes (pHa, 7.33 +/- 0.001); at 60 minutes (pHa, 7.21 +/- 0.02), PaO2 was 108 +/- 2 mm Hg. For the same pHa decrease, the PaO2 increase was less in group III. In group I, hypocalcemia caused PaO2 to progressively increase (from 95 +/- 2 mm Hg to 104 +/- 3 mm Hg), which correlated (r = -0.66) significantly with a decrease in systolic blood pressure (from 156 +/- 9 mm Hg to 118 +/- 10 mm Hg). Parathyroidectomy did not alter PaO2 values.

CONCLUSIONS AND CLINICAL RELEVANCE

Induction of hypocalcemia and metabolic acidosis each increased PaO2 in anesthetized dogs, whereas acidosis-induced hypercalcemia attenuated that increase. In anesthetized dogs, development of metabolic acidosis or hypocalcemia is likely to affect ventilatory control.

Consequences of an acute increase in P50 in anaesthetized guinea pigs

In anaesthetized guinea pigs, ventilated with ambient air, the peripheral haemodynamics and oxygen transport characteristics have been studied following a blood exchange transfusion with rat erythrocytes suspended in guinea pig plasma. Since the rat haemoglobin exhibited a lower oxygen affinity than guinea pig haemoglobin, the oxygen partial pressure at 50% of oxygen haemoglobin saturation (P50) increased from 25.2 +/- 1.1 to 37.2 +/- 0.9 mm Hg (n = 10). This increase in P50 was accompanied by a significant increase in arterial oxygen partial pressure (PaO2) and in arterio-venous difference (AVDO2). Cardiac output (Q) was decreased significantly, but oxygen consumption (VO2) remained within control values. The increase in P50 was associated with a venous oxygen partial pressure (P-VO2) which remained constant but an increase in blood lactate concentration was observed. Control exchange transfusion with fresh guinea pig blood had no effect on acid-base status, on oxygen transport, or on peripheral resistance. The sudden reduction in haemoglobin oxygen affinity induced an increase in peripheral resistance with a decrease in cardiac output, the arterial systemic pressure being maintained. These results suggested that an acute decrease in haemoglobin oxygen affinity was compensated for by a simultaneous diminution of overall tissue blood flow and reduction of capillary recruitment.

Effect of shifts of the O2 dissociation curve upon alveolar-arterial O2 gradients in computer models of the lung with ventilation-perfusion mismatching

The effect of a shift of the blood O2 dissociation curve (ODC) on the alveolar-arterial O2 gradient was studied in computer models of the lung with several degrees of VA/Q inequality during air breathing. A shift to the left decreases and a shift to the right increases not only the mixed-venous but also the arterial PO2. Consequently the alveolar-arterial O2 gradient is larger with a left and smaller with a right shift of the ODC. This effect of a shift of the ODC on the alveolar-arterial O2 gradient is negligible in a healthy lung but becomes quite considerable in a diseased lung with a severe mismatching of VA/Q.