Acute hypercapnia increases the oxygen-carrying capacity of the blood in ventilated dogs.
OBJECTIVE
To test the hypothesis that PaCO2 levels generated during permissive hypercapnia may enhance arterial oxygenation, when ventilation is maintained.


METHODS
Prospective study.


METHODS
Research laboratory in a hospital.


METHODS
One group of eight mongrel dogs (four male; four female).


METHODS
The dogs were anesthetized (30 mg/kg iv pentobarbital), intubated, and cannulated in one femoral artery and vein. While paralyzed with 0.1 mg/kg/hr iv vecouronium bromide, all subjects were ventilated with room air. Anesthesia was maintained, using 2 to 3 mg/kg/hr iv pentobarbital. Arterial hypercapnia at the levels generated during permissive hypercapnia was produced by stepwise increases in the dry, inspired Pco2 (PiCO2) (0, 30, 45, 60 and 75 torr [0, 4, 6, 8, and 10 kPa]; 15 mins each).


RESULTS
Blood gas profiles were determined at each level of hypercapnia. The minute volume was maintained at the baseline level during all exposures. Arterial hypercapnia produced gradual and significant increases in the hemoglobin concentration. These increases were approximately 6%, 7%, 11%, and 14% at PiCO2 of 30, 45, 60, and 75 torr (4, 6, 8, and 10 kPa), respectively (p < .05; repeated analysis of variance followed by Dunnett multiple comparisons test). In parallel, the oxygen content increased by approximately 6%, 7%, 11%, and 13%, respectively. During hypercapnic trials, the PaO2 remained at the normal range, whereas the dry, inspired PO2 (PiO2) was reduced from 150 to 138 torr (20 to 18.4 kPa). The average PaO2 at the highest investigated level of arterial hypercapnia was at a normal range. The hemoglobin concentration and oxygen content returned to baseline values 30 mins after hypercapnic trials. The PaCO2 and pH became normalized 15 mins after hypercapnic trials. Indirect evidence for a similar response to hypercapnia in humans is presented.


CONCLUSIONS
Permissive hypercapnia due to inhaled CO2 increases oxygen-carrying capacity in dogs. The PaO2 remains at normal range even at a PiCO2 of 75 torr (10 kPa). The benefits of these effects during permissive hypercapnia, due to controlled hypoventilation, warrants investigation.
Torbati
D
D
Division of Critical Care Medicine, Miami Children's Hospital, FL 33155-3009, USA.
Mangino
M J
MJ
Garcia
E
E
Estrada
M
M
Totapally
B R
BR
Wolfsdorf
J
J
D000208:Acute Disease; D000704:Analysis of Variance; D000818:Animals; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000097:blood; D004285:Dogs; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006935:Hypercapnia / Q000097:blood*; D008297:Male; D010100:Oxygen / Q000097:blood*; D010313:Partial Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial; D013997:Time Factors
D006454:Hemoglobins; D002245:Carbon Dioxide; D010100:Oxygen