Hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption

Pavlos M. Myrianthefs; Arturo Briva; Emilia Lecuona; Vidas Dumasius; David H. Rutschman; Karen M. Ridge; George J. Baltopoulos; Jacob Iasha Sznajder

doi:10.1164/rccm.200408-998OC

Hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption

Pavlos M. Myrianthefs, Arturo Briva, Emilia Lecuona, Vidas Dumasius, David H. Rutschman, Karen M. Ridge, George J. Baltopoulos, Jacob Iasha Sznajder^*

^*Corresponding author for this work

Medicine, Pulmonary Division

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

21 Scopus citations

Abstract

Acid-base disturbances, such as metabolic or respiratory alkalosis, are relatively common in critically ill patients. We examined the effects of alkalosis (hypocapnic or metabolic alkalosis) on alveolar fluid reabsorption in the isolated and continuously perfused rat lung model. We found that alveolar fluid reabsorption after 1 hour was impaired by low levels of CO ₂ partial pressure (PCO ₂; 10 and 20 mm Hg) independent of pH levels (7.7 or 7.4). In addition, PCO ₂ higher than 30 mm Hg or metabolic alkalosis did not have an effect on this process. The hypocapnia-mediated decrease of alveolar fluid reabsorption was associated with decreased Na,K-ATPase activity and protein abundance at the basolateral membranes of distal air-spaces. The effect of low PCO ₂ on alveolar fluid reabsorption was reversible because clearance normalized after correcting the PCO ₂ back to normal levels. These data suggest that hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption. Conceivably, correction of hypocapnic alkalosis in critically ill patients may contribute to the normalization of lung ability to clear edema.

Original language	English (US)
Pages (from-to)	1267-1271
Number of pages	5
Journal	American journal of respiratory and critical care medicine
Volume	171
Issue number	11
DOIs	https://doi.org/10.1164/rccm.200408-998OC
State	Published - Jun 1 2005

Keywords

Alveolar epithelial cells
Hypocapnic alkalosis
Ion transport
Na, K-ATPase
Pulmonary edema

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine

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title = "Hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption",

abstract = "Acid-base disturbances, such as metabolic or respiratory alkalosis, are relatively common in critically ill patients. We examined the effects of alkalosis (hypocapnic or metabolic alkalosis) on alveolar fluid reabsorption in the isolated and continuously perfused rat lung model. We found that alveolar fluid reabsorption after 1 hour was impaired by low levels of CO 2 partial pressure (PCO 2; 10 and 20 mm Hg) independent of pH levels (7.7 or 7.4). In addition, PCO 2 higher than 30 mm Hg or metabolic alkalosis did not have an effect on this process. The hypocapnia-mediated decrease of alveolar fluid reabsorption was associated with decreased Na,K-ATPase activity and protein abundance at the basolateral membranes of distal air-spaces. The effect of low PCO 2 on alveolar fluid reabsorption was reversible because clearance normalized after correcting the PCO 2 back to normal levels. These data suggest that hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption. Conceivably, correction of hypocapnic alkalosis in critically ill patients may contribute to the normalization of lung ability to clear edema.",

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author = "Myrianthefs, {Pavlos M.} and Arturo Briva and Emilia Lecuona and Vidas Dumasius and Rutschman, {David H.} and Ridge, {Karen M.} and Baltopoulos, {George J.} and Sznajder, {Jacob Iasha}",

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Hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption. / Myrianthefs, Pavlos M.; Briva, Arturo; Lecuona, Emilia; Dumasius, Vidas; Rutschman, David H.; Ridge, Karen M.; Baltopoulos, George J.; Sznajder, Jacob Iasha.

In: American journal of respiratory and critical care medicine, Vol. 171, No. 11, 01.06.2005, p. 1267-1271.

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

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AU - Myrianthefs, Pavlos M.

AU - Briva, Arturo

AU - Lecuona, Emilia

AU - Dumasius, Vidas

AU - Rutschman, David H.

AU - Ridge, Karen M.

AU - Baltopoulos, George J.

AU - Sznajder, Jacob Iasha

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N2 - Acid-base disturbances, such as metabolic or respiratory alkalosis, are relatively common in critically ill patients. We examined the effects of alkalosis (hypocapnic or metabolic alkalosis) on alveolar fluid reabsorption in the isolated and continuously perfused rat lung model. We found that alveolar fluid reabsorption after 1 hour was impaired by low levels of CO 2 partial pressure (PCO 2; 10 and 20 mm Hg) independent of pH levels (7.7 or 7.4). In addition, PCO 2 higher than 30 mm Hg or metabolic alkalosis did not have an effect on this process. The hypocapnia-mediated decrease of alveolar fluid reabsorption was associated with decreased Na,K-ATPase activity and protein abundance at the basolateral membranes of distal air-spaces. The effect of low PCO 2 on alveolar fluid reabsorption was reversible because clearance normalized after correcting the PCO 2 back to normal levels. These data suggest that hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption. Conceivably, correction of hypocapnic alkalosis in critically ill patients may contribute to the normalization of lung ability to clear edema.

AB - Acid-base disturbances, such as metabolic or respiratory alkalosis, are relatively common in critically ill patients. We examined the effects of alkalosis (hypocapnic or metabolic alkalosis) on alveolar fluid reabsorption in the isolated and continuously perfused rat lung model. We found that alveolar fluid reabsorption after 1 hour was impaired by low levels of CO 2 partial pressure (PCO 2; 10 and 20 mm Hg) independent of pH levels (7.7 or 7.4). In addition, PCO 2 higher than 30 mm Hg or metabolic alkalosis did not have an effect on this process. The hypocapnia-mediated decrease of alveolar fluid reabsorption was associated with decreased Na,K-ATPase activity and protein abundance at the basolateral membranes of distal air-spaces. The effect of low PCO 2 on alveolar fluid reabsorption was reversible because clearance normalized after correcting the PCO 2 back to normal levels. These data suggest that hypocapnic but not metabolic alkalosis impairs alveolar fluid reabsorption. Conceivably, correction of hypocapnic alkalosis in critically ill patients may contribute to the normalization of lung ability to clear edema.

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