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Canadian journal of veterinary research = Revue canadienne de recherche veterinaire2013; 76(4); 275-280;

Hypercapnic respiratory acidosis: a protective or harmful strategy for critically ill newborn foals?

Abstract: This paper reviews both the beneficial and adverse effects of permissive hypercapnic respiratory acidosis in critically ill newborn foals. It has been shown that partial carbon dioxide pressure (PCO2) above the traditional safe range (hypercapnia), has beneficial effects on the physiology of the respiratory, cardiovascular, and nervous system in neonates. In human neonatal critical care medicine permissive hypercapnic acidosis is generally well-tolerated by patients and is more beneficial to their wellbeing than normal carbon dioxide (CO2) pressure or normocapnia. Even though adverse effects of hypercapnia have been reported, especially in patients with central nervous system pathology and/or chronic infection, critical care clinicians often artificially increase PCO2 to take advantage of its positive effects on compromised neonate tissues. This is referred to as therapeutic hypercapnia. Hypercapnic respiratory acidosis is common in critically ill newborn foals and has traditionally been considered as not beneficial. A search of online scientific databases was conducted to survey the literature on the effects of hypercapnia in neonates, with emphasis on newborn foals. The dynamic status of safety levels of PCO2 and data on the effectiveness of different carbon dioxide levels are not available for newborn foals and should be scientifically determined. Presently, permissive hypercapnia should be implemented or tolerated cautiously in compromised newborn foals and its use should be based on relevant data from adult horses and other species. Le présent article traite des effets bénéfiques et adverses de l’acidose respiratoire hypercapnique permissive chez des poulains nouveau-nés sévèrement malades. Il a été démontré qu’une pression partielle de dioxyde de carbone (PCO) supérieure à l’écart traditionnel sécuritaire (hypercapnée), avait des effets bénéfiques sur la physiologie des systèmes respiratoire, cardio-vasculaire et nerveux chez les nouveau-nés. En médecine des soins critiques chez les nouveau-nés humains, l’acidose hypercapnique est généralement bien tolérée par les patients et est plus bénéfique à leur bien-être qu’une pression normale de dioxyde de carbone (CO) ou normocapnée. Même si des effets adverses de l’hypercapnée ont été rapportés, spécialement chez des patients avec une pathologie du système nerveux central et/ou une infection chronique, les cliniciens en soins critiques augmentent souvent artificiellement la PCO afin de prendre avantage de ses effets positifs sur les tissus des nouveau-nés compromis. On désigne cette pratique comme étant de l’hypercapnée thérapeutique. L’acidose respiratoire hypercapnique est fréquente chez les poulains nouveau-nés sévèrement malades et a traditionnellement été considérée comme étant non-bénéfique. Une recherche en ligne des bases de données scientifiques a été menée afin de recenser la littérature sur les effets de l’hypercapnée chez les nouveau-nés, avec une emphase sur les poulains nouveau-nés. Le statut dynamique des niveaux sécuritaires de PCO et des données sur l’efficacité de différents niveaux de CO ne sont pas disponibles pour les poulains nouveau-nés et devraient être déterminés scientifiquement. Présentement, l’hypercapnée permissive devrait être mise en place ou tolérée avec précaution chez les poulains nouveau-nés compromis et son utilisation devrait être basée sur des données pertinentes provenant de chevaux adultes et d’autres espèces.(Traduit par Docteur Serge Messier).
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Publication Date: 2013-04-02 PubMed ID: 23543953PubMed Central: PMC3460606
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article investigates the effects, both beneficial and detrimental, of heightened levels of carbon dioxide or permissive hypercapnic respiratory acidosis in severely ill newborn horses known as foals.

Overview of Permissive Hypercapnic Acidosis

  • The term “permissive hypercapnic respiratory acidosis” refers to artificially increasing levels of carbon dioxide in the bodies of critical care patients to leverage its benefic results.
  • Increased amounts of CO2, or hypercapnia, have been found to have positive effects on the respiratory, cardiovascular, and nervous systems of newborns.
  • In human critical care for neonates, this strategy is generally well-tolerated by patients and deemed more beneficial than maintaining normal CO2 pressure levels.

Context in Foal Critical Care

  • The research explores the implications of these findings on critically ill newborn foals, where hypercapnic respiratory acidosis is common but traditionally viewed as harmful.
  • The researchers undertook a comprehensive survey of online scientific literature to gain insight into hypercapnia’s effects on neonates, focusing on its effects on newborn foals.
  • Currently, appropriate safety levels of CO2 and data on the effectiveness of varying carbon dioxide level are not available for newborn foals.

Research Recommendations

  • The paper proposes that permissive hypercapnia should be applied or endured carefully in compromised newborn foals.
  • The researchers suggest any use of this method should rely on applicable data drawn from adult horses and from other species.
  • Further study is recommended to scientifically establish the levels of CO2 that are appropriate for these animals.

Cite This Article

APA
Vengust M. (2013). Hypercapnic respiratory acidosis: a protective or harmful strategy for critically ill newborn foals? Can J Vet Res, 76(4), 275-280.

Publication

Canadian journal of veterinary research = Revue canadienne de recherche veterinaire
ISSN: 1928-9022
NlmUniqueID: 8607793
Country: Canada
Language: English
Volume: 76
Issue: 4
Pages: 275-280

Researcher Affiliations

Vengust, Modest
  • Veterinary Faculty, University of Ljubljana, Ljubljana SI-1115, Slovenia. modest.vengust@vf.uni-lj.si

MeSH Terms

  • Acidosis, Respiratory / veterinary
  • Animals
  • Animals, Newborn
  • Critical Care / methods
  • Horse Diseases / blood
  • Horse Diseases / therapy
  • Horses
  • Hypercapnia / veterinary

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Citations

This article has been cited 2 times.
  1. Raidal SL, Catanchin CSM, Burgmeestre L, Quinn CT. Bi-Level Positive Airway Pressure for Non-invasive Respiratory Support of Foals. Front Vet Sci 2021;8:741720.
    doi: 10.3389/fvets.2021.741720pubmed: 34660771google scholar: lookup
  2. Bautista AF, Akca O. Hypercapnia: is it protective in lung injury?. Med Gas Res 2013 Nov 11;3(1):23.
    doi: 10.1186/2045-9912-3-23pubmed: 24209944google scholar: lookup
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