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Biomedical subjects

F J Hurtado

Publications and source records attributed to F J Hurtado.

6 recordsLinked to original sources

Gastric intramucosal pH and intraluminal PCO2 during weaning from mechanical ventilation.

OBJECTIVE: To study the value of gastric intramucosal pH and gastric intraluminal PCO2 measurements to predict weaning outcome from mechanical ventilation. DESIGN: Prospective clinical study. SETTING: Intensive care medicine department of a university hospital. PATIENTS: Nineteen adult critically ill patients who were mechanically ventilated because of acute respiratory failure and were considered ready to be weaned. INTERVENTIONS: The patients were weaned with: synchronized intermittent mandatory ventilation plus positive end-expiratory pressure (SIMV+PEEP) or continuous positive airway pressure with pressure support ventilation (CPAP+PSV). A gastric tonometer was placed in all the patients. Tonometric, respiratory, and hemodynamic variables were measured during the weaning process. MEASUREMENTS: Hemodynamic variables, respiratory mechanics, pulmonary gas exchange, respiratory muscle force, spontaneous pattern of breathing, and the central control of breathing were recorded. Simultaneously, the intramucosal pH and gastric intraluminal PCO2 were measured. MAIN RESULTS: Eleven patients were successfully extubated and eight failed. The patients who failed showed higher values of mouth occlusion pressure, respiratory rate, and effective inspiratory impedance (mouth occlusion pressure/mean inspiratory flow). The intramucosal pH was initially 7.19 +/- 0.22 and decreased to 7.10 +/- 0.16 during the weaning process in patients who failed (p < .05). At the same time, the intramucosal pH showed a nonsignificant change from 7.36 +/- 0.07 to 7.32 +/- 0.07 in the patients who were successfully extubated. The intramucosal pH was statistically different when both groups were compared during the initial and the final evaluations (p < .05). For the initial evaluation, the sensitivity and specificity to predict weaning failure when the intramucosal pH was < or =7.30 were 0.88 (95% confidence interval [CI], 0.66-1) and 0.82 (95% CI, 0.59-1), respectively. The gastric intraluminal PCO2 was higher in patients who failed (p < .05). When gastric intraluminal PCO2 was . or =40 torr during the initial evaluation, weaning failure occurred with a sensitivity of 1 (95% CI, 0.31-1) and a specificity of 0.55 (95% CI, 0.26-0.84). CONCLUSIONS: Weaning failure was associated with gastric intramucosal acidosis. The intramucosal pH and gastric intraluminal PCO2 may be helpful to predict weaning outcome. Further controlled clinical trials in a larger group of patients are needed.

Adolescent↗

Method for collecting Hypoderma spp. (Diptera: Oestridae) larvae from cattle.

A new method for collecting 3rd-instar Hypoderma lineatum (Villers) and Hypoderma bovis (L.) is described. A procedure for carrying out chronobiological and other studies involving the life cycle of these flies is included. The larvae are collected from cattle using a dressing made of a circle of cardboard attached to a piece of tulle similar in color to the coat of the animal. These small cloth cages were attached to the animal skin with fast-drying contact glue wherever the swellings produced by 2nd- or 3rd-instar Hypoderma spp. had been previously detected. Each animal was inspected daily to detect the appearance of new larvae. This procedure allows the collection of each emerged larva without contact with other larvae and avoids friction of the cloth cages or dressing with the larvae, thus reducing larval death and increasing viability of the parasite.

Animals↗

Inhibitory effect of Escherichia coli endotoxin on skeletal muscle contractility.

OBJECTIVE: Endotoxemia in rabbits is associated with decreases in oxygen transport, tissue hypoxia, metabolic acidosis, and impaired oxygen extraction. In this study, we tested the hypothesis that endotoxin also inhibits skeletal muscle contractility directly. DESIGN: Randomized animal study. SETTING: Accredited animal research facility. SUBJECTS: New Zealand white rabbits of either sex, weighing 2.55 +/- 0.20 kg. INTERVENTIONS: We compared two groups of rabbits (n = 10 each) undergoing continuous electrical stimulation of the left hindlimb (maximal isometric twitch contraction at 0.25 Hz). One group (septic) was given an intravenous infusion of Escherichia coli endotoxin. The control group was subjected to decreases in cardiac output by inflating a balloon placed in the right ventricle. MEASUREMENTS AND MAIN RESULTS: Endotoxin or balloon inflation resulted in comparable decreases in cardiac output (49% and 53%, respectively). Hindlimb oxygen transport decreased to similar values for both groups (4.9 +/- 0.3 and 4.2 +/- 0.5 mL/min/kg, respectively). Systemic oxygen extraction ratio was greater in the control group (0.72 +/- 0.03) than in the septic group (0.55 +/- 0.04; p < .05). There were no differences in hindlimb oxygen extraction ratio. Decreases in hindlimb forces were greater in the septic group (42 +/- 4%) than in the control group (18 +/- 3%, p < .01). Force frequency curves obtained at the beginning and the end of the experiment showed greater fatigue in the septic group. CONCLUSIONS: The intravenous infusion of Escherichia coli endotoxin produces a direct inhibitory effect on skeletal muscle contractility in rabbits. This phenomenon is independent of decreases in oxygen transport and blood pH. Our data support the notion of a direct cellular effect of endotoxin, or of an associated cytokine, on skeletal muscle contractility. The mechanism responsible for this phenomenon is unknown.

Animals↗

Hydroxymalonate inhibits lactate uptake by the rabbit hindlimb.

Lactate uptake by skeletal muscle occurs under diverse conditions, including hypoxia and electrical stimulation. A possible metabolic fate of lactate in resting muscle is its conversion to pyruvate followed by carboxylation to malate in the cytosolic malic reaction. To test this hypothesis, we measured hindlimb lactate uptake in hypoxic mechanically ventilated rabbits. Rabbits were given intravenous infusions of hydroxymalonate, an inhibitor of the malic reaction (200 mM; n = 7), or normal saline (n = 7) at 1.1 ml/min. Hindlimb lactate uptake/release was calculated as femoral blood flow times the arteriovenous lactate difference. Saline or hydroxymalonate was infused continuously during sequential 30-min periods of normoxia (arterial PO2 approximately 150 Torr), hypoxemia (arterial PO2 approximately 30 Torr), and reoxygenation (arterial PO2 approximately 150 Torr). Hindlimb O2 transport decreased with hypoxemia, but O2 consumption remained unchanged in both groups. During hypoxemia there was net uptake of lactate by the hindlimb of the group given normal saline [4.5 +/- 0.9 (SE) mumol/min]. The hindlimb of the hydroxymalonate group continued to release lactate (-0.5 +/- 1.0 mumol/min). The inhibition of lactate uptake by hydroxymalonate supports the hypothesis that the malic reaction plays a major role in the metabolism of lactate by resting rabbit skeletal muscle.

Animals↗

Net uptake of lactate by rabbit hindlimb during hypoxia.

Lactate uptake by normoxic tissues is a pH-dependent phenomenon that occurs with increases in arterial lactate concentration. In this study we sought to determine the effect of hypoxia on lactate uptake by the rabbit hindlimb at different arterial blood pH (pHa). Two groups of rabbits were subjected to 20 min of arterial hypoxemia (PaO2 approximately 20 mm Hg). One group was allowed to maintain normal pHa (approximately 7.40 to 7.45; n = 5), whereas the other group was hyperventilated, resulting in hypocarbia and alkalemia (pHa > 7.50; n = 5). Lactate uptake was computed from measurements of femoral blood flow and the arterio-venous lactate difference. We found decreases in hindlimb O2 consumption during hypoxemia from 0.79 +/- 0.08 to 0.33 +/- 0.06 ml/min in the normal pH group (p < 0.01) and from 0.49 +/- 0.06 to 0.24 +/- 0.02 ml/min in the high pH group (p < 0.01). At that time there was net uptake of lactate by the hindlimb of the normal pH group (8.1 +/- 2.0 mumol/min; p < 0.001) and lactate release by the alkalemic group (1.61 +/- 1.0 mumol/min). Furthermore, hindlimb lactate uptake was associated with increased glucose consumption (p < 0.001). We hypothesize that the mechanisms responsible for lactate uptake by resting skeletal muscle during hypoxia may be similar to those that regulate lactate uptake during normoxic exercise.

Animals↗

Role of tissue hypoxia as the mechanism of lactic acidosis during E. coli endotoxemia.

We compared the hemodynamic and metabolic alterations produced in rabbits by similar decreases in cardiac output created by inflating a balloon placed in the right ventricle (n = 6) with those produced by an intravenous bolus of Escherichia coli lipopolysaccharide (LPS; SEP group; n = 6). We measured O2 consumption (VO2), O2 transport (TO2), and O2 extraction ratio (ERO2) for the whole animal and also for the left hindlimb. Both groups experienced similar decreases in cardiac output, systemic TO2, and VO2 and similar increases in ERO2. For the hindlimb, TO2 was similar, but VO2 and ERO2 were lower for the SEP group 30 min after LPS administration (P less than 0.05); however, this difference disappeared during the remainder of the experiment. Arterial lactate concentration was greater (P less than 0.05) for the SEP group. There were no differences in skeletal muscle PO2, measured with a multiwire surface electrode, or in cardiac and skeletal muscle concentrations of high-energy phosphates. We hypothesize that a direct effect of LPS on cellular metabolism may have resulted in greater arterial lactate concentration for the SEP group.

Acidosis, Lactic↗