Hypoxia, Metabolic Acidosis, and the Circulation
Allen Ives Arieff, American Physiological Society (1887- )
American Physiological Society, 1992 - Science - 215 pages
In recent years, there has been a wealth of new information on the physiological and biochemical consequences of hypoxia, or low blood levels of oxygen. This new volume discusses the implications of these new findings on the pathophysiology, development, and treatment of hypoxic metabolic acidosis. The volume is part of the Clinical Physiology series sponsored by the American Physiological Society, and is based on a FASEB symposium held in May 1988. Hypoxia was once thought to affect organs in a similar manner, but it is now known that each is affected differently. The author shows how hypoxia and metabolic acidosis affect the heart, lungs, blood vessels and other organs at the cellular level, the tissue level, and finally, at the level of the entire organ. The book then proceeds to a description of the situations in which hypoxic metabolic acidosis develops, such as during high altitude exposure, cardiac arrest, and lactic acidosis. The last few chapters give an overview of treatment. Traditional therapy has consisted largely of the intravenous administration of sodium bicarbonate. This method has come under increasing scrutiny however, and the range of problems associated with the use of sodium bicarbonate is examined fully. Newer alternative agents for managing hypoxic acidosis are reviewed as well. This up-to-date review of hypoxia and metabolic acidosis should be of interest to physiologists, internists, cardiologists, chest physicians, anesthesiologists, and intensive care specialists.
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Regulation of Myocardial Blood Flow and Oxygen Delivery
AcidBase Status and Blood Lactate at Extreme Altitude
Effects of Ischemia Hypoxia and Acidosis on Cardiac Systolic
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acid-base acute alkalosis arterial blood arterial Pco2 arterial pH bicarbonate administration blood lactate blood pH buffer Carbicarb cardiac arrest cardiac output Cardiol changes chemoreceptor Circ Circulation Clin clinical coronary blood flow coronary circulation coronary flow coronary vascular creased decrease demand ischemia dogs effects of sodium FIGURE gluconeogenesis glucose glycolysis glycolytic Heart Circ hemodynamic hemoglobin hepatic high altitude hypercapnia hypertensive hypertrophy hypoxemia hypoxemic hypoxic lactic acidosis increase infusion inhibition intracellular pH ischemic lactate lactate concentration lactate production lactic acid lactic acidosis levels liver lungs mechanism metabolic acidosis myocardial blood flow myocardial contractility myocardial oxygen myocardial pH myocardium NaHCO3 normal oxygen consumption oxygen delivery oxygen extraction patients perfusion perfusion pressure peripheral phenformin phosphate plasma pyruvate rat heart reduced respiratory respiratory acidosis response to hypoxia result resuscitation skeletal muscle sleep apnea sodium bicarbonate studies therapy tion tissue hypoxia tissue oxygen uptake vasodilation venous ventilation ventricle