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1.
Sci Total Environ ; 716: 134959, 2020 May 10.
Article in English | MEDLINE | ID: mdl-31837845

ABSTRACT

Urban aerosol is a growing concern for people living within cities; aerosol have been implicated in many ill health conditions, including that of the lung and of the heart. Atmospheric potential gradient is a consequence of charge carried to the ionosphere through thunderstorms, and its value depends on highly electrically mobile ion concentrations, hence local conductivity of the air. Ions attach to aerosol in the atmosphere, reducing their mobility and therefore increasing the potential gradient, and so potential gradient measurements have been suggested as a proxy for aerosol measurements. Particle number count, size distribution and potential gradient were measured for two campaigns in Manchester, U.K., and one campaign in Bristol, U.K. Using a factor based on size distribution to account for preferential attachment at larger sizes provided the best relationship with potential gradient, but particle count alone showed a weaker, but similar relationship. The increase in particle count caused by annual bonfire and fireworks celebrations (November) was evidenced in both potential gradient and particle numbers. Daily regression or correlation did not show a consistent relationship. In the larger Bristol data set, increasing humidity led to a reduction of potential gradient, while increasing particle number led to an increase.

2.
Environ Sci Process Impacts ; 20(3): 437-453, 2018 Mar 01.
Article in English | MEDLINE | ID: mdl-29480909

ABSTRACT

Criegee intermediates (CIs), carbonyl oxides formed in ozonolysis of alkenes, play key roles in the troposphere. The decomposition of CIs can be a significant source of OH to the tropospheric oxidation cycle especially during nighttime and winter months. A variety of model-measurement studies have estimated surface-level stabilized Criegee intermediate (sCI) concentrations on the order of 1 × 104 cm-3 to 1 × 105 cm-3, which makes a non-negligible contribution to the oxidising capacity in the terrestrial boundary layer. The reactions of sCI with the water monomer and the water dimer have been found to be the most important bimolecular reactions to the tropospheric sCI loss rate, at least for the smallest carbonyl oxides; the products from these reactions (e.g. hydroxymethyl hydroperoxide, HMHP) are also of importance to the atmospheric oxidation cycle. The sCI can oxidise SO2 to form SO3, which can go on to form a significant amount of H2SO4 which is a key atmospheric nucleation species and therefore vital to the formation of clouds. The sCI can also react with carboxylic acids, carbonyl compounds, alcohols, peroxy radicals and hydroperoxides, and the products of these reactions are likely to be highly oxygenated species, with low vapour pressures, that can lead to nucleation and SOA formation over terrestrial regions.


Subject(s)
Air Pollutants/chemistry , Alkenes/chemistry , Atmosphere/chemistry , Carboxylic Acids/chemistry , Heterocyclic Compounds/chemistry , Ozone/chemistry , Hydroxides/chemistry , Oxidation-Reduction , Oxides/chemistry , Oxygen/chemistry , Sulfates/chemistry
3.
Geophys Res Lett ; 44(10): 5167-5177, 2017 05 28.
Article in English | MEDLINE | ID: mdl-28781391

ABSTRACT

A large fraction of atmospheric organic aerosol (OA) originates from natural emissions that are oxidized in the atmosphere to form secondary organic aerosol (SOA). Isoprene (IP) and monoterpenes (MT) are the most important precursors of SOA originating from forests. The climate impacts from OA are currently estimated through parameterizations of water uptake that drastically simplify the complexity of OA. We combine laboratory experiments, thermodynamic modeling, field observations, and climate modeling to (1) explain the molecular mechanisms behind RH-dependent SOA water-uptake with solubility and phase separation; (2) show that laboratory data on IP- and MT-SOA hygroscopicity are representative of ambient data with corresponding OA source profiles; and (3) demonstrate the sensitivity of the modeled aerosol climate effect to assumed OA water affinity. We conclude that the commonly used single-parameter hygroscopicity framework can introduce significant error when quantifying the climate effects of organic aerosol. The results highlight the need for better constraints on the overall global OA mass loadings and its molecular composition, including currently underexplored anthropogenic and marine OA sources.

4.
J Geophys Res Atmos ; 121(23): 14188-14200, 2016 12 16.
Article in English | MEDLINE | ID: mdl-28261536

ABSTRACT

Methane stored in seabed reservoirs such as methane hydrates can reach the atmosphere in the form of bubbles or dissolved in water. Hydrates could destabilize with rising temperature further increasing greenhouse gas emissions in a warming climate. To assess the impact of oceanic emissions from the area west of Svalbard, where methane hydrates are abundant, we used measurements collected with a research aircraft (Facility for Airborne Atmospheric Measurements) and a ship (Helmer Hansen) during the Summer 2014 and for Zeppelin Observatory for the full year. We present a model-supported analysis of the atmospheric CH4 mixing ratios measured by the different platforms. To address uncertainty about where CH4 emissions actually occur, we explored three scenarios: areas with known seeps, a hydrate stability model, and an ocean depth criterion. We then used a budget analysis and a Lagrangian particle dispersion model to compare measurements taken upwind and downwind of the potential CH4 emission areas. We found small differences between the CH4 mixing ratios measured upwind and downwind of the potential emission areas during the campaign. By taking into account measurement and sampling uncertainties and by determining the sensitivity of the measured mixing ratios to potential oceanic emissions, we provide upper limits for the CH4 fluxes. The CH4 flux during the campaign was small, with an upper limit of 2.5 nmol m-2 s-1 in the stability model scenario. The Zeppelin Observatory data for 2014 suggest CH4 fluxes from the Svalbard continental platform below 0.2 Tg yr-1. All estimates are in the lower range of values previously reported.

5.
J Geophys Res Atmos ; 121(23): 14257-14270, 2016 Dec 16.
Article in English | MEDLINE | ID: mdl-31413935

ABSTRACT

A stratified air mass enriched in methane (CH4) was sampled at ~600 m to ~2000 m altitude, between the north coast of Norway and Svalbard as part of the Methane in the Arctic: Measurements and Modelling campaign on board the UK's BAe-146-301 Atmospheric Research Aircraft. The approach used here, which combines interpretation of multiple tracers with transport modeling, enables better understanding of the emission sources that contribute to the background mixing ratios of CH4 in the Arctic. Importantly, it allows constraints to be placed on the location and isotopic bulk signature of the emission source(s). Measurements of δ13C in CH4 in whole air samples taken while traversing the air mass identified that the source(s) had a strongly depleted bulk δ13C CH4 isotopic signature of -70 (±2.1)‰. Combined Numerical Atmospheric-dispersion Modeling Environment and inventory analysis indicates that the air mass was recently in the planetary boundary layer over northwest Russia and the Barents Sea, with the likely dominant source of methane being from wetlands in that region.

6.
Sci Total Environ ; 506-507: 201-16, 2015 Feb 15.
Article in English | MEDLINE | ID: mdl-25460953

ABSTRACT

High-resolution measurements of gas and aerosols' chemical composition along with meteorological and turbulence parameters were performed over the Aegean Sea (AS) during an Etesian outbreak in the framework of the Aegean-GAME airborne campaign. This study focuses on two distinct Etesian patterns, with similarities inside the Marine Atmospheric Boundary Layer (MABL) and differences at higher levels. Under long-range transport and subsidence the pollution load is enhanced (by 17% for CO, 11% for O3, 28% for sulfate, 62% for organic mass, 47% for elemental carbon), compared to the pattern with a weaker synoptic system. Sea surface temperature (SST) was a critical parameter for the MABL structure, turbulent fluxes and pollutants' distribution at lower levels. The MABL height was below 500 m asl over the eastern AS (favoring higher accumulation), and deeper over the western AS. The most abundant components of total PM1 were sulfate (40-50%) and organics (30-45%). Higher average concentrations measured over the eastern AS (131 ± 76 ppbv for CO, 62.5 ± 4.1 ppbv for O3, 5.0 ± 1.1 µg m(-3) for sulfate, 4.7 ± 0.9 µg m(-3) for organic mass and 0.5 ± 0.2 µg m(-3) for elemental carbon). Under the weaker synoptic system, cleaner but more acidic air masses prevailed over the eastern part, while distinct aerosol layers of different signature were observed over the western part. The Aitken and accumulation modes contributed equally during the long-range transport, while the Aitken modes dominated during local or medium range transport.


Subject(s)
Air Movements , Air Pollutants/analysis , Air Pollution/statistics & numerical data , Environmental Monitoring , Aerosols/analysis , Chemical Phenomena , Mediterranean Sea , Meteorological Concepts , Oceans and Seas , Particulate Matter/analysis
7.
Indoor Air ; 24(5): 495-502, 2014 Oct.
Article in English | MEDLINE | ID: mdl-24512513

ABSTRACT

Criegee intermediates are formed in the ozonolysis of alkenes and play an important role in indoor chemistry, notably as a source of OH radicals. Recent studies have shown that these Criegee intermediates react very quickly with NO2 , SO2 , and carbonyls, and in this study, steady-state calculations are used to inspect the potential impact of these data on indoor chemistry. It is shown that these reactions could accelerate NO3 formation and SO2 removal in the indoor environment significantly. In addition, reaction between Criegee intermediates and halogenated carbonyls could provide a significant loss process indoors, where currently one does not exist.


Subject(s)
Air Pollutants/chemistry , Air Pollution, Indoor , Alkenes/chemistry , Nitrates/chemical synthesis , Sulfur Dioxide/chemistry , Ozone/chemistry
8.
Environ Sci Technol ; 40(21): 6674-81, 2006 Nov 01.
Article in English | MEDLINE | ID: mdl-17144295

ABSTRACT

The products arising from the ozonolysis of oleic acid (cis-9-octadecenoic acid) in solution have been studied using negative ion mode electrospray ionization ion trap mass spectrometry. Oleic acid is an important component of atmospheric organic aerosol and is a key model species in predicting aerosol physical and chemical characteristics. The four predicted reaction products, 1-nonanal, nonanoic acid, 9-oxononanoic acid, and azelaic acid, were all observed in roughly equal yields. In addition to these products a large number of higher molecular weight compounds were detected with m/z ratios of up to 1000 Daltons. Tandem mass spectrometry of these larger ions revealed thatthey represented a complex mixture of linear alpha-acyloxyalkyl hydroperoxides, secondary ozonides, and cyclic diperoxides, formed by reactions between ozonolysis products and Criegee intermediates. These comprise the first directly elucidated structures of large oligomeric species from oleic acid ozonolysis. The degree of oligomerization and hence molecular weight distribution was observed to increase with reaction time in solution.


Subject(s)
Chemistry, Organic/methods , Oleic Acid/analysis , Organic Chemicals/analysis , Ozone/chemistry , Aldehydes/analysis , Dicarboxylic Acids/analysis , Fatty Acids/analysis , Ions , Keto Acids/analysis , Mass Spectrometry , Models, Chemical , Molecular Weight , Oleic Acid/chemistry , Spectrometry, Mass, Electrospray Ionization , Time Factors
9.
Analyst ; 131(8): 892-4, 2006 Aug.
Article in English | MEDLINE | ID: mdl-17028721

ABSTRACT

The transduction signals from the immobilisation of a class I heavy chain, HLA-A2, on a layer guided acoustic plate mode device, followed by binding of beta(2)-microglobulin and subsequent selective binding of a target peptide are reported.


Subject(s)
Biosensing Techniques/methods , HLA-A2 Antigen/metabolism , Streptavidin/metabolism , Biosensing Techniques/instrumentation , Humans , Microscopy, Acoustic , Protein Folding , Protein Interaction Mapping , beta 2-Microglobulin/metabolism
10.
Br J Psychiatry ; 189: 367-72, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17012661

ABSTRACT

BACKGROUND: The extent to which depression impairs health-related quality of life (HRQoL) in the physically ill has not been clearly established. AIMS: To quantify the adverse influence of depression and anxiety, assessed at the time of first myocardial infarction and 6 months later, on the physical aspect of HRQoL 12 months after the infarction. METHOD: In all, 260 in-patients, admitted following first myocardial infarction, completed the Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36 assessment before discharge and at 6- and 12-month follow-up. RESULTS: Depression and anxiety 6 months after myocardial infarction predicted subsequent impairment in the physical aspects of HRQoL (attributable adjusted R(2)=9%, P<0.0005). These negative effects of depression and anxiety on outcome were mediated by feelings of fatigue. Depression and anxiety present before myocardial infarction did not predict HRQoL 12 months after myocardial infarction. CONCLUSIONS: Detection and treatment of depression and anxiety following myocardial infarction improve the patient's health-related quality of life.


Subject(s)
Anxiety Disorders/psychology , Depressive Disorder/psychology , Myocardial Infarction/psychology , Quality of Life , Age Factors , Female , Humans , Male , Middle Aged , Quality of Life/psychology , Risk Factors , Surveys and Questionnaires
11.
Psychol Med ; 34(6): 1083-92, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15554578

ABSTRACT

BACKGROUND: Depression affects outcome following myocardial infarction but the risk factors for such depression have been little studied. This study considered whether the causes of depression occurring before and after myocardial infarction were similar to those of depression in the general population. METHOD: Consecutive patients admitted to hospital following their first myocardial infarction were interviewed with the Schedule for Clinical Assessment in Neuropsychiatry to detect psychiatric disorders and the Life Events and Difficulties Schedule to assess recent stress. Participants completed the Hospital Anxiety and Depression Scale (HADS) at entry to the study and 1 year later and the risk factors associated with a high score at both times were assessed. RESULTS: Of 314 (88% of eligible) patients who were recruited, 199 (63%) were male and 63 (20%) had depressive disorders. Logistic regression identified the following as independently associated with depressive disorder that had been present for at least I month before the myocardial infarction: younger age, female sex, past psychiatric history, social isolation, having marked non-health difficulties and lack of a close confidant. At follow-up 269/298 (90%) responded; of 189 participants not depressed at first assessment, 39 (21%) became depressed by the 1 year follow-up. Logistic regression identified frequent angina as the only significant predictor of raised HADS scores at 12 months. CONCLUSIONS: Depression developing during the year following myocardial infarction does not have the same risk factors as that which precedes myocardial infarction. Further clarification of the mechanisms linking depression to poor outcome may require separation consideration of pre- and post-myocardial infarction depression, and its risk factors.


Subject(s)
Depressive Disorder/etiology , Myocardial Infarction/psychology , Age Factors , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Myocardial Infarction/complications , Psychiatric Status Rating Scales , Risk Factors , Sex Factors , Social Support , Time Factors
12.
Heart ; 90(5): 518-22, 2004 May.
Article in English | MEDLINE | ID: mdl-15084548

ABSTRACT

OBJECTIVE: To assess the role of depression and lack of social support before myocardial infarction (MI) in determining outcome in a large representative sample of patients admitted after MI in the UK. DESIGN: Prospective cohort design. PATIENTS: 1034 consecutive patients were screened 3-4 days after MI. MAIN OUTCOME MEASURES: Mortality and further cardiac events over one year after an MI. RESULTS: At 12 months' follow up mortality and further cardiac events were assessed in 583 of 654 eligible patients (90% response); 140 of 589 for whom baseline data were collected (23.8%) were depressed before their MI. Patients who were depressed before their MI were not more likely to die (mortality 5.2% v 5.0% of non-depressed patients) or suffer further cardiac events (cardiac events rate 20.7% v 20.3% of non-depressed patients). After controlling for demographic factors and severity of MI, the absence of a close confidant predicted further cardiac events (hazard ratio 0.57, p = 0.022). CONCLUSION: Lack of a close confidant but not depression before MI was associated with adverse outcome after MI in this sample. This association may be mediated by unhealthy behaviours and lack of compliance with medical recommendations, but it is also compatible with difficulties in early life leading to heart disease.


Subject(s)
Depressive Disorder/complications , Myocardial Infarction/psychology , Age Factors , Aged , Aged, 80 and over , Anxiety/etiology , Depressive Disorder/mortality , England/epidemiology , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Myocardial Infarction/mortality , Recurrence , Social Support
13.
Anal Chem ; 75(7): 1573-7, 2003 Apr 01.
Article in English | MEDLINE | ID: mdl-12705587

ABSTRACT

A chemically coated piezoelectric sensor has been developed for the determination of PAHs in the liquid phase. An organic monolayer attached to the surface of a gold electrode of a quartz crystal microbalance (QCM) via a covalent thiol-gold link complete with an ionically bound recognition element has been produced. This study has employed the PAH derivative 9-anthracene carboxylic acid which, once bound to the alkane thiol, functions as the recognition element. Binding of anthracene via pi-pi interaction has been observed as a frequency shift in the QCM with a detectability of the target analyte of 2 ppb and a response range of 0-50 ppb. The relative response of the sensor altered for different PAHs despite pi-pi interaction being the sole communication between recognition element and analyte. It is envisaged that such a sensor could be employed in the identification of key marker compounds and, as such, give an indication of total PAH flux in the environment.


Subject(s)
Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Environmental Pollutants/analysis , Polycyclic Aromatic Hydrocarbons/analysis , Anthracenes/chemistry , Quartz
14.
Analyst ; 127(8): 1024-6, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12195940

ABSTRACT

An acoustic wave sensor coated with an artificial biomimetic recognition element has been developed to selectively screen for nandrolone in the liquid phase. A highly specific covalently imprinted polymer (MIP) was spin coated onto one electrode of a quartz crystal microbalance (QCM) as a thin permeable film. Selective rebinding of the nandrolone was observed as a frequency shift in the QCM for concentrations up to 0.2 ppm with the sensor binding shown to favour nandrolone over analogous compounds.


Subject(s)
Anabolic Agents/urine , Nandrolone/urine , Substance Abuse Detection/methods , Electrochemistry , Electrophoresis/instrumentation , Epitestosterone/urine , Flow Injection Analysis , Humans , Polymers , Sensitivity and Specificity , Testosterone/urine
15.
J Endourol ; 15(6): 641-4, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11552791

ABSTRACT

BACKGROUND AND PURPOSE: Bladder surface hyperpermeability may be a factor in the etiology of interstitial cystitis (IC). We evaluated the intravesical instillation of ethanol as a quantitative measure of bladder hyperpermeability in an experimental model in male New Zealand White rabbits. MATERIALS AND METHODS: In two study groups (N = 4 each), the glycosaminoglycan (GAG) layer on the bladder surface was disrupted via a 10-minute exposure to 10% protamine sulfate (PS). The study groups then underwent bladder instillation of 10% (group 1) and 20% (group 2) ethanol. The control groups underwent bladder instillation of either 10% (N = 2) or 20% ethanol (N = 2) without exposure to PS. Ten minutes after ethanol instillation, venous blood was sampled, and the ethanol concentration was determined by mass spectrometry. Study group animals were sacrificed after blood sampling. Control animals were sacrificed at 2 weeks and 4 weeks for histologic examination of the bladder. RESULTS: The blood alcohol concentration was 0 in the control animals exposed to 10% or 20% ethanol, 14.5+/-2.2 ng/dL in the 10% ethanol study group, and 25.6+/-3.6 ng/dL in the 20% ethanol study group. Histologic examination of bladder tissue revealed no ethanol-induced abnormalities in the control animals. CONCLUSION: Intravesical instillation of 10% and 20% ethanol is a safe and reliable quantitative measure of bladder hyperpermeability in an animal model. Clinical trials are ongoing to evaluate the utility of the intravesical ethanol test for diagnosing IC and monitoring the response to therapy.


Subject(s)
Ethanol/pharmacokinetics , Urinary Bladder/metabolism , Animals , Ethanol/blood , Ethanol/pharmacology , Male , Osmolar Concentration , Permeability , Rabbits , Reference Values , Safety , Urinary Bladder/drug effects , Veins
16.
Anal Chem ; 73(17): 4225-8, 2001 Sep 01.
Article in English | MEDLINE | ID: mdl-11569813

ABSTRACT

A piezoelectric sensor coated with an artificial biomimetic recognition element has been developed for the determination of L-menthol in the liquid phase. A highly specific noncovalently imprinted polymer (MIP) was cast in situ on to the surface of a gold-coated quartz crystal microbalance (QCM) electrode as a thin permeable film. Selective rebinding of the target analyte was observed as a frequency shift quantified by piezoelectric microgravimetry with the QCM. The detectability of L-menthol was 200 ppb with a response range of 0-1.0 ppm. The response of the MIP-QCM to a range of monoterpenes was investigated with the sensor binding menthol in favor of analogous compounds. The sensor was able to distinguish between the D- and L-enantiomers of menthol owing to the enantioselectivity of the imprinted sites. To our knowledge, this is the first report describing enantiomeric resolution within an MIP utilizing a single monomer-functional moiety interaction. It is envisaged that this technique could be employed to determine the concentration of terpenes in the atmosphere.

17.
J Endourol ; 14(6): 483-8, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10954303

ABSTRACT

BACKGROUND AND PURPOSE: A significant problem associated with catheterization in the urinary tract is the encrustation of the catheter materials. One approach to reducing encrustation is to alter the surface properties of the catheters. We evaluated the effectiveness of coating with pentosanpolysulfate (PPS), a semisynthetic polysaccharide similar to heparin, in reducing encrustation and the foreign-body inflammatory response to silicone stents in the bladders of male New Zealand White rabbits. MATERIALS AND METHODS: Sixteen rabbits were divided into three groups to receive placement in their bladders of uncoated (N = 7), PPS-coated (N = 7), or sham matrix-processed silicone rings (N = 2) via open cystotomy. After 50 days of maintenance on normal food and water, all rabbits were sacrificed, and the air-dried, unfixed silicone ring surfaces were examined by scanning electron microscopy. Bladders and remaining silicone rings were removed and preserved separately. Silicone rings, cleaned of all encrustation, were stained with toluidene blue to determine the presence or absence of PPS coating on the surface. RESULTS: Histologic examination revealed normal tissue in bladder sections exposed to coated silicone rings and an inflammatory response in sections from bladders having uncoated silicone rings. Coating with PPS was associated with an eightfold reduction in the amount of encrustation of silicone and a marked reduction in the inflammatory response of the bladder wall to the foreign body. CONCLUSIONS: A PPS coating may be useful in reducing the encrustation of long-term indwelling silicone stents or catheters in the human urinary tract.


Subject(s)
Anticoagulants/pharmacology , Foreign-Body Reaction/prevention & control , Pentosan Sulfuric Polyester/pharmacology , Urinary Catheterization/adverse effects , Urinary Catheterization/instrumentation , Animals , Equipment Design , Inflammation , Male , Rabbits , Silicones , Stents/adverse effects , Urinary Bladder/pathology
18.
Anesth Analg ; 72(5): 716-7, 1991 May.
Article in English | MEDLINE | ID: mdl-2018236
19.
Kidney Int ; 30(6): 920-3, 1986 Dec.
Article in English | MEDLINE | ID: mdl-3820942

ABSTRACT

UNLABELLED: Pulmonary gas exchange was continuously measured in 13 mechanically ventilated patients during 24 hemodialyses for acute renal failure. Minute-ventilation was maintained constant by controlled ventilation and gas exchange was continuously measured by a mass-spectrometer system. Three groups were compared: a cuprophan membrane with an acetate dialysate; a polyacrilonitrile membrane (PAN) with an acetate dialysate; and PAN with a bicarbonate dialysate. Arterial PO2 and the O2 alveolar-arterial gradient were the same regardless of the membrane used. [H+] mildly decreased with all dialysates used. Arterial PCO2 decreased only with the acetate dialysate. O2 consumption increased, up to 20 +/- 5% of the initial values during hemodialysis, and remained increased during the two hours following the hemodialysis. Respiratory exchange ratio was lower after than before the hemodialysis. IN CONCLUSION: the maintenance of a constant minute ventilation prevented hemodialysis induced hypoxemia. VO2 increased during hemodialysis.


Subject(s)
Pulmonary Gas Exchange , Renal Dialysis , Acute Kidney Injury/therapy , Adult , Aged , Blood Gas Analysis , Female , Humans , Leukocyte Count , Male , Middle Aged , Oxygen/metabolism , Partial Pressure , Platelet Count
20.
Am Rev Respir Dis ; 133(6): 999-1001, 1986 Jun.
Article in English | MEDLINE | ID: mdl-3521420

ABSTRACT

This study was designed to determine whether acute alterations in oxygen delivery (DO2) induced by the institution of positive end-expiratory pressure (PEEP) would affect oxygen uptake (VO2) in patients with adult respiratory distress syndrome (ARDS). In 8 patients with ARDS who exhibited normal blood lactate concentrations, we evaluated the relationship between DO2 and VO2 during 3 consecutive periods: intermittent positive pressure ventilation (IPPV), continuous positive pressure ventilation (CPPV) with a 10 cm H2O PEEP, and finally CPPV with volume loading. Oxygen uptake was measured directly with a mass spectrometer system. Oxygen delivery was calculated as the product of cardiac output (thermodilution) and arterial blood oxygen content (Lex-O2-Con analyzer). By comparison with the IPPV period, application of PEEP led to a decrease of DO2, which returned to baseline values when volume loading was added to PEEP. In none of the patients did VO2 parallel the changes of DO2. They demonstrated, therefore, a properly enhanced oxygen extraction during the PEEP-induced decrease of DO2. We conclude that, when measured independently, DO2 and VO2 are not correlated in patients with ARDS with normal blood lactate who are mechanically ventilated with PEEP.


Subject(s)
Lactates/blood , Oxygen Consumption , Respiratory Distress Syndrome/physiopathology , Adult , Biological Availability , Cardiac Output , Female , Humans , Male , Middle Aged , Positive-Pressure Respiration/methods , Respiratory Distress Syndrome/blood
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