tailieunhanh - Báo cáo y học: "Another explanation for decreased oxygen consumption in lactic acidosis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Another explanation for decreased oxygen consumption in lactic acidosis. | Rosival Critical Care 2010 14 427 http content 14 4 427 CRITICAL CARE LETTER L_ Another explanation for decreased oxygen consumption in lactic acidosis Viktor Rosival See related research by Protti etal. http content 14 1 R22 In their recent paper Protti and colleagues reported depressed oxygen consumption in patients with lactic acidosis due to biguanide intoxication and they suppose that the cause is inhibited mitochondrial respiration 1 . Another explanation for depressed oxygen consumption in these patients is also possible however. If the blood pH is very low glucose utilization is decreased 2 because the glycolytic enzyme phosphofructokinase is pH dependent -with decreasing pH its activity is also decreasing 3 . Glucose utilization is an oxygen-consuming process C6H12O6 6O2 6CO2 6H2O The consequence of decreased utilization of glucose is thus also decreased oxygen consumption. The patients reported by Protti and colleagues had on admission very low blood pH of and systemic oxygen consumption of 67 28 ml min m 2 1 . Systemic oxygen consumption normalized within the next 4872 hours and Systemic O2 consumption was positively associated with arterial pH P . According to Tables 2 and 3 1 arterial pH reached normal values on days 2 to 3. Depressed oxygen consumption in patients reported by Protti and colleagues can thus be explained by their very low blood pH. Authors response Alessandro Protti and Luciano Gattinoni We thank Dr Rosival for his stimulating comment. Whether acidosis has an impact on oxygen consumption VO2 remains unclear. In vitro several studies have demonstrated that tissue VO2 only starts to diminish when the pH falls below 6 to 4 5 . In vivo both animal and clinical studies have reported normal or even Correspondence rosivalv@ SYNLAB Department of Laboratory Medicine Derer s Hospital Limbová 5 SK-833 05 Bratislava Slovakia 2 BioMed Central 2010 BioMed Central Ltd increased whole-body .

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