Sunday, June 3, 2012

Painful, detailed stuff?

One can hope.  I want to try my hand at analyzing one article of Ray's.  Here we go:

Protective CO2 and Aging

"The therapeutic effects of increasing carbon dioxide are being more widely recognized in recent years. Even Jane Brody, the NY Times writer on health topics, has favorably mentioned the use of the Buteyko method for asthma, and the idea of “permissive hypercapnia” during mechanical ventilation, to prevent lung damage from excess oxygen, has been discussed in medical journals. But still very few biologists recognize its role as a fundamental, universal protective factor. I think it will be helpful to consider some of the ways carbon dioxide might be controlling situations that otherwise are poorly understood."

Ray had mentioned in a few places that some clinicians are doing this "permissive hypercapnia" thing with their ventilated patients.  I unfortunately have not come across a setting where this is considered "best practice", but I am hopeful.  If only to see it in action in real life.  But before we get to that, Let's touch upon the phenomenon that is Jane Brody and her obscure 'Zine, The New York Times.  Jane Brody talks Buteyko

I think that she did a decent job writing the thing.  She's extremely conventional in her viewpoints and I think she showed remarkable open-mindedness in her treatment of it.  To be honest, there isn't much to the whole Buteyko thing that I can see.  It's just "Bohr effect... albumin.. hemoglobin....oxygen... etc."  Which is cool.  The important part is that carbon dioxide is awesome and they know it.

Now on to permissive hypercapnia.  From what I've been reading and watching (youtube it!), it's mostly used for people in "Acute respiratory distress".  At this point, they don't even know what the best setting is.  There is no official "best practice" for it yet that I know of.  The protocol consists of "cut tidal volume in half and tinker if they twitch too much."  No really.  From the conventional perspective, most of the damage comes from the air pressure on the alveoli.  Well, it comes from a few places.

1.  The air pressure itself (barotrauma) 

2.  The stress caused from the repetitive inflating and collapsing of the alveoli (atelectrauma)

3.  Excessive tidal volumes (volutrauma)

There is a concern for oxygen toxicity, but it's low on the list.  

The frustrating part is they do not view carbon dioxide as having any protective effect in and of itself.  At least not commonly.  In fact, they have special machines that filter the CO2 out of a person receiving this protocol.  So it would seem that indeed few biologists are on board with this idea.  

I may continue with this and I may not.  There's a lot of paragraphs in this article and it's seriously cutting into my "Netflix and chicharrones" time.

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