{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T20:11:59Z","timestamp":1790539919301,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Understanding the physiology of CO2 stores mobilization is a prerequisite for intermittent extracorporeal CO2 removal (ECCO2R) in patients with chronic hypercapnia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the dynamics of CO2 stores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifteen pigs (61.7\u2009\u00b1\u20094.3 kg) were randomized to 48 hours of hyperventilation (group \u201cHyper,\u201d n\u2009=\u20094); 48 hours of hypoventilation (group \u201cHypo,\u201d n\u2009=\u20094); 24 hours of hypoventilation plus 24 hours of normoventilation (group \u201cHypo-Baseline,\u201d n\u2009=\u20094); or 24 hours of hypoventilation plus 24 hours of hypoventilation plus ECCO2R (group \u201cHypo-ECCO2R,\u201d n\u2009=\u20093). Forty-eight hours after randomization, the current V. \u00a0e was reduced by 50% in every pig.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>We evaluated V. \u00a0co2, V. \u00a0o2, and metabolic V. \u00a0co2 (V. \u00a0o2 times the metabolic respiratory quotient). Changes in the CO2 stores were calculated as V. \u00a0co2\u2009\u2212\u2009metabolic V\u0307co2. After 48 hours, the CO2 stores decreased by 0.77\u2009\u00b1\u20090.17 l kg\u22121 in group Hyper and increased by 0.32\u2009\u00b1\u20090.27 l kg\u22121 in group Hypo (P\u2009=\u20090.030). In group Hypo-Baseline, they increased by 0.08\u2009\u00b1\u20090.19 l kg\u22121, whereas in group Hypo-ECCO2R, they decreased by 0.32\u2009\u00b1\u20090.24 l kg\u22121 (P\u2009=\u20090.197). In the second 24-hour period, in groups Hypo-Baseline and Hypo-ECCO2R, the CO2 stores decreased by 0.15\u2009\u00b1\u20090.09 l kg\u22121 and 0.51\u2009\u00b1\u20090.06 l kg\u22121, respectively (P\u2009=\u20090.002). At the end of the experiment, the 50% reduction of V. \u00a0e caused a PaCO2 rise of 9.3\u2009\u00b1\u20091.1, 32.0\u2009\u00b1\u20095.0, 16.9\u2009\u00b1\u20091.2, and 11.7\u2009\u00b1\u20092.0 mm Hg h\u22121 in groups Hyper, Hypo, Hypo-Baseline, and Hypo-ECCO2R, respectively (P\u2009&amp;lt;\u20090.001). The PaCO2 rise was inversely related to the previous CO2 stores mobilization (P\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CO2 from body stores can be mobilized over 48 hours without reaching a steady state. This provides a physiological rationale for intermittent ECCO2R in patients with chronic hypercapnia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202005-1687oc","type":"journal-article","created":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T17:38:42Z","timestamp":1597858722000},"page":"318-327","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":28,"title":["Mobilizing Carbon Dioxide Stores. An Experimental Study"],"prefix":"10.1093","volume":"203","author":[{"given":"Lorenzo","family":"Giosa","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1626-1278","authenticated-orcid":false,"given":"Mattia","family":"Busana","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Bonifazi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Romitti","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vassalli","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iacopo","family":"Pasticci","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo Maria","family":"Macr\u00ec","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"D\u2019Albo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Collino","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center \u2013 IRCCS, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gatta","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care, Rimini \u2013 Riccione, AUSL Romagna, Rimini, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Michela","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onnen","family":"Moerer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Iapichino","sequence":"additional","affiliation":[{"name":"Past Professor of Anesthesia, and Intensive Care, University of Milan, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Meissner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Medical University of G\u00f6ttingen, 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