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Effects of Hypercapnia on BP in Hypoalbuminemic and Nagase Analbuminemic Rats^*

Jose L. Gómez, MD; Kyle J. Gunnerson, MD; Mingchen Song, MD, PhD; Jinyou Li, PhD and John A. Kellum, MD, FCCP

^* From the MANTRA Laboratory, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. Presently at Virginia Commonwealth University Reanimation Engineering and Shock Center Laboratory, Departments of Anesthesiology/Critical Care and Emergency Medicine, Virginia Commonwealth University Medical Center, Richmond, VA.

Correspondence to: John A. Kellum, MD, FCCP, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Scaife Hall, Room 608, 3550 Terrace St, Pittsburgh, PA 15261; e-mail: kellumja{at}ccm.upmc.edu

Abstract

Study objective: To determine if animals with abnormally low albumin levels are more susceptible to the effects of hypercapnia on BP compared to normal animals.

Design: Prospective, controlled laboratory experiment.

Setting: University research laboratory.

Animals: Eighteen male Sprague-Dawley rats: 6 rats 10 to 12 weeks old (young Sprague-Dawley [YSD]), 6 rats 6 to 9 months old (old Sprague-Dawley [OSD]), and 6 rats 10 to 12 weeks old (Nagase analbuminemic mutant Sprague-Dawley [NAR]).

Methods: Under general anesthesia and paralysis, we varied the PaCO₂ by changing the respiratory rate on mechanical ventilation. Mean arterial pressure (MAP) was monitored in a continuous fashion. We obtained arterial blood for blood gas and electrolyte analysis, and nitric oxide (NO) production.

Results: OSD rats had reduced serum albumin, while NAR rats were analbuminemic. Although NAR animals had a decreased buffer capacity compared to age-matched control animals (0.010 vs 0.013, p < 0.05), the MAP decreased in an identical fashion in all three groups. NO production increased with hypercapnia but was similar in all three groups. However, NAR rats had consistently higher plasma strong ion gap (2.8 to 4.1 mEq/L greater) compared to either YSD or OSD rats (p < 0.01), and baseline strong ion difference (mean ± SD) was significantly lower in NAR rats (28.7 ± 2.1 mEq/L) compared to either YSD rats (33.0 ± 5.1 mEq/L) or OSD rats (31.2 ± 5.1 mEq/L) [p < 0.05].

Conclusions: These findings suggest that analbuminemic or hypoalbuminemic rats are not more susceptible to hypercapnia-induced hemodynamic instability. Baseline values for apparent strong ion difference are lower in NA rats consistent with a reduced buffer base resulting from analbuminemia.

Key Words: acid-base balance • analbuminemia • BP • hypercapnia • hypoalbuminemia • pH

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