A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome
Acute respiratory distress syndrome (ARDS) represents an acute diffuse inflammation of the lungs triggered by different causes, uniformly leading to a noncardiogenic pulmonary edema with inhomogeneous densities in lung X-ray and lung CT scan and acute hypoxemia. Edema formation results in “heavy” lu...
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doaj-32cdea16b982476781b2bbc0e4c747b62021-01-20T16:32:28ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-01-011110.3389/fphys.2020.588248588248A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory SyndromeSwen Hülsmann0Sepideh Khabbazzadeh1Konrad Meissner2Michael Quintel3Michael Quintel4Universitätsmedizin Göttingen, Klinik für Anästhesiologie, Georg-August-Universität, Göttingen, GermanyUniversitätsmedizin Göttingen, Klinik für Anästhesiologie, Georg-August-Universität, Göttingen, GermanyUniversitätsmedizin Göttingen, Klinik für Anästhesiologie, Georg-August-Universität, Göttingen, GermanyUniversitätsmedizin Göttingen, Klinik für Anästhesiologie, Georg-August-Universität, Göttingen, GermanyDONAUISAR Klinikum Deggendorf, Deggendorf, GermanyAcute respiratory distress syndrome (ARDS) represents an acute diffuse inflammation of the lungs triggered by different causes, uniformly leading to a noncardiogenic pulmonary edema with inhomogeneous densities in lung X-ray and lung CT scan and acute hypoxemia. Edema formation results in “heavy” lungs, inducing loss of compliance and the need to spend more energy to “move” the lungs. Consequently, an ARDS patient, as long as the patient is breathing spontaneously, has an increased respiratory drive to ensure adequate oxygenation and CO2 removal. One would expect that, once the blood gases get back to “physiological” values, the respiratory drive would normalize and the breathing effort return to its initial status. However, in many ARDS patients, this is not the case; their respiratory drive appears to be upregulated and fully or at least partially detached from the blood gas status. Strikingly, similar alteration of the respiratory drive can be seen in patients suffering from SARS, especially SARS-Covid-19. We hypothesize that alterations of the renin-angiotensin-system (RAS) related to the pathophysiology of ARDS and SARS are involved in this dysregulation of chemosensitive control of breathing.https://www.frontiersin.org/articles/10.3389/fphys.2020.588248/fullacute lung damagerespiratory chemoreflexesneuronal control of breathingbrainstemhomeostasis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Swen Hülsmann Sepideh Khabbazzadeh Konrad Meissner Michael Quintel Michael Quintel |
spellingShingle |
Swen Hülsmann Sepideh Khabbazzadeh Konrad Meissner Michael Quintel Michael Quintel A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome Frontiers in Physiology acute lung damage respiratory chemoreflexes neuronal control of breathing brainstem homeostasis |
author_facet |
Swen Hülsmann Sepideh Khabbazzadeh Konrad Meissner Michael Quintel Michael Quintel |
author_sort |
Swen Hülsmann |
title |
A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome |
title_short |
A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome |
title_full |
A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome |
title_fullStr |
A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome |
title_full_unstemmed |
A Potential Role of the Renin-Angiotensin-System for Disturbances of Respiratory Chemosensitivity in Acute Respiratory Distress Syndrome and Severe Acute Respiratory Syndrome |
title_sort |
potential role of the renin-angiotensin-system for disturbances of respiratory chemosensitivity in acute respiratory distress syndrome and severe acute respiratory syndrome |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2021-01-01 |
description |
Acute respiratory distress syndrome (ARDS) represents an acute diffuse inflammation of the lungs triggered by different causes, uniformly leading to a noncardiogenic pulmonary edema with inhomogeneous densities in lung X-ray and lung CT scan and acute hypoxemia. Edema formation results in “heavy” lungs, inducing loss of compliance and the need to spend more energy to “move” the lungs. Consequently, an ARDS patient, as long as the patient is breathing spontaneously, has an increased respiratory drive to ensure adequate oxygenation and CO2 removal. One would expect that, once the blood gases get back to “physiological” values, the respiratory drive would normalize and the breathing effort return to its initial status. However, in many ARDS patients, this is not the case; their respiratory drive appears to be upregulated and fully or at least partially detached from the blood gas status. Strikingly, similar alteration of the respiratory drive can be seen in patients suffering from SARS, especially SARS-Covid-19. We hypothesize that alterations of the renin-angiotensin-system (RAS) related to the pathophysiology of ARDS and SARS are involved in this dysregulation of chemosensitive control of breathing. |
topic |
acute lung damage respiratory chemoreflexes neuronal control of breathing brainstem homeostasis |
url |
https://www.frontiersin.org/articles/10.3389/fphys.2020.588248/full |
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