<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092016000300204</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hiperlactatemia por estados de hiperventilación y alcalosis respiratoria: reporte de tres casos y revisión de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Hyperlactatemia in hyperventilation and respiratory alkalosis: report of three cases and literature review]]></article-title>
<article-title xml:lang="pt"><![CDATA[Hiperlactatemia por hiperventilação e alcalose respiratória: relato de três casos e revisão da literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manzur Sandoval]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2016</year>
</pub-date>
<volume>30</volume>
<numero>3</numero>
<fpage>204</fpage>
<lpage>208</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092016000300204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092016000300204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092016000300204&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Los estados de hiperventilación se acompañan de alcalosis respiratoria e hipocapnia. La hiperventilación se genera cuando existe algún estímulo que genera el inicio del impulso ventilatorio en el centro respiratorio (hipoxemia), cuando existe algún trastorno intrínseco o estimulación extrínseca del centro respiratorio que condiciona que éste genere aumento de la ventilación de manera inapropiada (origen psicógeno) o ante la presencia de impulsos aferentes del parénquima pulmonar por la presencia de una neumopatía subyacente (fibrosis pulmonar). Los estados de hiperventilación son una causa poco reconocida de hiperlactatemia, lo cual puede generar confusión y medidas diagnósticas y terapéuticas inadecuadas. Los mecanismos que explican la hiperlactatemia en los estados de hiperventilación son probablemente una disminución de la depuración consecuencia de los efectos de la alcalosis y la hipocapnia en los diversos lechos circulatorios, aunque esto no está bien definido. En la presente revisión se exponen tres casos de estados de hiperventilación en los cuales se documentó hiperlactatemia, la cual se revirtió al eliminar el estímulo que desencadenó la ventilación excesiva. Se revisarán además los mecanismos fisiopatológicos involucrados en la generación de alcalosis respiratoria e hipocapnia en los estados de hiperventilación, así como las teorías propuestas para explicar los niveles séricos aumentados de lactato en este escenario clínico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Hyperventilation is accompanied by respiratory alkalosis and hypocapnia. Hyperventilation is generated when there is any stimulus that generates the start of the ventilatory drive in the respiratory center (hypoxemia), when there is some intrinsic or extrinsic stimulation of the respiratory center which generates increased ventilation improperly (psychogenic mechanism) or the presence of afferent impulses of the lung parenchyma by the presence of underlying lung disease (pulmonary fibrosis). Conditions that generate hyperventilation are an under-recognized cause of hyperlactatemia, which can cause confusion and inadequate diagnostic and therapeutic measures. The mechanisms explaining hyperlactatemia in hyperventilation are probably decreased clearance due to the effects of alkalosis and hypocapnia in various circulatory beds, although this is not well defined. We review three cases of hyperventilation in which it was documented hyperlactatemia which was reversed by removing the stimulus that triggered excessive ventilation. The pathophysiological mechanisms involved in generating respiratory alkalosis and hypocapnia in hyperventilation and the theories proposed to explain the increased serum levels of lactate in this clinical setting are also reviewed.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: Os estados de hiperventilação são acompanhados por alcalose respiratória e hipocapnia. A hiperventilação é originada quando existe um estímulo que produz o início do impulso ventilatório no centro respiratório (hipoxemia), com algum desordem intrínseco ou uma estimulação extrínseca do centro respiratório, que condiciona que este gere o aumento da ventilação inadequada (origem psicogénica), ou a presença de impulsos aferentes do parênquima pulmonar pela existência de uma neumopatia subjacente (fibrose pulmonar). Os estados de hiperventilação são uma causa pouco reconhecida de hiperlactatemia que pode causar confusão e medidas diagnósticas e terapêuticas inadequadas. Os mecanismos que explicam a hiperlactatemia nos estados de hiperventilação são provavelmente uma diminuição da depuração devido aos efeitos da alcalose e hipocapnia nos diversos leitos circulatórios, embora isso não esteja bem definido. Nesta revisão, apresentamos três casos de estados de hiperventilação em que foi documentado hiperlactatémia que se reverteu após a remoção do estímulo que provocou a ventilação excessiva. Também foram revisados os mecanismos fisiopatológicos envolvidos na geração da alcalose respiratória e hipocapnia nos estados de hiperventilação, bem como as teorias propostas para explicar o aumento dos níveis séricos de lactato neste cenário clínico.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hiperventilación]]></kwd>
<kwd lng="es"><![CDATA[alcalosis respiratoria]]></kwd>
<kwd lng="es"><![CDATA[hipocapnia]]></kwd>
<kwd lng="es"><![CDATA[hiperlactatemia]]></kwd>
<kwd lng="en"><![CDATA[Hyperventilation]]></kwd>
<kwd lng="en"><![CDATA[respiratory alkalosis]]></kwd>
<kwd lng="en"><![CDATA[hypocapnia]]></kwd>
<kwd lng="en"><![CDATA[hyperlactatemia]]></kwd>
<kwd lng="pt"><![CDATA[Hiperventilação]]></kwd>
<kwd lng="pt"><![CDATA[alcalose respiratória]]></kwd>
<kwd lng="pt"><![CDATA[hipocapnia]]></kwd>
<kwd lng="pt"><![CDATA[hiperlactatemia]]></kwd>
</kwd-group>
</article-meta>
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