Engineered algal systems for the treatment of anaerobic digestate: A meta-analysis.

The objective of this review was to provide quantitative insights into algal growth and nutrient removal in anaerobic digestate. To synthesize the relevant literature, a meta-analysis was conducted using data from 58 articles to elucidate key factors that impact algal biomass productivity and nutrient removal from anaerobic digestate. On average, algal biomass productivity in anaerobic digestate was significantly lower than that in synthetic control media (p < 0.05) but large variation in productivity was observed. A mixed-effects multiple regression model across study revealed that biological or chemical pretreatment of digestate significantly increase productivity (p < 0.001). In contrast, the commonly used practice of digestate dilution was not a significant factor in the model. High initial total ammonia nitrogen suppressed algal growth (p = 0.036) whereas initial total phosphorus concentration, digestate sterilization, CO2 supplementation, and temperature were not statistically significant factors. Higher growth corresponded with significantly higher NH4-N and phosphorus removal with a linear relationship of 6.4 mg NH4-N and 0.73 mg P removed per 100 mg of algal biomass growth (p < 0.001). The literature suggests that suboptimal algal growth in anaerobic digestate could be due to factors such as turbidity, high free ammonia, and residual organic compounds. This analysis shows that non-dilution approaches, such as biological or chemical pretreatment, for alleviating algal inhibition are recommended for algal digestate treatment systems.

Moisture content and aeration control mineral nutrient solubility in poultry litter.

Poultry litter waste is typically land-applied as a soil amendment but repeated application in the vicinity of poultry houses has led to phosphorus accumulation in soil. Such application can also lead to runoff that causes eutrophication. Most farmers store litter under dry conditions or compost the litter prior to land application, but it is not clear if these approaches are best from a nutrient management-perspective. The objective of this study was to investigate the effects of moisture content and active aeration on soluble mineral forms of nitrogen and phosphorus in poultry litter incubated for roughly one month. Mineral forms of nutrients are immediately plant-available upon field application and also most conducive to low-cost stripping and recovery methods. Litters were incubated at 50% and 70% moisture content with and without active aeration. Litter aeration led to significant ammonia losses and a consequent decline in litter pH but it had no effect on phosphate solubility. Moisture content during litter incubation governed the levels of plant-available phosphate and nitrification. High (70%) moisture led to 41%-78% higher plant-available phosphate (4.2-4.8 mg/g litter) compared to litters with 50% moisture content (2.7-3.0 mg/g litter). In contrast, the 50% moisture litters experienced 5-6 fold higher levels of nitrification (0.11-0.12 mg NO3-N/g litter) than litters with 70% moisture content (0.02 mg NO3-N/g litter), regardless of aeration. The implication is that lower-moisture litter storage is likely best for field application because phosphate is less soluble under neutral-alkaline conditions and therefore less likely to end up in runoff. In contrast, higher-moisture litter storage may be amenable to low-cost processes to leach and recover phosphate from litter.

Algal photosynthetic aeration increases the capacity of bacteria to degrade organics in wastewater.

Wastewater treatment is an energy-intensive process and a net emitter of greenhouse gas emissions. A large fraction of these emissions is due to intensive aeration of aerobic bacteria to facilitate break-down of organic compounds. Algae can generate dissolved oxygen at levels in excess of saturation, and therefore hold the potential to partially displace or complement mechanical aeration in wastewater treatment processes. The objective of this study was to develop an internally consistent experimental and modeling approach to test the hypothesis that algal photosynthetic aeration can speed the removal of organic constituents by bacteria. This framework was developed using a simplified wastewater treatment process consisting of a model bacteria (Escherichia coli), a model algae (Auxenochlorella protothecoides), and a single carbon source that was consumable by bacteria only. This system was then tested both with and without the presence of algae. A MATLAB model that considered mass transfer and biological kinetics was used to estimate the production and consumption of O2 and CO2 by algae and bacteria. The results indicated that the presence of algae led to 18-66% faster removal of COD by bacteria, and that roughly one-third of biochemical oxygen demand was offset by algal photosynthetic aeration.

Minimum 2-year clinical outcomes after superior capsule reconstruction compared with reverse total shoulder arthroplasty for the treatment of irreparable posterosuperior rotator cuff tears in patients younger than 70 years.

BACKGROUND: To compare clinical outcomes following arthroscopic superior capsule reconstruction (SCR) using a dermal allograft (DA) with reverse total shoulder arthroplasty (RTSA) when used to treat irreparable posterosuperior rotator cuff tears without glenohumeral osteoarthritis (GHOA) in patients younger than 70 years. METHODS: In this case-control study, patients who underwent SCR or RTSA for the treatment of irreparable posterosuperior rotator cuff tears, who were younger than 70 years at the time of surgery, and who were at least 2 years out of surgery were included. Clinical outcomes were assessed using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), Single Assessment Numerical Evaluation (SANE), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores and the 12-Item Short Form Health Survey (SF-12). Return to sports and patient satisfaction along with clinical failures (recurrent pain or persistent pain or loss of function), revisions, and complications were reported. RESULTS: Two-year follow-up was obtained on 22/22 patients (100%) in the SCR group and 29/33 patients (88%) in the RTSA group. Group differences were significant for age (SCR mean, 57 ± 6.6 years, vs. RTSA mean, 63 ± 4.9 years; P < .001) and follow-up interval (SCR mean, 2.1 years, vs. RTSA mean, 2.9 years; P = .001). Preoperative outcome scores showed no significant differences (all P > .05) between groups. No significant differences in postoperative outcome scores were detected (P > .05) between SCR and RTSA: the mean ASES score was 82.6 ± 15.5 vs. 79.3 ± 21.4, mean SANE score was 71.4 ± 24.5 vs. 75.4 ± 23.3, mean QuickDASH score was 16.2 ± 16.9 vs. 25.3 ± 21.0, and mean SF-12 was 47.7 ± 8.8 vs. 46.9 ± 10.4. No significant differences in return-to-sport responses were noticed between groups at baseline or postoperatively (P = .585, P = .758). One SCR was revised at 1.2 years with revision SCR and 1 RTSA had the glenoid component revised day 1 postoperatively for instability. Both patient groups achieved successful clinical outcomes. CONCLUSION: SCR using DA results in similar postoperative functional outcomes in a younger patient population when compared to RTSA for the treatment of irreparable posterosuperior rotator cuff tears, without GHOA, at short-term follow-up.

Umbilical Cord-Derived CD362+ Mesenchymal Stromal Cells Attenuate Polymicrobial Sepsis Induced by Caecal Ligation and Puncture.

Mesenchymal stromal cells (MSCs) have a multimodal, immunomodulatory mechanism of action and are now in clinical trials for single organ and systemic sepsis. However, a number of practicalities around source, homogeneity and therapeutic window remain to be determined. Here, we utilised conditioned medium from CD362+-sorted umbilical cord-human MSCs (UC-hMSCs) for a series of in vitro anti-inflammatory assays and the cryopreserved MSCs themselves in a severe (Series 1) or moderate (Series 2+3) caecal ligation and puncture (CLP) rodent model. Surviving animals were assessed at 48 h post injury induction. MSCs improved human lung, colonic and kidney epithelial cell survival following cytokine activation. In severe systemic sepsis, MSCs administered at 30 min enhanced survival (Series 1), and reduced organ bacterial load. In moderate systemic sepsis (Series 2), MSCs were ineffective when delivered immediately or 24 h later. Of importance, MSCs delivered 4 h post induction of moderate sepsis (Series 3) were effective, improving serum lactate, enhancing bacterial clearance from tissues, reducing pro-inflammatory cytokine concentrations and increasing antimicrobial peptides in serum. While demonstrating benefit and immunomodulation in systemic sepsis, therapeutic efficacy may be limited to a specific point of disease onset, and repeat dosing, MSC enhancement or other contingencies may be necessary.

MS-DIAL: data-independent MS/MS deconvolution for comprehensive metabolome analysis.

Data-independent acquisition (DIA) in liquid chromatography (LC) coupled to tandem mass spectrometry (MS/MS) provides comprehensive untargeted acquisition of molecular data. We provide an open-source software pipeline, which we call MS-DIAL, for DIA-based identification and quantification of small molecules by mass spectral deconvolution. For a reversed-phase LC-MS/MS analysis of nine algal strains, MS-DIAL using an enriched LipidBlast library identified 1,023 lipid compounds, highlighting the chemotaxonomic relationships between the algal strains.

Co-culturing Chlorella minutissima with Escherichia coli can increase neutral lipid production and improve biodiesel quality.

Lipid productivity and fatty acid composition are important metrics for the production of high quality biodiesel from algae. Our previous results showed that co-culturing the green alga Chlorella minutissima with Escherichia coli under high-substrate mixotrophic conditions enhanced both culture growth and crude lipid content. To investigate further, we analyzed neutral lipid content and fatty acid content and composition of axenic cultures and co-cultures produced under autotrophic and mixotrophic conditions. We found that co-culturing C. minutissima with E. coli under high substrate conditions (10 g/L) increased neutral lipid content 1.9- to 3.1-fold and fatty acid content 1.5- to 2.6-fold compared to equivalent axenic C. minutissima cultures. These same co-cultures also exhibited a significant fatty acid shift away from trienoic and toward monoenoic fatty acids thereby improving the quality of the synthesized fatty acids for biodiesel production. Further investigation suggested that E. coli facilitates substrate uptake by the algae and that the resulting growth enhancement induces a nitrogen-limited condition. Enhanced carbon uptake coupled with nitrogen limitation is the likely cause of the observed neutral lipid accumulation and fatty acid profile changes.

Anterior vs. posterior approach for total hip arthroplasty, a systematic review and meta-analysis.

The objective of this study is to compare the clinical, radiographic and surgical outcomes among patients undergoing primary THA performed via the anterior versus posterior approach. We searched numerous sources and eventually included 17 studies, totaling 2302 participants. In terms of post-operative pain and function, the anterior approach was significantly favored in 4 studies at short-term follow-up. Pooled estimates showed a significant difference in favor of the anterior approach in terms of length of stay and dislocations. Current evidence comparing outcomes following anterior versus posterior THA does not demonstrate clear superiority of either approach. Until more rigorous, randomized evidence is available, we recommend choice of surgical approach for THA be based on patient characteristics, surgeon experience and surgeon and patient preference.

Microplate assay for quantitation of neutral lipids in extracts from microalgae.

Lipid quantitation is widespread in the algae literature, but popular methods such as gravimetry, gas chromatography and mass spectrometry (GC-MS), and Nile red cell staining suffer drawbacks, including poor quantitation of neutral lipids, expensive equipment, and variable results among algae species, respectively. A high-throughput microplate assay was developed that uses Nile red dye to quantify neutral lipids that have been extracted from algae cells. Because the algal extracts contained pigments that quenched Nile red fluorescence, a mild bleach solution was used to destroy pigments, resulting in a nearly linear response for lipid quantities in the range of 0.75 to 40 µg. Corn oil was used as a standard for quantitation, although other vegetable oils displayed a similar response. The assay was tested on lipids extracted from three species of Chlorella and resulted in close agreement with triacylglycerol (TAG) levels determined by thin layer chromatography. The assay was found to more accurately measure algal lipids conducive to biodiesel production and nutrition applications than the widely used gravimetric assay. Assay response was also consistent among different species, in contrast to Nile red cell staining procedures.

Hypercapnic acidosis attenuates ventilation-induced lung injury by a nuclear factor-κB-dependent mechanism.

OBJECTIVES: Hypercapnic acidosis protects against ventilation-induced lung injury. We wished to determine whether the beneficial effects of hypercapnic acidosis in reducing stretch-induced injury were mediated via inhibition of nuclear factor-κB, a key transcriptional regulator in inflammation, injury, and repair. DESIGN: Prospective randomized animal study. SETTING: University research laboratory. SUBJECTS: Adult male Sprague-Dawley rats. INTERVENTIONS: In separate experimental series, the potential for hypercapnic acidosis to attenuate moderate and severe ventilation-induced lung injury was determined. In each series, following induction of anesthesia and tracheostomy, Sprague-Dawley rats were randomized to (normocapnia; FICO2 0.00) or (hypercapnic acidosis; FICO2 0.05), subjected to high stretch ventilation, and the severity of lung injury and indices of activation of the nuclear factor-κB pathway were assessed. Subsequent in vitro experiments examined the potential for hypercapnic acidosis to reduce pulmonary epithelial inflammation and injury induced by cyclic mechanical stretch. The role of the nuclear factor-κB pathway in hypercapnic acidosis-mediated protection from stretch injury was then determined. MEASUREMENTS AND MAIN RESULTS: Hypercapnic acidosis attenuated moderate and severe ventilation-induced lung injury, as evidenced by improved oxygenation, compliance, and reduced histologic injury compared to normocapnic conditions. Hypercapnic acidosis reduced indices of inflammation such as interleukin-6 and bronchoalveolar lavage neutrophil infiltration. Hypercapnic acidosis reduced the decrement of the nuclear factor-κB inhibitor IκBα and reduced the generation of cytokine-induced neutrophil chemoattractant-1. Hypercapnic acidosis reduced cyclic mechanical stretch-induced nuclear factor-κB activation, reduced interleukin-8 production, and decreased epithelial injury and cell death compared to normocapnia. CONCLUSIONS: Hypercapnic acidosis attenuated ventilation-induced lung injury independent of injury severity and decreased mechanical stretch-induced epithelial injury and death, via a nuclear factor-κB-dependent mechanism.

Evolution of the inflammatory and fibroproliferative responses during resolution and repair after ventilator-induced lung injury in the rat.

BACKGROUND: The time course and mechanisms of resolution and repair, and the potential for fibrosis following ventilation-induced lung injury (VILI), are unclear. We sought to examine the pattern of inflammation, injury, repair, and fibrosis following VILI. METHODS: Sixty anesthetized rats were subject to high-stretch; low-stretch, or sham ventilation, and randomly allocated to undergo periods of recovery of 6, 24, 48, and 96 h, and 7 and 14 days. Animals were then reanesthetized, and the extent of lung injury, inflammation, and repair determined. RESULTS: No injury was seen following low-stretch or sham ventilation. VILI caused severe lung injury, maximal at 24 h, but largely resolved by 96 h. Arterial oxygen tension decreased from a mean (SD) of 144.8 (4.1) mmHg to 96.2 (10.3) mmHg 6 h after VILI, before gradually recovering to 131.2 (14.3) mmHg at 96 h. VILI induced an early neutrophilic alveolitis and a later lymphocytic alveolitis, followed by a monocyte/macrophage infiltration. Alveolar tumor necrosis factor-α, interleukin-1ß, and transforming growth factor-ß1 concentrations peaked at 6 h and returned to baseline within 24 h, while interleukin-10 remained increased for 48 h. VILI generated a marked but transient fibroproliferative response, which restored normal lung architecture. There was no evidence of fibrosis at 7 and 14 days. CONCLUSIONS: High-stretch ventilation caused severe lung injury, activating a transient inflammatory and fibroproliferative repair response, which restored normal lung architecture without evidence of fibrosis.

Acclimation of an algal consortium to sequester nutrients from anaerobic digestate.

The objective of this research was to investigate the growth, community composition, and digestate treatment performance of a local algae consortium that was adapted to bacteria-pretreated digestate. The approach was to subculture a local consortium on pretreated dairy manure digestate and then municipal wastewater sludge digestate, allowing the community to adapt before assessing its performance. The adapted consortium was then tested for growth and nutrient removal performance on the digestates and compared to the model organism, Chlorella sorokiniana. Dramatic restructuring of the consortium took place when subcultured on the digestates with Scenedesmaceae and Chlorellaceae almost completely replacing Euglena. The consortium was consistently less productive than C. sorokiniana (184 vs. 248 mg/L/d in dairy digestate and 32 vs. 48 mg/L/d in municipal digestate, P < 0.01). Pretreatment increased growth by 81% and 500% for C. sorokiniana and the consortium, respectively, in dairy digestate (P < 0.01), and allowed for algal growth in municipal digestate.

Azospirillum brasilense reduces oxidative stress in the green microalgae Chlorella sorokiniana under different stressors.

In this study, we investigated oxidative stress in the green microalgae, Chlorella sorokiniana, in co-culture with the plant growth promoting bacteria (PGPB), Azospirillum brasilense. This relationship was studied in the absence of an exogenous stressor, under copper stress, and under nitrogen limitation stress. We confirmed that copper and nitrogen limitation induced algal oxidative stress and reductions in chlorophyll content. In all cases, the presence of A. brasilense lowered the accumulation of intracellular reactive oxygen species (ROS) while promoting chlorophyll content. This effect was driven, in part, by A. brasilense's secretion of the auxin hormone, indole-3-acetic acid, which is known to mitigate stress in higher plants. The findings of the present study show that stress mitigation by A. brasilense resulted in suppressed starch accumulation under nitrogen limitation stress and neutral lipid accumulation under copper stress. In fact, A. brasilense could almost completely mitigate oxidative stress in C. sorokiniana resulting from nitrogen limitation, with ROS accumulation rates comparable to the axenic control cultures. The biotechnological implication of these findings is that co-culture strategies with A. brasilense (and similar PGPB) are most effective for high growth applications. A second growth stage may be needed to induce accumulation of desired products.

Interactions of microalgae-bacteria consortia for nutrient removal from wastewater: A review.

Nitrogen and phosphorus pollution can cause eutrophication, resulting in ecosystem disruption. Wastewater treatment systems employing microalgae-bacteria consortia have the potential to enhance the nutrient removal efficiency from wastewater through mutual interaction and synergetic effects. The knowledge and control of the mechanisms involved in microalgae-bacteria interaction could improve the system's ability to transform and recover nutrients. In this review, a critical evaluation of recent literature was carried out to synthesize knowledge related to mechanisms of interaction between microalgae and bacteria consortia for nutrient removal from wastewater. It is now established that microalgae can produce oxygen through photosynthesis for bacteria and, in turn, bacteria supply the required metabolites and inorganic carbon source for algae growth. Here we highlight how the interaction between microalgae and bacteria is highly dependent on the nitrogen species in the wastewater. When the nitrogen source is ammonium, the generated oxygen by microalgae has a positive influence on nitrifying bacteria. When the nitrogen source is nitrate, the oxygen can have an inhibitory effect on denitrifying bacteria. However, some strains of microalgae have the capability to supply hydrogen gas for hydrogenotrophic denitrifiers as an energy source. Recent literature on biogranulation of microalgae and bacteria and its application for nutrient removal and biomass recovery is also discussed as a promising approach. Significant research challenges remain for the integration of microalgae-bacteria consortia into wastewater treatment processes including microbial community control and process stability over long time horizons.

Effect of ammonia removal and biochar detoxification on anaerobic digestion of aqueous phase from municipal sludge hydrothermal liquefaction.

Hydrothermal liquefaction is a promising method to convert municipal sludge into an energy-dense fuel. The inevitable by-product aqueous phase is rich in complex organics, which has the potential for energy and nutrient recovery and can be treated by anaerobic digestion to produce methane. However, toxic compounds such as ammonia and phenolics present would inhibit the function of micro-organisms. This study investigated the influence of ammonia and phenolics removal on anaerobic digestion. The results showed that the treated aqueous phase resulted in up to 225 ml CH4/g COD. The highest methane production was obtained in the culture with both ammonia and phenolics removal at pH 7.0, which was about 90% higher than only ammonia removal and seven times higher than only phenolics removal. The microbial community analysis results showed that these two treatments could increase microbial diversity and upregulate the relative abundance of methanogens.

Hypercapnia and acidosis in sepsis: a double-edged sword?

Acute respiratory distress syndrome is a devastating disease that causes substantial morbidity and mortality. Mechanical ventilation can worsen lung injury, whereas ventilatory strategies that reduce lung stretch, resulting in a "permissive" hypercapnic acidosis (HCA), improve outcome. HCA directly reduces nonsepsis-induced lung injury in preclinical models and, therefore, has therapeutic potential in these patients. These beneficial effects are mediated via inhibition of the host immune response, particularly cytokine signaling, phagocyte function, and the adaptive immune response. Of concern, these immunosuppressive effects of HCA may hinder the host response to microbial infection. Recent studies suggest that HCA is protective in the earlier phases of bacterial pneumonia-induced sepsis but may worsen injury in the setting of prolonged lung sepsis. In contrast, HCA is protective in preclinical models of early and prolonged systemic sepsis. Buffering of the HCA is not beneficial and may worsen pneumonia-induced injury.

Anaerobic microbial communities can influence algal growth and nutrient removal from anaerobic digestate.

The objective of this work was to test the impact of anaerobic digester microorganisms on algal growth, composition, and nutrient removal from digestate. Culture studies were carried out to determine the impacts of the microbial community on treatment of poultry litter anaerobic digestate by two strains of green algae: Auxenochlorella protothecoides and Chlorella sorokiniana. The results showed that the community doubled the growth of A. protothecoides but had no impact on C. sorokiniana growth. A similar result was observed for nutrient removal where the microbial community increased the capacity of A. protothecoides to remove ammonium and phosphate. The impact of the microbial community on biomass composition was minimal for both algae types.

Future Trends in Nebulized Therapies for Pulmonary Disease.

Aerosol therapy is a key modality for drug delivery to the lungs of respiratory disease patients. Aerosol therapy improves therapeutic effects by directly targeting diseased lung regions for rapid onset of action, requiring smaller doses than oral or intravenous delivery and minimizing systemic side effects. In order to optimize treatment of critically ill patients, the efficacy of aerosol therapy depends on lung morphology, breathing patterns, aerosol droplet characteristics, disease, mechanical ventilation, pharmacokinetics, and the pharmacodynamics of cell-drug interactions. While aerosol characteristics are influenced by drug formulations and device mechanisms, most other factors are reliant on individual patient variables. This has led to increased efforts towards more personalized therapeutic approaches to optimize pulmonary drug delivery and improve selection of effective drug types for individual patients. Vibrating mesh nebulizers (VMN) are the dominant device in clinical trials involving mechanical ventilation and emerging drugs. In this review, we consider the use of VMN during mechanical ventilation in intensive care units. We aim to link VMN fundamentals to applications in mechanically ventilated patients and look to the future use of VMN in emerging personalized therapeutic drugs.

Enhancement of biogas production from wastewater sludge via anaerobic digestion assisted with biochar amendment.

Studies have shown that biochar enhances methane formation due to the presence of redox active moieties and its conductive properties. This study investigated the influence of biochar, which was produced from Douglas fir pyrolysis, on biogas production and microbial community during anaerobic digestion (AD) of wastewater sludge. The results showed that biochar significantly enhances methane (CH4) production rate and increases its final yield during AD. The cumulative highest CH4 production obtaining in cultures with DF500 (biochar from Douglas fir at 500 °C) were about 11% and 98% more than the culture without biochar at 37 °C and 25 °C AD temperature, respectively. At 55 °C, the maximum CH4 yield reached 172.3 ml/g COD with DF730, which was about 48.3% more than control culture. The microbial community analysis results showed that biochar could up-regulate the role of micro-ecology especially the methanogens and improve the AD process.

Hypercapnic acidosis attenuates shock and lung injury in early and prolonged systemic sepsis.

OBJECTIVE: To investigate whether acute hypercapnic acidosis--induced by adding CO2 to inspired gas--would protect against severe systemic sepsis-induced lung and systemic organ injury resulting from cecal ligation and puncture. Acute hypercapnic acidosis protects against lung injury after both nonseptic and early pneumonia-induced lung injury. In contrast, prolonged hypercapnia worsens pneumonia-induced lung injury. The effects of hypercapnia and acidosis in the setting of systemic sepsis remain to be determined. DESIGN: Prospective randomized animal study. SETTING: University research laboratory. SUBJECTS: Adult male Sprague-Dawley rats. INTERVENTIONS: In the early systemic sepsis series, post induction of anesthesia and tracheostomy placement, animals were randomized to normocapnia (Fico2 = 0.00, n = 12) or hypercapnic acidosis (Fico2 = 0.05, n = 12). Cecal ligation and puncture were performed and the animals were ventilated for 3 hrs. In the prolonged systemic sepsis series, rats were anesthetized, cecal ligation and puncture were performed, and the animals were allowed to recover. The animals were then randomized to housing under conditions of environmental normocapnia (Fico2 = 0.00, n = 20) or hypercapnia (Fico2 = 0.08, n = 20). After 96 hrs, the animals were reanesthetized, and the severity of lung and hemodynamic injury was assessed. RESULTS: In early systemic sepsis, hypercapnic acidosis attenuated the development and severity of hypotension, and reduced lactate accumulation and the decrement in central venous oxyhemoglobin levels, compared with normocapnia. Hypercapnic acidosis reduced bronchoalveolar lavage neutrophil infiltration, and lung wet/dry weight ratios. In prolonged systemic sepsis, hypercapnic acidosis reduced histologic indices of lung injury. There was no evidence that hypercapnia worsened prolonged systemic sepsis-induced lung injury. Hypercapnic acidosis did not alter lung or systemic bacterial loads in early or prolonged systemic sepsis. CONCLUSION: Hypercapnic acidosis exerts beneficial effects in early and prolonged cecal ligation and puncture-induced polymicrobial systemic sepsis.