Relationship Between Interdialytic Weight Gain and Acid-Base Status in Hemodialysis by Bicarbonate

Background: Different treatment modalities and procedures have been tried for the management of infantile hypertrophic pyloric stenosis. But surgery remains the mainstay for management of IHPS. Ramstedts pyloromyotomy was described almost over a hundred years ago and to date remains the surgical technique of choice. An alternative and better technique is the double-Y pyloromyotomy, which offer better results for management of this common condition.Methods: A prospective comparative interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. The study was designed that all patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy(DY) and the next by aRamstedts Pyloromyotomy (RP). Data on patient demographics, operative time, anesthesia complications, postoperative complications including vomiting and weight gain were collected. Patients were followed up for a period of 3 months postoperatively. Statistical assessments were done by using t test.Results: From July 2008 through July 2010, fourty patients were finally analyzed for this study. Any statistical differences were observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status were recorded. Significant differences were found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups were collected. Vomiting in double-Y(DY) pyloromyotomy group (1.21 ± 0.45days) vs Ramstedts pyloromyotomy (RP) group(3.03 ± 0.37days) p= 0.0001.Weight gain after 1st 10 days DY vs RP is ( 298 ± 57.94 gm vs193±19.8 gm p=0.0014), after 1 month (676.67±149.84 gm vs 466.67 ± 127.71 gm, p=0.0001), after 2months (741.33± 278.74 gm vs 490±80.62 gm, p=0.002) and after 3 months (582±36.01gm vs 453.33±51.64 gm, p=0.0001).No long-term complications were reported and no re-do yloromyotomy was needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19532

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Metabolic and volume status evaluation of hemodialysis patients with and without residual renal function in the long interdialytic interval

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2018-0171 ◽

2019 ◽

Vol 41 (4) ◽

pp. 481-491 ◽

Cited By ~ 1

Author(s):

Lenina Ludimila Sampaio de Almeida ◽

Luís Henrique Bezerra Cavalanti Sette ◽

Fernando Luiz Affonso Fonseca ◽

Leila Silveira Vieira da Silva Bezerra ◽

Francisco Hélio Oliveira Júnior ◽

...

Keyword(s):

Renal Function ◽

Serum Potassium ◽

Ph Value ◽

Residual Renal Function ◽

Acid Base ◽

Serum Samples ◽

Cross Sectional ◽

Interdialytic Weight Gain ◽

Base Disorder ◽

Acid Base Status

Abstract Introduction: It is unclear whether residual renal function (RRF) in dialysis patients can attenuate the metabolic impact of the long 68-hour interdialytic interval, in which water, acid, and electrolyte accumulation occurs. Objective: to evaluate serum electrolyte levels, water balance, and acid-base status in dialytic patients with and without RRF over the long interdialytic interval (LII). Methodology: this was a single-center, cross-sectional, and analytical study that compared patients with and without RRF, defined by diuresis above 200 mL in 24 hours. Patients were weighed and serum samples were collected for biochemical and gasometric analysis at the beginning and at the end of the LII. Results: 27 and 24 patients with and without RRF were evaluated, respectively. Patients without RRF had a higher increase in serum potassium during the LII (2.67 x 1.14 mEq/L, p < 0.001), reaching higher values at the end of the study (6.8 x 5.72 mEq/L, p < 0.001) and lower pH value at the beginning of the interval (7.40 x 7.43, p = 0.018). More patients with serum bicarbonate < 18 mEq/L (50 x 14.8%, p = 0.007) and mixed acid-base disorder (57.7 x 29.2%, p = 0.042), as well as greater interdialytic weight gain (14.67 x 8.87 mL/kg/h, p < 0.001) and lower natremia (137 x 139 mEq/L, p = 0.02) at the end of the interval. Calcemia and phosphatemia were not different between the groups. Conclusion: Patients with RRF had better control of serum potassium, sodium, acid-base status, and volemia throughout the LII.

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Surgical Management of Infantile Hypertrophic Pyloric Stenosis by Double-Y Pyloromyotomy: A Better Approach

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v3i2.12076 ◽

2012 ◽

Vol 3 (2) ◽

pp. 38-40

Author(s):

Md. Ansar Ali ◽

Kaniz Hasina ◽

Abu Naim ◽

Md. Anwar Israil ◽

Md. Mahbub-Ul-Alam ◽

...

Keyword(s):

Weight Gain ◽

Surgical Management ◽

Pyloric Stenosis ◽

Hypertrophic Pyloric Stenosis ◽

Treatment Modalities ◽

Infantile Hypertrophic Pyloric Stenosis ◽

Postoperative Vomiting ◽

Acid Base ◽

Feeding Regimes ◽

Acid Base Status

Background: Various treatment modalities have been applied for the management of infantile hypertrophic pyloric stenosis. However surgery remains the mainstay of treatment for IHPS of which Ramstedt's pyloromyotomy remains the surgical technique of choice. Objective: To see the outcome of surgical management of infantile hypertrophic pyloric stenosis by double-Y pyloromyotomy. Methods: A prospective interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. All patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy (DY) and the next by a Ramstedt's Pyloromyotomy (RP). Data on patient demographics, operative time, anaesthesia complications and postoperative complications including vomiting and weight gain were collected. Patients were followed up for a period of 3 months postoperatively. Statistical assessments were done by using t test. Results: From July 2008 through July 2010, forty patients were finally analyzed for this study. Any statistical differences were observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status were recorded. Significant differences were found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups were collected. Vomiting in double-Y(DY) pyloromyotomy group vs Ramstedt's pyloromyotomy (RP) group was significant (p= 0.0001). Weight gain after 1st 10 days DY vs RP is 298 ± 57.94 gm vs 193±19.8 gm (p=0.0014), after 1 month 676.67±149.84 gm vs 466.67 ± 127.71 gm (p=0.0001), after 2 months 741.33± 278.74 gm vs 490±80.62 gm (p=0.002) and after 3 months 582±36.01gm vs 453.33±51.64 gm (p=0.0001). No long-term complications were reported and no re-do pyloromyotomy was needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain. J Shaheed Suhrawardy Med Coll, 2011;3 (2): 38-40 DOI: http://dx.doi.org/10.3329/jssmc.v3i2.12076

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Nutrient intake, acid base status and weight gain in water buffalo calves fed different dietary levels of sodium bicarbonate

South African Journal of Animal Science ◽

10.4314/sajas.v41i2.71012 ◽

2011 ◽

Vol 41 (2) ◽

Author(s):

M Sarwar ◽

MA Shahzad ◽

M Nisa ◽

S Amjad

Keyword(s):

Weight Gain ◽

Sodium Bicarbonate ◽

Nutrient Intake ◽

Water Buffalo ◽

Buffalo Calves ◽

Acid Base ◽

Acid Base Status

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A Prospective Comparative Study of the Outcome of Double-Y Pyloromyotomy (Alayet's Pyloromyotomy) and Ramstedt's Pyloromyotomy for the Surgical Management of Infantile Hypertrophic Pyloric Stenosis

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v1i1.19449 ◽

2014 ◽

Vol 1 (1) ◽

pp. 15-18

Author(s):

Md. Ansar Ali ◽

Md. Sharifuzzaman ◽

Md. Ashraf Ul Huq ◽

Md. Mahbub-Ul Alam

Keyword(s):

Weight Gain ◽

Surgical Management ◽

Pyloric Stenosis ◽

Hypertrophic Pyloric Stenosis ◽

Infantile Hypertrophic Pyloric Stenosis ◽

Postoperative Vomiting ◽

Acid Base ◽

Feeding Regimes ◽

Acid Base Status ◽

A New Technique

Background: Many innovations and approaches have been tried for the surgical management of Infantile Hypertrophic Pyloric Stenosis (IHPS) since Ramstedts first successful surgery almost one hundred years ago. Here a new technique focusing on the pylorus which may offer better results for this common condition.Methods: A prospective on going study of 20 patients with IHPS are carried out over a period of 15 months from July 2008 to September 2009. The patients are divided into 2 equal groups of 10 patients in each. The study is designed that all patients selected for study are optimized preoperatively with regard to hydration, acid-base status and electrolytes imbalance. All surgeries are performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes are used. The patients are operated on an alternate basis, i.e., one patient by double-Y pyloromyotomy(DY) and the next by a Ramstedts pyloromyotomy(RP). Data on patient demographics, operative time, anesthesia complications, Postoperative complications including vomiting and weight gain are collected. Patients are followed up for a period of 3 months postoperatively. Statistical assessments are done by using Student test.Results: No statistical differences are observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status. Significant differences are found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups are collected. Vomiting in double- Y(DY) pyloromyotomy group (1.23 ± 0.98 days) vsRamstedts pyloromyotomy (RP) group(2.950.99 days) p= 0.0094.Weight gain after 1st 10 days DY vs RP is ( 298 ± 57.94 gm vs193±19.8 gm p=0.0014), after 1 month (685±15.72 gm vs 498 ± 12.36 gm, p=0.0008), after 2months (670± 105.93 gm vs 455±79.76 gm, p=0.00013) and after 3 months (555±86.44 gm vs 435±47.43 gm, p=0.00098).No long-term complications are reported and no re-do pyloromyotomy is needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.DOI: http://dx.doi.org/10.3329/jpsb.v1i1.19449

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