scholarly journals Connecting two worlds: positive correlation between physicochemical approach with blood gases and pH in pediatric ICU setting

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Chanapai Chaiyakulsil ◽  
Papope Mueanpaopong ◽  
Rojjanee Lertbunrian ◽  
Somchai Chutipongtanate
Keyword(s):  
Physicochemical Parameters ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Strong Ion Difference ◽  
Blood Gas ◽  
Acid Base ◽  
Positive Correlation ◽  
Acid Base Disturbance ◽  
Base Disturbance ◽  
Physicochemical Approach

Abstract Objective Physicochemical approach such as strong ion difference provides a novel concept in understanding and managing acid–base disturbance in patients. However, its application in pediatrics is limited. This study aimed to evaluate a correlation between the physicochemical approach and blood gas pH for acid–base determination in critically ill pediatric patients. Results A total of 130 pediatric patients were included, corresponding to 1338 paired measures for analyses. Of these, the metabolic subgroup (743 paired measures) was defined. Among physicochemical parameters, the effective strong ion difference showed the best correlation with the blood gas pH in the whole cohort (R = 0.398; p < 0.001) and the metabolic subgroup (R = 0.685; p < 0.001). Other physicochemical parameters (i.e., the simplified and the apparent strong ion difference, the strong ion gap, and the sodium chloride gap) and the traditional measures (standard base excess, lactate, chloride and bicarbonate) also showed varying degrees of correlation. This study revealed the positive correlation between physicochemical parameters and the blood gas pH, serving as a connecting dot for further investigations using physicochemical approach to evaluate acid–base disturbance in pediatric population.

scholarly journals Acid-base disturbance during hemorrhage in rats: significant role of strong inorganic ions

1999 ◽  
Vol 86 (5) ◽  
pp. 1617-1625 ◽  
Author(s):  
V. Alfaro ◽  
J. Pesquero ◽  
L. Palacios
Keyword(s):  
Blood Volume ◽  
Lactate Concentration ◽  
Inorganic Ions ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Inorganic Ion ◽  
Base Disorder ◽  
Arterial Plasma ◽  
Acid Base Disturbance ◽  
Base Disturbance

The present study tests the hypothesis that changes in the strong inorganic ion concentrations contribute significantly to the acid-base disturbance that develops during hemorrhage in the arterial plasma of rats in addition to lactate concentration ([Lac−]) increase. The physicochemical origins for this acid-base disorder were studied during acute, graded hemorrhage (10, 20, and 30% loss of blood volume) in three groups of rats: conscious, anesthetized with ketamine, and anesthetized with urethan. The results support the hypothesis examined: strong-ion difference (SID) decreased in the arterial plasma of all groups studied because of an early imbalance in the main strong inorganic ions during initial hemorrhagic phase. Moreover, changes in plasma [Lac−] contributed to SID decrease in a later hemorrhagic phase (after 10% hemorrhage in urethan-anesthetized, after 20% hemorrhage in ketamine-anesthetized, and after 30% hemorrhage in conscious group). Inorganic ion changes were due to both dilution of the vascular compartment and ion exchange with extravascular space and red blood cells, as compensation for blood volume depletion and hypocapnia. Nevertheless, anesthetized rats were less able than conscious rats to preserve normal arterial pH during hemorrhage, mainly because of an impaired peripheral tissue condition and incomplete ventilatory compensation.

Metabolic Alkalosis Secondary to Baking Soda Treatment of a Diaper Rash

PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 820-822
Author(s):  
Jose Gonzalez ◽  
Ronald J. Hogg
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Sodium Bicarbonate ◽  
Complete Resolution ◽  
Metabolic Alkalosis ◽  
Acid Base ◽  
Prior Application ◽  
Acid Base Disturbance ◽  
Base Disturbance

A 4-month-old infant was seen with hypokalemic metabolic alkalosis that was associated with prior application of liberal amounts of sodium bicarbonate (baking soda) to a diaper rash. After exclusion of other etiologies of the infant's acid-base disturbance, a complete resolution occurred following discontinuation of the baking soda applications. This case report provides a reminder of the significant side effects that may result from the excessive use of a seemingly harmless household substance.

Branchial ion uptake in arctic grayling: resting values and effects of acid-base disturbance

1976 ◽  
Vol 64 (3) ◽  
pp. 711-725
Author(s):  
J. N. Cameron
Keyword(s):  
Ion Exchange ◽  
Hypercapnic Acidosis ◽  
Compensation Mechanism ◽  
Acid Base ◽  
Arctic Grayling ◽  
Unidirectional Flux ◽  
Acid Base Disturbance ◽  
Base Disturbance ◽  
Na Uptake

1. Techniques for the measurement of unidirectional flux rates in fish which require no anaesthesia or surgery are described. 2. Resting values for Cl- uptake at 10 and 17 degrees C were 8–03 +/− 1–11 and 13–52 +/− 0–95 mu-equiv. 200 g-1 h-1 (+/− S.E.), respectively; and for Na+ the rates were 15–49 +/− 0–40 and 26–30 +/− 0–36, respectively. 3. Hypercapnic acidosis caused an increase in Na+ uptake, presumably through Na+/H+ (or NH+4) exchange. It is suggested that this is a compensation mechanism leading to the increase in blood buffering observed in response to hypercapnia. 4. Alkalosis was observed following acute temperature increase and was accompanied by an increase in the rate of Cl-/HCO-3 exchange and also by an increase in Na+/H+ exchange. 5. The role of these branchial ion exchange mechanisms in overall acidbase regulation is discussed.

The effects of enforced activity on ventilation, circulation and blood acid-base balance in the semi-terrestrial anuran, Bufo marinus

1980 ◽  
Vol 84 (1) ◽  
pp. 273-287
Author(s):  
D. G. McDonald ◽  
R. G. Boutilier ◽  
D. P. Toews
Keyword(s):  
Time Course ◽  
Ventilation Rate ◽  
Strenuous Exercise ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Blood ◽  
Base Balance ◽  
Lactate Levels ◽  
Acid Base Disturbance ◽  
Base Disturbance

Strenuous exercise results in a marked blood acid-base disturbance which is accompanied by large increases in ventilation rate, heart rate and mean arterial blood pressure. Recovery to normal resting values follows an exponential time course with a half-time of approximately 2 h for all parameters except Pa, CO2 and ventilation rate. The latter return to normal by 30 min following the exercise period. Analysis reveals that there is initially a large discrepancy between the quantity of metabolic acids buffered in the blood and the blood lactate levels. The significance of this finding is discussed. Significant changes in the concentrations of chloride, bicarbonate and lactate, in both plasma and erythrocytes, accompany the blood acid-base disturbance. Chloride and bicarbonate appear to be passively distributed between the two compartments according to a Gibbs-Donnan equilibrium whereas lactate only slowly permeates the erythrocyte.

An Analysis of Acid-Base Disturbances in the Haemolymph Following Strenuous Activity in the Dungeness Crab, Cancer Magister

1979 ◽  
Vol 79 (1) ◽  
pp. 47-58
Author(s):  
D. G. McDONALD ◽  
B. R. McMAHON ◽  
C. M. WOOD
Keyword(s):  
Lactate Concentration ◽  
Dungeness Crab ◽  
Acid Base ◽  
Cancer Magister ◽  
Rapid Release ◽  
Strenuous Activity ◽  
Lactate Levels ◽  
Acid Base Disturbance ◽  
Base Disturbance

Enforced activity causes a marked depression of haemofymph pH in Cancer magister. Both lactate concentration and PCOCO2 of the haemolymph are elevated immediately following exercise but resting PCOCO2 is restored within 30 min whereas resting lactate levels are not restored for at least 8 h. The haemolymph acid-base disturbance is caused largely by elevated haemolymph lactate levels but a Davenport analysis based on measurements of pH and total CO2 reveals a marked discrepancy between the amount of metabolic acid buffered by the haemolymph and the lactate anion concentration. This appears due to a more rapid release of lactate from the tissues than H+ ions produced with lactate.

scholarly journals Comparison of electrolyte and acid-base balances of Dorper breed ewes between single and twin pregnancies

2019 ◽  
Vol 39 (10) ◽  
pp. 789-795
Author(s):  
Bianca P. Santarosa ◽  
Gabriela N. Dantas ◽  
Danilo O.L. Ferreira ◽  
Marina G. Carvalho ◽  
Mirian Rodrigues ◽  
...  
Keyword(s):  
Energy Demand ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Strong Ion Difference ◽  
Electrolyte Balance ◽  
Blood Gas ◽  
Acid Base ◽  
Ultrasonographic Diagnosis ◽  
Carbon Dioxide Pressure ◽  
Group 2

ABSTRACT: During pregnancy there are modifications in the metabolic profile of sheep that may predispose to the occurrence of metabolic disorders, of which pregnancy toxaemia (PT) is highlighted. Blood gas analysis is detects changes in acid-base and electrolyte balance effectively. The objectives of this study were to study the acid-base and electrolyte balance of sheep during gestation and in the immediate peripartum (up to 48 hours postpartum), comparing single gestation with twins. Sixty healthy sheep of Dorper breed, two to five years old were raised in a semi-intensive system and were divided in two experimental groups: Group 1: 30 ewes, with ultrasonographic diagnosis of single fetus gestation; Group 2: 30 ewes, with ultrasonographic diagnosis of twin pregnancy. The experimental moments were defined as: MI-immediately after artificial insemination (control); MG30 - 30 days of gestation; MG90 - 90 days of gestation; MG120 - 120 days of gestation; MG130 - 130 days of gestation; MG140 - 140 days of gestation; MP - lambing; MPP1 - 24h postpartum; MPP2 - 48h postpartum. At all times 1mL of blood was collected per jugular vein puncture for blood gas evaluation in a portable equipament (I-Stat®). The pH, carbon dioxide pressure (PCO2), bicarbonate (HCO3-), base excess (BE), sodium (Na+), potassium (K+), chloride (Cl-), ionized calcium (Ca+2), lactate, anion gap (AG) were mensured and strong ion difference (SID) were calculed. This work showed that there were changes in acid-base and electrolyte balance in pregnant ewes, due to the decrease in BE, HCO3-, TCO2 and increase of lactate and AG during gestation, but the pH remained normal and did not present any difference among moments in both groups. Comparing the groups, single-gestation ewes presented higher alkaline expenditure at delivery than twin-gestation, evidenced by lower levels of BE and HCO3-. Lower Na+ levels were observed in prepartum; drop in K+ values with advancing gestation; hyperchloremia and hypocalcemia during gestation according to the reference standards for species; decreased iCa+2 levels in the final third of gestation in both groups. It was concluded that the ewes of this study were healthy until the last moment analyzed (48h postpartum), although have shown greater consumption of the alkaline reserve in the peripartum, being more explicit in the single gestation animals. In addition, this situation can be physiological and result in increased energy demand during gestation, more exacerbated by peripartum.

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