scholarly journals Hyperlactacemia in critically ill children: comparison of traditional and Fencl-Stewart methods

2007 ◽  
Vol 47 (1) ◽  
pp. 35
Author(s):  
Hari Kushartono ◽  
Antonius H. Pudjiadi ◽  
Susetyo Harry Purwanto ◽  
Imral Chair ◽  
Darlan Darwis ◽  
...  
Keyword(s):  
Base Excess ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
Critically Ill Children ◽  
Strongly Correlated ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Lactate Levels ◽  
Elevated Lactate

Background Base excess is a single variable used to quantifymetabolic component of acid base status. Several researches havecombined the traditional base excess method with the Stewartmethod for acid base physiology called as Fencl-Stewart method.Objective The purpose of the study was to compare two differentmethods in identifying hyperlactacemia in pediatric patients withcritical illness.Methods The study was performed on 43 patients admitted tothe pediatric intensive care unit of Cipto MangunkusumoHospital, Jakarta. Sodium, potassium, chloride, albumin, lactateand arterial blood gases were measured. All samples were takenfrom artery of all patients. Lactate level of >2 mEq/L was definedas abnormal. Standard base excess (SBE) was calculated fromthe standard bicarbonate derived from Henderson-Hasselbalchequation and reported on the blood gas analyzer. Base excessunmeasured anions (BE UA ) was calculated using the Fencl-Stewartmethod simplified by Story (2003). Correlation between lactatelevels in traditional and Fencl-Stewart methods were measuredby Pearson’s correlation coefficient .Results Elevated lactate levels were found in 24 (55.8%) patients.Lactate levels was more strongly correlated with BE UA (r = - 0.742,P<0.01) than with SBE (r = - 0.516, P<0.01).Conclusion Fencl-Stewart method is better than traditionalmethod in identifying patients with elevated lactate levels, so theFencl-Stewart method is suggested to use in clinical practice.

Anesthetic effects on liver and muscle glycogen concentrations: rest and postexercise

1989 ◽  
Vol 66 (6) ◽  
pp. 2895-2900 ◽  
Author(s):  
T. I. Musch ◽  
B. S. Warfel ◽  
R. L. Moore ◽  
D. R. Larach
Keyword(s):  
Skeletal Muscles ◽  
Respiratory Acidosis ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Arterial Lactate ◽  
Arterial Pco2 ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Gastrocnemius Muscles

We compared the effects of three different anesthetics (halothane, ketamine-xylazine, and diethyl ether) on arterial blood gases, acid-base status, and tissue glycogen concentrations in rats subjected to 20 min of rest or treadmill exercise (10% grade, 28 m/min). Results demonstrated that exercise produced significant increases in arterial lactate concentrations along with reductions in arterial Pco2 (PaCO2) and bicarbonate concentrations in all rats compared with resting values. Furthermore, exercise produced significant reductions in the glycogen concentrations in the liver and soleus and plantaris muscles, whereas the glycogen concentrations found in the diaphragm and white gastrocnemius muscles were similar to those found at rest. Rats that received halothane and ketamine-xylazine anesthesia demonstrated an increase in Paco2 and a respiratory acidosis compared with rats that received either anesthesia. These differences in arterial blood gases and acid-base status did not appear to have any effect on tissue glycogen concentrations, because the glycogen contents found in liver and different skeletal muscles were similar to one another cross all three anesthetic groups. These data suggest that even though halothane and ketamine-xylazine anesthesia will produce a significant amount of ventilatory depression in the rat, both anesthetics may be used in studies where changes in tissue glycogen concentrations are being measured and where adequate general anesthesia is required.

Arterial blood gases and acid-base status of dogs during graded dynamic exercise

1986 ◽  
Vol 61 (5) ◽  
pp. 1914-1919 ◽  
Author(s):  
T. I. Musch ◽  
D. B. Friedman ◽  
G. C. Haidet ◽  
J. Stray-Gundersen ◽  
T. G. Waldrop ◽  
...  
Keyword(s):  
Steady State ◽  
Blood Gases ◽  
Respiratory Alkalosis ◽  
Submaximal Exercise ◽  
O2 Consumption ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Vo2 Max ◽  
Arterial Blood ◽  
Acid Base Status

The objective of this study was to determine whether arterial PCO2 (PaCO2) decreases or remains unchanged from resting levels during mild to moderate steady-state exercise in the dog. To accomplish this, O2 consumption (VO2) arterial blood gases and acid-base status, arterial lactate concentration ([LA-]a), and rectal temperature (Tr) were measured in 27 chronically instrumented dogs at rest, during different levels of submaximal exercise, and during maximal exercise on a motor-driven treadmill. During mild exercise [35% of maximal O2 consumption (VO2 max)], PaCO2 decreased 5.3 +/- 0.4 Torr and resulted in a respiratory alkalosis (delta pHa = +0.029 +/- 0.005). Arterial PO2 (PaO2) increased 5.9 +/- 1.5 Torr and Tr increased 0.5 +/- 0.1 degree C. As the exercise levels progressed from mild to moderate exercise (64% of VO2 max) the magnitude of the hypocapnia and the resultant respiratory alkalosis remained unchanged as PaCO2 remained 5.9 +/- 0.7 Torr below and delta pHa remained 0.029 +/- 0.008 above resting values. When the exercise work rate was increased to elicit VO2 max (96 +/- 2 ml X kg-1 X min-1) the amount of hypocapnia again remained unchanged from submaximal exercise levels and PaCO2 remained 6.0 +/- 0.6 Torr below resting values; however, this response occurred despite continued increases in Tr (delta Tr = 1.7 +/- 0.1 degree C), significant increases in [LA-]a (delta [LA-]a = 2.5 +/- 0.4), and a resultant metabolic acidosis (delta pHa = -0.031 +/- 0.011). The dog, like other nonhuman vertebrates, responded to mild and moderate steady-state exercise with a significant hyperventilation and respiratory alkalosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Breath holding during intense exercise: arterial blood gases, pH, and lactate

1988 ◽  
Vol 64 (5) ◽  
pp. 1947-1952 ◽  
Author(s):  
G. O. Matheson ◽  
D. C. McKenzie
Keyword(s):  
Repeated Measures ◽  
Intermittent Exercise ◽  
Blood Gases ◽  
Breath Holding ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Arterial Blood ◽  
Repeated Measures Analysis ◽  
Acid Base Status ◽  
Arterial Po2

Seven healthy endurance-trained [maximal O2 uptake (VO2max) = 57.1 +/- 4.1 ml.kg-1.min-1)] female volunteers (mean age 24.4 +/- 3.6 yr) served as subjects in an experiment measuring arterial blood gases, acid-base status, and lactate changes while breath holding (BH) during intense intermittent exercise. By the use of a counterbalance design, each subject repeated five intervals of a 15-s on:30-s off treadmill run at 125% VO2max while BH and while breathing freely (NBH). Arterial blood for pH, PO2, PCO2, O2 saturation (SO2) HCO3, and lactate was sampled from a radial arterial catheter at the end of each work and rest interval and throughout recovery, and the results were analyzed using repeated-measures analysis of variance. Significant reductions in pHa (delta mean = 0.07, P less than 0.01), arterial PO2 (delta mean = 24.2 Torr, P less than 0.01), and O2 saturation (delta mean = 4.6%, P less than 0.01) and elevations in arterial PCO2 (delta mean = 8.2 Torr, P less than 0.01) and arterial HCO3 (delta mean = 1.3 meq/l, P = 0.05) were found at the end of each exercise interval in the BH condition. All of the observed changes in arterial blood gases and acid-base status induced by BH were reversed during the rest intervals. During recovery, significantly (P less than 0.025) greater levels of arterial lactate were found in the BH condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial blood gases fail to reflect acid-base status during cardiopulmonary resuscitation

1985 ◽  
Vol 13 (11) ◽  
pp. 884-885 ◽  
Author(s):  
MAX HARRY WEIL ◽  
WILLIAM GRUNDLER ◽  
MASANOBU YAMAGUCHI ◽  
SYBIL MICHAELS ◽  
ERIC C. RACKOW
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status

Arterial blood gases and acid-base status in awake rats

1982 ◽  
Vol 48 (1) ◽  
pp. 45-57 ◽  
Author(s):  
M. Brun-Pascaud ◽  
C. Gaudebout ◽  
M.C. Blayo ◽  
J.J. Pocidalo
Keyword(s):  
Blood Gases ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status ◽  
Awake Rats

Arterial Blood Gases

2014 ◽  
pp. 410-419
Author(s):  
Jeremy B. Richards ◽  
David H. Roberts
Keyword(s):  
Partial Pressure ◽  
Arterial Oxygen Saturation ◽  
Blood Gases ◽  
Altered Mental Status ◽  
Arterial Oxygen ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Clinical Syndromes ◽  
Acid Base Status

An arterial blood gas (ABG) provides clinically useful information about an individual's acid–base status, the partial pressure of arterial carbon dioxide, the partial pressure of arterial oxygen, and the arterial oxygen saturation. Hypoxia, dyspnea, or suspected acid–base disturbance are clear indications to check an ABG. Altered mental status, critical illness, and acute respiratory distress syndrome (ARDS) are specific clinical syndromes or presentations that warrant checking an ABG. An ABG is helpful in evaluating pulmonary pathophysiology as the presence and severity of hypoxia and/or hypercapnia can be quantified. Because an ABG can rapidly provide information about oxygenation, ventilation, and acid–base status, ABGs are particularly useful and common in the critical care setting.

Arterial Blood Gases Fail to Reflect Acid-Base Status During Cardiopulmonary Resuscitation

1986 ◽  
Vol 30 (5) ◽  
pp. 298
Author(s):  
M. H. WEIL ◽  
W. GRUNDLER ◽  
M. YAMAGUCHI ◽  
S. MICHAELS ◽  
E. C. RACKOW
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Acid Base ◽  
Arterial Blood ◽  
Acid Base Status

scholarly journals Acid-Base Status Disturbances in Patients on Chronic Hemodialysis at High Altitudes

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Javier Enrique Cely ◽  
Oscar G. Rocha ◽  
María J. Vargas ◽  
Rafael M. Sanabria ◽  
Leyder Corzo ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Metabolic Alkalosis ◽  
Base Excess ◽  
Chronic Hemodialysis ◽  
High Altitudes ◽  
Acid Base ◽  
Arterial Blood ◽  
Base Disorder ◽  
Acid Base Status ◽  
Normal Acid

Background. Acid-base disorders have been previously described in patients with chronic hemodialysis, with metabolic acidosis being the most important of them; however, little is known about the potential changes in acid-base status of patients on dialysis living at high altitudes. Methods. Cross-sectional study including 93 patients receiving chronic hemodialysis on alternate days and living in Bogotá, Colombia, at an elevation of 2,640 meters (8,661 feet) over sea level (m.o.s.l.). Measurements of pH, PaCO2, HCO3, PO2, and base excess were made on blood samples taken from the arteriovenous fistula (AVF) during the pre- and postdialysis periods in the midweek hemodialysis session. Normal values for the altitude of Bogotá were taken into consideration for the interpretation of the arterial blood gases. Results. 43% (n= 40) of patients showed predialysis normal acid-base status. The most common acid-base disorder in predialysis period was metabolic alkalosis with chronic hydrogen ion deficiency in 19,3% (n=18). Only 9,7% (n=9) had predialysis metabolic acidosis. When comparing pre- and postdialysis blood gas analysis, higher postdialysis levels of pH (7,41 versus 7,50, p<0,01), bicarbonate (21,7mmol/L versus 25,4mmol/L, p<0,01), and base excess (-2,8 versus 2,4, p<0,01) were reported, with lower levels of partial pressure of carbon dioxide (34,9 mmHg versus 32,5 mmHg, p<0,01). Conclusion. At an elevation of 2,640 m.o.s.l., a large percentage of patients are in normal acid-base status prior to the dialysis session (“predialysis period”). Metabolic alkalosis is more common than metabolic acidosis in the predialysis period when compared to previous studies. Paradoxically, despite postdialysis metabolic alkalosis, PaCO2 levels are lower than those found in the predialysis period.

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