RULES OF EVIDENCE APPLIED TO TREATMENTS OF NEONATAL HYPOXEMIA AND ACIDOSIS

PEDIATRICS ◽  
1968 ◽  
Vol 42 (4) ◽  
pp. 563-564
Author(s):  
L. S. Prod'hom
Keyword(s):  
Respiratory Distress ◽  
Clinical Signs ◽  
Assisted Ventilation ◽  
Vasomotor Tone ◽  
Acid Base Balance ◽  
The Past ◽  
O2 Concentration ◽  
Base Balance ◽  
Slow Infusion ◽  
Adequate Oxygenation

BIOCHEMICAL MONITORING of the low birth weight infant during the first 24 hours of life frequently reveals abnormalities of acid-base balance and hypoxemia; these anomalies are very striking in infants with clinical signs of respiratory distress. The clinician is then faced with two problems: the first in diagnosis, the second in treatment. In the past few years certain regimes for respiratory distress have been recommended with varying degrees of fact and forcefulness. These include the careful maintenance of thermal balance to keep oxygen consumption at a minimum, correction of acidosis by NaHCO3 or THAM in rapid or slow infusion, adequate oxygenation sometimes requiring an inspired O2 concentration above 40%, assisted ventilation (either through a tracheal tube or by a negative pressure tank), and, finally, administration of agents acting on vasomotor tone.

DUNCAN'S DISEASES OF METABOLISM: ENDOCRINOLOGY, ed 7. Edited by Philip K. Bondy and Leon E. Rosenberg. Philadelphia, WB Saunders Co, 1974, $26; 736 pp

PEDIATRICS ◽  
1977 ◽  
Vol 59 (5) ◽  
pp. 794-794
Author(s):  
Lester F. Soyka
Keyword(s):  
Clinical Endocrinology ◽  
Normal Structure ◽  
Acid Base Balance ◽  
Acid Base ◽  
Telephone Directory ◽  
The Past ◽  
Big City ◽  
Recent Developments ◽  
Base Balance ◽  
And Function

The endocrinology section of Duncan's Diseases of Metabolism comprises 736 pages, or about 44% of the total text. The division of this seventh edition of a classic text in the field is perhaps a logical expression of the splitting of endocrinology from metabolism as each field has grown tremendously in the past decade. The endocrinology portion is compact and easy to use because of this division, aided by the employment of thin, though substantial paper and small, but easily readable type. These combine to avoid the feeling of consulting a big-city telephone directory, which is so common with use of many of the standard textbooks of today. The illustrations are generally excellent and the 54-page index, which covers both sections of the book, is unusually thorough. As in all textbooks, many sections are outdated before they appear in print. Although the editors, Philip K. Bondy and Leon E. Rosenberg, propose to avoid this by means of a "last-minute" addendum, only two of the 13 chapters bear such, and one of these lists only three references, all dating to 1972. The other recent-developments section is longer and more helpful. The content is essentially that of general clinical endocrinology, each chapter using the standard approach of considering normal structure and function and then diseases in a gland arrangement, starting with the hypothalamus and traveling downward to the testis and ovary. A small chapter on acid-base balance seems out of place, whereas those on nonendocrine-secreting tumors and serotonin and the carcinoid syndrome are useful extensions of the scope of endocrinology.

482 Awardee Talk: Challenges and Opportunities Facing Mineral Nutrition in the Next Decade

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 213-214
Author(s):  
John Patience
Keyword(s):  
Mineral Nutrition ◽  
Environmental Sustainability ◽  
Good Reason ◽  
Acid Base Balance ◽  
Pork Production ◽  
The Past ◽  
Feeding Programs ◽  
Challenges And Opportunities ◽  
Base Balance ◽  
Definition Of

Abstract The science associated with mineral nutrition is evolving at an accelerated pace. Some topics of investigation have persisted for decades; typical examples include clarification of mineral requirements, evaluation of mineral sources, definition of mineral bioavailability and physiological and metabolic interactions among minerals, to name a few. The fact that these topics have endured for so long serves to illustrate their importance to our craft, as well as the increasing sophistication of the science available to delve more deeply into our understanding of mineral nutrition. Newer topics that involve minerals directly and/or indirectly are attracting increasing attention – and for good reason. As one example, there is a growing body of data pointing to oxidative stress as a relevant issue in modern pork production. As another, the interaction of minerals with fiber has received considerable interest in the past, but recently, the topic has been further elevated by health and environmental concerns. While the above might be considered typical classical nutrition topics, mineral nutrition can also be viewed in a more holistic manner. To what extent is mineral nutrition involved in the observed increase in sow mortality in the past decade? How can and should mineral nutrition be included in precision feeding programs? What further roles of mineral nutrition might be involved in environmental sustainability? Where do we stand on the involvement of mineral nutrition in acid-base balance and does it have greater value in production today than previously considered? This presentation will consider current examples of how mineral nutrition impacts applied swine nutrition as well as overall pork production.

ADJUSTMENT OF VENTILATION, INTRAPULMONARY GAS EXCHANGE, AND ACID-BASE BALANCE DURING THE FIRST DAY OF LIFE

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 682-693
Author(s):  
L. Samuel Prod'hom ◽  
Henry Levison ◽  
Ruth B. Cherry ◽  
James E. Drorbaugh ◽  
John P. Hubbell ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Respiratory Distress ◽  
Respiratory Acidosis ◽  
Acid Base Balance ◽  
Acid Base ◽  
Infants Of Diabetic Mothers ◽  
Arterial Blood ◽  
Physiologic Dead Space ◽  
Base Balance ◽  
Diabetic Mothers

Determinations of blood gases and of acid-base balance were done in umbilical vein and artery blood at birth and in arterial blood at the age of 20 minutes in 20 infants of diabetic mothers. All were born by cesarean section, 18 of them between 36 and 37 weeks gestation. None showed respiratory distress at any time. Ventilation, gaseous metabolism, functional residual capacity, intrapulmonary gas exchange, and acid-base balance were determined at the age of 1, 4, and 24 hours in these 20 infants. The results indicate the following conclusions with regard to infants of diabetic mothers. 1. Adjustment of ventilation to perfusion in the lung appears to be complete at 4 hours of life. 2. Throughout the first 24 hours there is a persistence of an over-all true right to left shunt of approximately 20-25% of the total cardiac output. The exact localization of this shunt is unknown. 3. Acid-base balance in cord blood and in arterial blood during the first day of life in infants of diabetic mothers differs only slightly from that of infants of nondiabetic mothers. At 1 and 4 hours of age there is some persistence of a slight respiratory acidosis. 4. At 24 hours infants of diabetic mothers have the usual low arterial Pco2 of other newborn infants, but a ventilation equivalent of 16.5, which is normal for adults. 5. Although 6 of the 17 infants studied at 4 hours have shown a respiratory rate above 60 without other signs of respiratory distress, these infants with high rates had small tidal volumes, high physiologic dead-space/tidal volume ratios, and relatively little increase in minute volume.

scholarly journals The 100th anniversary of pH (1909-2009). Negative logarithms for measuring hydrogen ions: are they essential in medicine? Part I

2013 ◽  
pp. 147-155
Author(s):  
Francesco Sgambato ◽  
Sergio Prozzo ◽  
Ester Sgambato ◽  
Rosa Sgambato ◽  
Luca Milano
Keyword(s):  
Human Life ◽  
100Th Anniversary ◽  
Hydrogen Ion ◽  
Hydrogen Ions ◽  
Acid Base Balance ◽  
Acid Base ◽  
The Past ◽  
Scientific Papers ◽  
Base Balance ◽  
Ph Scale

Introduction: It has been 100 years since the concept of pH (1909-2009) was ‘‘invented’’ by the Danish chemist-mathematician Søren Peter Lauritz Sørensen (1868-1939) in the chemistry laboratories of the Carlsberg Brewery in Copenhagen. The anniversary provides an opportunity to examine the crucial importance in human life of acid-base balance. Materials and methods: The authors review the historical process that led to the creation of the pH scale, with citation of passages from the original work of Sørensen published 100 years ago. This is followed by a critical analysis of the debate regarding the use of logarithmstomeasure hydrogen ion concentrations based on data from scientific papers published over the past 50 years (1960-2010). Results and discussion: The authors conclude that the concept of acid-base balance can be approached and taught in a simpler, more exciting, and even pleasant fashion without using the infamous and abstruse Henderson-Hasselbalch equation. The whole rationale underlying the understanding and clinical application of this vital topic is clearly and unquestionably inherent simpler, more manageable formula introduced by Henderson (without logs), which is useful and quite adequate for use in medical education.

Clinical signs, blood gases and acid–base balance after nitrate administration in calves

2012 ◽  
Vol 23 (3) ◽  
pp. 647-652
Author(s):  
Oskar Nagy ◽  
Iveta Paulíková ◽  
Herbert Seidel ◽  
Csilla Tóthová ◽  
Helena Šoltésová
Keyword(s):  
Clinical Signs ◽  
Blood Gases ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance

scholarly journals Physiological and Pathological Functions of SLC26A6

2021 ◽  
Vol 7 ◽  
Author(s):  
Juan Wang ◽  
Wenkang Wang ◽  
Hui Wang ◽  
Biguang Tuo
Keyword(s):  
Ion Homeostasis ◽  
Acid Base Balance ◽  
Acid Base ◽  
The Past ◽  
Anion Transporter ◽  
Transporter Family ◽  
Base Balance ◽  
Extensive Exchange ◽  
Solute Carrier

Solute Carrier Family 26 (SLC26) is a conserved anion transporter family with 10 members in human (SLC26A1-A11, A10 being a pseudogene). All SLC26 genes except for SLC26A5 (prestin) are versatile anion exchangers with notable ability to transport a variety of anions. SLC26A6 has the most extensive exchange functions in the SLC26 family and is widely expressed in various organs and tissues of mammals. SLC26A6 has some special properties that make it play a particularly important role in ion homeostasis and acid-base balance. In the past few years, the function of SLC26A6 in the diseases has received increasing attention. SLC26A6 not only participates in the development of intestinal and pancreatic diseases but also serves a significant role in mediating nephrolithiasis, fetal skeletal dysplasia and arrhythmia. This review aims to explore the role of SLC26A6 in physiology and pathophysiology of relative mammalian organs to guide in-depth studies about related diseases of human.

scholarly journals Ultrasonographic Imaging for Structural Characterization of Renal Affections and Diagnosis of Associated Chronic Renal Failure in 10 Dogs

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Vijay Kumar ◽  
Adarsh Kumar ◽  
A. C. Varshney
Keyword(s):  
Renal Failure ◽  
Clinical Signs ◽  
Renal Cysts ◽  
Renal Medulla ◽  
Acid Base Balance ◽  
Renal Sinus ◽  
Primary Indication ◽  
Base Balance ◽  
Renal Size ◽  
End Stage

The present study comprises of 10 dogs of either sex with primary indication of azotaemia. All the dogs were subjected to detailed clinical, haematobiochemical, urinalysis, and microbiological examination along with radiographical and ultrasonographical examination. Based on the ultrasonographic structural abnormalities, the different renal affections associated with CRF in majority of dogs were diagnosed. The different affections included “end-stage” kidneys (n=4), hydronephrosis (n=1), renomegaly (n=1), nephritis (n=1), nephrolithiasis (n=1), nephrocalcinosis (n=1), and renal cyst (n=1). The significant ultrasonographic features in these affections included small kidneys with loss of corticomedullary demarcation (“end-stage” kidneys); increased cortical echogenicity (nephritis); dilation of the renal pelvis, separation of the central renal sinus with anechoic space, atrophy of renal medulla, (hydronephrosis); enlarged kidneys with increased overall echogenicity of renal cortex (renomegaly and associated nephritis); hyperechoic-mineralized structure with shadowing (nephrolithiasis); diffuse, small, multiple hyperechoic structures in the renal parenchyma with distal acoustic shadowing (nephrocalcinosis); small spherical intercortical anechoic structures fluid (renal cysts). In the present study, ultrasound proved to be a quick, convenient, and sensitive modality in detecting alterations in renal size and parenchymal architecture. All the dogs so diagnosed with CRF were rendered conservative medical treatment to control clinical signs of uraemia; maintain adequate fluid, electrolyte, and acid/base balance; provide adequate nutrition; minimize progression of renal failure.

scholarly journals Clinical and Laboratory Correlates of Acute Respiratory Failure in Patients with COVID-19 Depending on the Values of Transcutaneous Saturation

2021 ◽  
Vol 18 (3) ◽  
pp. 15-22
Author(s):  
O. V. Voennov ◽  
V. I. Zagrekov ◽  
А. А. Ezhevskaya ◽  
Zh. B. Prusakova ◽  
O. N. Gunderchuk ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Oxygen Therapy ◽  
Clinical Signs ◽  
Gas Composition ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Acid Base ◽  
Hypoxemic Respiratory Failure ◽  
Base Balance ◽  
The Relationship

With a traditional approach to treatment of hypoxemic respiratory failure, it is believed that SpO2 reduction below 88-90% during oxygen therapy requires emergency care including invasive mechanical ventilation. However, the manifestations of hypoxemic respiratory failure in COVID-19 patients have certain features that have led to the change in the traditional respiratory support procedure. The therapeutic goals of respiratory support in this category of patients require clarification.The objective: in patients with COVID-19, to study the relationship of transcutaneous saturation values with clinical indicators that characterize ARF, the state of acid-base balance and blood gas composition.Subjects and methods. A multicenter prospective observational study included 90 COVID-19 patients treated in ICU whose transcutaneous saturation (SpO2) values were below 93% despite treatment. Depending on the degree of impaired oxygenation, patients underwent oxygen therapy through a mask or nasal cannula, high-flow oxygenation or non-invasive ventilation, while it was not always possible to achieve the target values of oxygenation parameters. The patients were divided into the following groups: Group 1 ‒ SpO2 above 93%, Group 2 ‒ SpO2 within 93–90%, Group 3 ‒ SpO2 within 85–89%, Group 4‒ SpO2 within 80–84%, Group 5 ‒ SpO2 within 75–79%, and Group 6 – below 75%.Results. It was revealed that during ARF management by noninvasive methods, different values of transcutaneous saturation and corresponding changes in the acid-base balance (ABB) and blood gas composition were determined When transcutaneous saturation (SpO2) decreased to 85%, there was a corresponding moderate decrease in PaO2 while no metabolic changes occurred. As a rule, there were no obvious clinical signs of respiratory failure (silent hypoxia). In patients with SpO2 reduction down 80–85%, clinical signs of respiratory failure (dyspnea, tachypnea, agitation) and, as a rule, a moderate increase in PаCO2 with the development of respiratory acidosis and compensatory metabolic alkalosis were noted. When SpO2 decreased down to 75–79%, arterial hypoxemia was usually accompanied by moderate hypercapnia and the development of decompensated mixed acidosis and venous desaturation as well as increased lactate levels. With transcutaneous saturation going below 74%, these changes were even more pronounced and were observed in all patients of this group.Conclusion. The revealed changes are mostly consistent with generally accepted ideas about the relationship between values of transcutaneous saturation and blood gas composition and parameters of blood ABB in the case of ARF. Reduction of transcutaneous saturation down to 85% not accompanied by pronounced clinical signs of respiratory failure (dyspnea, tachypnea, agitation), development of acidosis and venous desaturation, and the elevated lactate level can be regarded as relatively safe.

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