In Reply: Intrapartum Asphyxia and Cerebral Palsy

PEDIATRICS ◽  
1989 ◽  
Vol 83 (4) ◽  
pp. 654-654
Author(s):  
JOHN M. FREEMAN ◽  
KARIN B. NELSON
Keyword(s):  
Cohort Study ◽  
Neonatal Period ◽  
Birth Cohort Study ◽  
Acid Base Balance ◽  
Acid Base ◽  
Apgar Scores ◽  
Neurologic Dysfunction ◽  
Base Balance ◽  
Better Than

Dr Hermansen makes several points that do not contradict our paper and then he makes a leap in logic that does. We agree with him that there is some correlation, although a weak one, between pH and one-minute Apgar scores and that there is not much evidence that pH predicts long-term neurologic dysfunction. In fact, Dijxhoorn and co-workers found that pH does not explain most neurologic dysfunction even within the neonatal period. Ruth and Raivio, in the first birth cohort study of the predictive value of pH and other measures of neonatal acid-base balance, reported that none of these measures was better than, or even as good as, the Apgar score in predicting neurologic status at 1 year.

The Effect of Long-term Topiramate Treatment on Acid-base Balance in Children with Epilepsy

2016 ◽  
Vol 24 (3) ◽  
pp. 116-121
Author(s):  
김지용 ◽  
남상욱 ◽  
김영미 ◽  
이윤진 ◽  
이훈상 ◽  
...  
Keyword(s):  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance

Long-term regulation of renal Na-dependent cotransporters and ENaC: response to altered acid-base intake

2000 ◽  
Vol 279 (3) ◽  
pp. F459-F467 ◽  
Author(s):  
Gheun-Ho Kim ◽  
Stephen W. Martin ◽  
Patricia Fernández-Llama ◽  
Shyama Masilamani ◽  
Randall K. Packer ◽  
...  
Keyword(s):  
Collecting Duct ◽  
Na Channel ◽  
Thick Ascending Limb ◽  
Acid Base Balance ◽  
Acid Base ◽  
Opposite Pattern ◽  
Α Subunit ◽  
Base Balance ◽  
Acid Loading

Increased systemic acid intake is associated with an increase in apical Na/H exchange in the renal proximal tubule mediated by the type 3 Na/H exchanger (NHE3). Because NHE3 mediates both proton secretion and Na absorption, increased NHE3 activity could inappropriately perturb Na balance unless there are compensatory changes in Na handling. In this study, we use semiquantitative immunoblotting of rat kidneys to investigate whether acid loading is associated with compensatory decreases in the abundance of renal tubule Na transporters other than NHE3. Long-term (i.e., 7-day) acid loading with NH4Cl produced large decreases in the abundances of the thiazide-sensitive Na-Cl cotransporter (TSC/NCC) of the distal convoluted tubule and both the β- and γ-subunits of the amiloride-sensitive epithelial Na channel (ENaC) of the collecting duct. In addition, the renal cortical abundance of the proximal type 2 Na-dependent phosphate transporter (NaPi-2) was markedly decreased. In contrast, abundances of the bumetanide-sensitive Na-K-2Cl cotransporter of the thick ascending limb and the α-subunit of ENaC were unchanged. A similar profile of changes was seen with short-term (16-h) acid loading. Long-term (7-day) base loading with NaHCO3resulted in the opposite pattern of response with marked increases in the abundances of the β- and γ-subunits of ENaC and NaPi-2. These adaptations may play critical roles in the maintenance in Na balance when changes in acid-base balance occur.

scholarly journals Prognostic value of base excess as indicator of acid-base balance in acute heart failure

2020 ◽  
Vol 9 (5) ◽  
pp. 399-405 ◽  
Author(s):  
Hiroki Nakano ◽  
Toshiyuki Nagai ◽  
Yasuyuki Honda ◽  
Satoshi Honda ◽  
Naotsugu Iwakami ◽  
...  
Keyword(s):  
Heart Failure ◽  
Confidence Interval ◽  
Acute Heart Failure ◽  
Base Excess ◽  
Acid Base Balance ◽  
Acid Base ◽  
Heart Failure Patients ◽  
Base Balance ◽  
High Base

Background: Acid-base balance can change as a result of pulmonary oedema and low tissue perfusion in acute heart failure patients. However, its long-term prognostic significance remains to be clarified. Methods: We prospectively examined a cohort of 472 consecutive acute heart failure patients who underwent arterial blood gas analysis on admission between January 2013 and May 2016. Acidaemia, alkalaemia and normal range of base excess were defined as pH <7.38, >7.42 and −2 to 2 mEq/L, respectively. The primary outcome was all-cause death. Results: During a median follow-up period of 714 days, 101 patients died. Although there was no difference in mortality among patients with acidaemia, normal pH and alkalaemia ( p = 0.92), patients with high base excess had the highest mortality compared with others. Multivariable Cox proportional hazard models revealed that high base excess was an independent determinant of mortality (hazard ratio 1.83, 95% confidence interval 1.08–3.13 (high versus normal base excess), hazard ratio 0.81, 95% confidence interval 0.47–1.41 (low versus normal base excess)), even after adjustment for significant prognostic covariates. Furthermore, regarding mortality stratified by base excess and carbon dioxide partial pressure (pCO2), patients with high base excess (>2.1 mEq/L) and high pCO2 (>40 mmHg) had the highest mortality compared with others. Conclusions: High base excess, but not low base excess, on admission was associated with long-term mortality in acute heart failure patients, indicating the importance of evaluating acid-base balance on admission by base excess for stratifying the risk of mortality in patients with acute heart failure.

scholarly journals Association between Acid-Base Balance and Asphyxia in Newborn Infants

2018 ◽  
Vol 34 (1-2) ◽  
pp. 38-43
Author(s):  
Sari Leyli Harahap ◽  
Chairul Adillah Harahap ◽  
Sri Sulastri ◽  
Chairul Yoel ◽  
Noersida Raid
Keyword(s):  
Apgar Score ◽  
Newborn Infants ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Acid Base ◽  
Apgar Scores ◽  
Arterial Blood ◽  
Base Balance

We performed a prospective study on the association between acid-base balance and asphyxta based on Apgar scores in 45 newborn babies admitted to the Division of Perinatology, Pirngadi Hospital, Medan, from January 1 to February 28, 1993. Blood gas analysis was done on blood obtained from umbilical artery. Based on 1st and 5th minutes Apgar scores, 40 (88.9%) and 21 babies (46.7%}, respectively, had asphyxia. Relation to acid-base balance was determined with the sensitivity of the 5th minute Apgar score in predicting acidotic states. It was found that Apgar score had sensitivity of 57.7% and specificity of 68.4% in predicting the acidotic states. Apgar score of > 7 was unable to. exclude the possible acidosis in 45% of cases (negative predictive value 54.1%). Gestational age had no influence on Apgar Scores. Apgar score was more sensitive to eliminate suspected acidosis in term neonates than in preterms. We recommend to perform umbilical arterial blood gas analysis to determine acidotic state in high risk newborn infants.

Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake

2014 ◽  
Vol 84 (3-4) ◽  
pp. 0206-0217 ◽  
Author(s):  
Seyedeh-Elaheh Shariati-Bafghi ◽  
Elaheh Nosrat-Mirshekarlou ◽  
Mohsen Karamati ◽  
Bahram Rashidkhani
Keyword(s):  
Calcium Intake ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
Dietary Intakes ◽  
Iranian Women ◽  
Acid Base Balance ◽  
Mineral Density ◽  
Acid Base ◽  
Base Balance ◽  
Dietary Acid

Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50 - 85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference - 0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

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