scholarly journals Experimental protocol for metabolic acidosis induction by intravenous administration of hydrochloric acid in sheep

2019 ◽  
Vol 71 (1) ◽  
pp. 53-60 ◽  
Author(s):  
F.T.N.M.A. Romão ◽  
J.M. Curti ◽  
P.F.V. Pereira ◽  
K.K.M.C. Flaiban ◽  
J.A.N. Lisbôa
Keyword(s):  
Metabolic Acidosis ◽  
Side Effects ◽  
Hydrochloric Acid ◽  
Intravenous Administration ◽  
Total Concentration ◽  
Carbon Dioxide Partial Pressure ◽  
Strong Ion Difference ◽  
Experimental Protocol ◽  
Hyperchloremic Acidosis ◽  
Fractional Excretion Of Sodium

ABSTRACT The aim of this study was to assess the magnitude and duration of blood and urine changes and the side effects of hyperchloremic acidosis induced by the intravenous administration of hydrochloric acid in sheep. Five healthy, crossbred adult ewes, with a mean body weight of 44±2.9kg were used. The hydrochloric acid solution was administered intravenously at a rate of 25mL/kg/h for 4 hours continuously. Venous blood and urine samples were collected and pH values, blood carbon dioxide partial pressure, bicarbonate, base excess, strong ion difference, anion gap, total concentration of nonvolatile buffers, creatinine, plasma L-lactate, plasma and urine sodium, potassium, and chloride were determined. The experimental protocol induced severe hyperchloremic acidosis at the end of the infusion, with a decreased plasma strong ion difference. The fractional excretion of sodium and chloride remained increased during 4 hours after the infusion. Aciduria was observed at approximately 24 hours. Twenty-four hours after the infusion, the animals showed mild and compensated metabolic acidosis. This protocol was effective in inducing severe and long-lasting hyperchloremic acidosis and did not cause serious side effects. Therefore, this protocol can be used safely in adult sheep for studies on the treatment of this condition.

scholarly journals PENDEKATAN STEWART DALAM pH DARAH YANG MENDASARI ASIDOSIS METABOLIK

2018 ◽  
Vol 19 (2) ◽  
pp. 79
Author(s):  
Efrida Efrida ◽  
Ida Parwati ◽  
Ike Sri Redjeki
Keyword(s):  
Metabolic Acidosis ◽  
Ph Value ◽  
Total Concentration ◽  
Ph Measurement ◽  
Strong Ion Difference ◽  
Cross Sectional ◽  
Stewart Approach ◽  
Blood Ph ◽  
Base Disorder ◽  
The Mean

Metabolic acidosis is the most frequent acid-base disorder in patients of the Intensive Care Unit. By conventional approach based onpH value, [HCO3–], and base deficit (BD) from blood gas analyzer (BGA) measurement are often inappropriate with the clinical stateand inadequate in explaining the mechanism of the metabolic acidosis. The Stewart approach states that the blood pH is determinedby a strong ion difference (SID), the carbon dioxide tension (pCO2), the total concentration of non-volatile weak acid. The Stewartapproach may give a better understanding of the mechanisms that underlie the metabolic acidosis. The purpose of this study is to knowthe correlation of blood pH value measurement from BGA and calculation based on Stewart approach and identifying the mechanismsthat underlie a metabolic acidosis. In this study an analytic observational cross-sectional method was used. The examined subjectsconsisted of 71 patients who were admitted with a metabolic acidosis at the ICU from July up to August 2007. All patients were measuredfor their blood pH, pCO2, [HCO3–], BD, sodium, potassium, calcium, magnesium, chloride, lactate, albumin, and phosphate. The resultwas reported as the mean and standard deviation. The data were analyzed by Pearson’s correlation test and linier multiple regression.Statistical significance was determined at p < 0.05. The mean values of blood pH measurement from BGA and blood pH calculationbased on the Stewart approach were 7.33 (0.11) and 7.49 (0.11) (r = 0.681; p < 0.001). Most patients had two underlying mechanisms ofmetabolic acidosis. Hyperlactatemia was present in 61.8%, hyperchloremia was present in 58.2% of patients. Based on this study so far,by using the Stewart approach there is an excellent and significant correlation between the blood pH measurement from BGA and bloodpH calculation. Hyperlactatemia and hyperchloremia are the main causes of the metabolic acidosis in patients of the ICU ward.

Total weak acid concentration and effective dissociation constant of nonvolatile buffers in human plasma

2001 ◽  
Vol 91 (3) ◽  
pp. 1364-1371 ◽  
Author(s):  
Peter D. Constable
Keyword(s):  
Dissociation Constant ◽  
Human Plasma ◽  
Total Concentration ◽  
Weak Acid ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Horse Plasma ◽  
Using Data ◽  
Species Specific

The strong ion approach provides a quantitative physicochemical method for describing the mechanism for an acid-base disturbance. The approach requires species-specific values for the total concentration of plasma nonvolatile buffers (Atot) and the effective dissociation constant for plasma nonvolatile buffers ( K a), but these values have not been determined for human plasma. Accordingly, the purpose of this study was to calculate accurate Atot and K a values using data obtained from in vitro strong ion titration and CO2tonometry. The calculated values for Atot (24.1 mmol/l) and K a (1.05 × 10−7) were significantly ( P < 0.05) different from the experimentally determined values for horse plasma and differed from the empirically assumed values for human plasma (Atot = 19.0 meq/l and K a = 3.0 × 10−7). The derivatives of pH with respect to the three independent variables [strong ion difference (SID), Pco 2, and Atot] of the strong ion approach were calculated as follows: [Formula: see text] [Formula: see text], [Formula: see text]where S is solubility of CO2 in plasma. The derivatives provide a useful method for calculating the effect of independent changes in SID+, Pco 2, and Atot on plasma pH. The calculated values for Atot and K a should facilitate application of the strong ion approach to acid-base disturbances in humans.

Dr. Shannon Replies

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 619-619
Author(s):  
Daniel C. Shannon
Keyword(s):  
Gastrointestinal Tract ◽  
Side Effects ◽  
Intravenous Administration ◽  
Ductus Arteriosus ◽  
Oral Feeding ◽  
Blood Levels ◽  
Severe Toxicity ◽  
Potential Toxicity ◽  
Nasojejunal Tube ◽  
Rectal Route

Dr. Morens raises questions of potential toxicity of theophylline in the gastrointestinal tract, kidney and ductus arteriosus. Except for vomiting, which has occurred in some infants when blood levels have been excessive (mainly 2Oµg/ml), we have not observed any of these side effects in treating 93 infants. In all infants, treatment was given through a nasogastric or nasojejunal tube until oral feeding was possible. Because acute severe toxicity in children and adults has been related to intravenous administration, we have used this route only when necessary. Because of erratic absorption, we have avoided the rectal route.

Side Effects of Sugar Substitutes during Intravenous Administration

1975 ◽  
Vol 18 (1) ◽  
pp. 227-241 ◽  
Author(s):  
D.W. Thomas ◽  
J.B. Edwards ◽  
R.G. Edwards
Keyword(s):  
Side Effects ◽  
Intravenous Administration ◽  
Sugar Substitutes

Clinical Evaluation of High Weekly Intravenous Doses of Methotrexate in Advanced Oropharyngeal Carcinoma

1970 ◽  
Vol 56 (5) ◽  
pp. 259-268 ◽  
Author(s):  
Giuseppe M. de Palo ◽  
Mario De Lena ◽  
Roberto Molinari ◽  
Antonio Cunsolo ◽  
Silvio Monfardini ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Intravenous Administration ◽  
Renal Toxicity ◽  
Severe Depression ◽  
Response To Treatment ◽  
Oropharyngeal Carcinoma ◽  
Intraarterial Infusion ◽  
Intravenous Injections ◽  
Duration Of Response

Methotrexate (MTX) was given by weekly rapid intravenous injections to 27 patients with inoperable oropharyngeal carcinoma. 9 cases were untreated while 18 had received radiotherapy or chemotherapy before administration of MTX. In 20 cases the dose was 40 mg/m2/week (patients over 50 years) and in 7 cases 60 mg/m2/week (table 1). In responsive patients, maintenance treatment was given at the dose of 15 mg/m2 every 4 days either orally or intramuscularly. 23 cases were adequately evaluable, i.e. they received treatment for a minimum of 3 weeks. Response to treatment was evaluated according to Karnofsky's scale. Considering only category 1 regressions, 11/16 (75%) patients adequately treated with 40 mg/m2 showed objective improvement and respectively 4/7 (57%) given 60 mg/m*. 8 out of 15 cases (41%) with category 1 response showed a regression greater than 50%. The mean duration of response for category 1 patients was 3.5 months, while the longest regression lasted 9 months (table 2). 18 patients had one or more side effects: 9 had oral lesions or gastroenteritis, 12 bone marrow depression, 3 hepatic and 1 renal toxicity. One patient died from hepatic and renal toxicity; in the remaining cases the side effects were quickly reversible (table 3). The percent regression rate for category 1 response and its average duration obtained with intravenous MTX seems comparable to intraarterial infusion (table 4). Systemic toxicity seems also comparable (table 5). Furthermore, intravenous administration obviates the typical local complications occurring with intra-arterial treatment and therapy can be given also at outpatients. For this reason, intravenous administration of MTX is preferred to intra-arterial infusion in the control of primary inoperable oropharyngeal carcinomas, provided no severe depression of liver, kidney and bone marrow is present.

Effect of Intravenous Injection of Hypertonic Glucose Solution on External Secretion of the Pancreas

1956 ◽  
Vol 186 (2) ◽  
pp. 187-189 ◽  
Author(s):  
J. O. Crider ◽  
S. S. Conly ◽  
J. E. C. Dorchester ◽  
J. E. Thomas
Keyword(s):  
Hydrochloric Acid ◽  
Specific Gravity ◽  
Intravenous Injection ◽  
Pancreatic Juice ◽  
Intravenous Administration ◽  
Glucose Solution ◽  
Chronic Fistula ◽  
Hypertonic Glucose

Effect of the intravenous administration of hypertonic glucose solution on the specific gravity, volume and amylase content of pancreatic juice collected from unanesthetized, chronic fistula dogs secreting in response to hydrochloric acid in the duodenum was studied. There was an increase in the specific gravity and amylase but no change in volume.

Pathophysiology and causes of metabolic acidosis in the critically ill

2016 ◽  
Author(s):  
Patrick J. Neligan ◽  
Clifford S. Deutschman
Keyword(s):  
Metabolic Acidosis ◽  
Isotonic Saline ◽  
Lactate Production ◽  
Weak Acid ◽  
Strong Ion Difference ◽  
Waste Products ◽  
Renal Tubular ◽  
Specific Symptoms ◽  
Symptoms And Signs ◽  
Intracellular Glucose

Critical illness is typically characterized by changes in the balance of water and electrolytes in the extracellular space, resulting in the accumulation of anionic compounds that manifests as metabolic acidosis. Metabolic acidosis manifests with tachypnoea, tachycardia, vasodilatation, headache and a variety of other non-specific symptoms and signs. It is caused by a reduction in the strong ion difference (SID) or an increase in weak acid concentration (albumin or phosphate). Increased SID results from hyperchloraemia, haemodilution or accumulation of metabolic by-products. A reduction in SID results in a corresponding reduction is serum bicarbonate. There is a corresponding increase in alveolar ventilation and reduced PaCO2. Lactic acidosis results from increased lactate production or reduced clearance. Ketoacidosis is associated with reduced intracellular glucose availability for metabolism, and is associated with insulin deficiency and starvation. Hyperchloraemic acidosis is associated with excessive administration of isotonic saline solution, renal tubular acidosis and ureteric re-implantation. Renal acidosis is associated with hyperchloraemia, hyperphosphataemia, and the accumulation of medley nitrogenous waste products.

Sign in / Sign up

Export Citation Format

Share Document