scholarly journals Acid based disorders in intensive care unit: a hospital-based study

2019 ◽  
Vol 6 (1) ◽  
pp. 62 ◽  
Author(s):  
Babu Rajendran ◽  
Seetha Rami Reddy Mallampati ◽  
Sheju Jonathan Jha J.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Infectious Diseases ◽  
Respiratory Alkalosis ◽  
Simple Type ◽  
Acid Base ◽  
Icu Patients ◽  
Mixed Acid ◽  
Base Disorder

Background: Acid base disorders are common in the ICU patients and pose a great burden in the management of the underlying condition.Methods: Identifying the type of acid-base disorders in ICU patients using arterial blood gas analysis This was a retrospective case-controlled comparative study. 46 patients in intensive care unit of a reputed institution and comparing the type of acid-base disorder amongst infectious (10) and non-infectious (36) diseases.Results: Of the study population, 70% had mixed acid base disorders and 30% had simple type of acid base disorders. It was found that sepsis is associated with mixed type of acid-base disorders with most common being metabolic acidosis with respiratory alkalosis. Non-infectious diseases were mostly associated with metabolic alkalosis with respiratory acidosis. Analysis of individual acid base disorders revealed metabolic acidosis as the most common disturbance.Conclusions: These results projected the probability of acid bases disorders in various conditions and help in the efficient management. Mixed acid base disorders are the most common disturbances in the intensive care setup which is metabolic acidosis with respiratory alkalosis in infectious diseases and metabolic acidosis is the most common simple type of acid base disorder.

Teaching acid/base physiology in the laboratory

2010 ◽  
Vol 34 (4) ◽  
pp. 233-238 ◽  
Author(s):  
Ulla G. Friis ◽  
Ronni Plovsing ◽  
Klaus Hansen ◽  
Bent G. Laursen ◽  
Birgitta Wallstedt
Keyword(s):  
Metabolic Acidosis ◽  
Medical Students ◽  
Respiratory Alkalosis ◽  
Theory And Practice ◽  
Single Group ◽  
Acid Base ◽  
Laboratory Exercise ◽  
Base Disorder

Acid/base homeostasis is one of the most difficult subdisciplines of physiology for medical students to master. A different approach, where theory and practice are linked, might help students develop a deeper understanding of acid/base homeostasis. We therefore set out to develop a laboratory exercise in acid/base physiology that would provide students with unambiguous and reproducible data that clearly would illustrate the theory in practice. The laboratory exercise was developed to include both metabolic acidosis and respiratory alkalosis. Data were collected from 56 groups of medical students that had participated in this laboratory exercise. The acquired data showed very consistent and solid findings after the development of both metabolic acidosis and respiratory alkalosis. All results were consistent with the appropriate diagnosis of the acid/base disorder. Not one single group failed to obtain data that were compatible with the diagnosis; it was only the degree of acidosis/alkalosis and compensation that varied.

scholarly journals Admission Anion Gap Metabolic Acidosis and Its Impact on Patients in Medical Intensive Care Unit

2021 ◽  
Author(s):  
Akshay Dafal ◽  
Sunil Kumar ◽  
Sachin Agrawal ◽  
Sourya Acharya ◽  
Apoorva Nirmal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Length Of Stay ◽  
Medical Intensive Care Unit ◽  
Anion Gap ◽  
Acid Base ◽  
Acid Base Status ◽  
Medical Intensive Care ◽  
Time Of Admission

Abstract Introduction Anion gap (AG) metabolic acidosis is common in critically ill patients. The relationship between initial AG at the time of admission to the medical intensive care unit (MICU) and mortality or length of stay is unclear. This study was undertaken to evaluate this relationship. Materials and Method We prospectively examined the acid–base status of 500 consecutive patients at the time of MICU admission and outcome was measured in terms of mortality, length of ICU stay, need of ventilator, and laboratory parameters. The patients were divided into four stages based on the severity of AG. Outcome based on the severity of AG was measured, and comparisons that adjusted for baseline characteristics were performed. Results This study showed that increased AG was associated with the higher mortality. Patients with the highest AG also had the longest length of stay in the MICU, and patients with normal acid–base status had the shortest ICU length of stays (p < 0.05). Conclusion A high AG at the time of admission to the MICU was associated with higher mortality and length of stays. Initial risk stratification based on AG and metabolic acidosis may help guide appropriate patient disposition (especially in patients without other definitive criteria for MICU admission) and assist with prognosis.

scholarly journals Metabolic acidosis in medical intensive care unit with indicators and their prognostic value- A prospective observational study

2017 ◽  
Vol 8 (3) ◽  
pp. 60-67
Author(s):  
Prem Amalraj ◽  
Arun Kumar Narayanan ◽  
Satish Balan ◽  
Mathew Thomas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Traditional Method ◽  
Traditional Approach ◽  
Serum Lactate ◽  
Anion Gap ◽  
Apache Ii Score ◽  
Acid Base ◽  
Lactate Levels

Background: Metabolic acidosis is a common abnormality in the intensive care unit. There has recently been a surge of interest in nontraditional approaches to the analysis of acid base disorders.Aims and Objectives: This study was undertaken to compare the application of the physicochemical method of Stewart and the traditional Henderson-Hasselbach equation withcorrection for albumin in quantification of acid base disorders.Materials and Methods: All patients with metabolic acidosis admitted to the ICU as defined by a base deficit of >2.5 were included in the study. The APACHE II score was calculated at admission and the predicted mortality was defined. The acid base disorders were quantified by the traditional approach with anion gap correction for serum albumin as well as by the Stewart method with calculation of the strong anion gap acidosis.Results: One-hundred forty patients were included in the study of which 58% were males. In 125 subjects (89%) acidosis was discovered by the Stewart method. The traditional method detected increased anion gap in 109 subjects (78%) but this increased to 124 (88.5%) when corrected for albumin. Both the strong ion gap (SIG) and the albumin corrected anion gap correlated strongly. Serum lactate levels and SIG predicted mortality as did albumin corrected anion gap.Conclusion: Albumin correction of the anion gap correlates well with acidosis as discovered by the SIG and therefore should be used in the ICUs rather than the traditional anion gap. With this modification, we can thus depend on the application of the intuitive traditional method rather than the more difficult to apply Stewart method for analysis of the acid base abnormalities in the ICU.Asian Journal of Medical Sciences Vol.8(3) 2017 60-67

Metabolic Acidosis in the Cardiothoracic Intensive Care Unit

2020 ◽  
pp. 85-96
Author(s):  
Paul D. Weyker ◽  
Christopher Webb
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Cardiac Output ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Common Type ◽  
Hydrogen Ion ◽  
Production Loss ◽  
Icu Patients ◽  
Ion Production

This chapter explores metabolic acidosis in cardiothoracic intensive care unit (ICU) patients, the most common type of which is lactic acidosis. There are generally thought to be 3 different mechanisms that lead to the development of metabolic acidosis: increased hydrogen ion production, loss of bicarbonate production, and decreased hydrogen ion excretion. Metabolic acidosis following cardiac surgery can have several detrimental effects in critically ill patients. Acidosis results in myocardial depression, which will limit cardiac output and oxygen delivery. Acidosis also leads to arterial vasodilation and resultant hypotension. Importantly, decreased pH and increases in partial pressure of carbon dioxide are independent potent pulmonary vasoconstrictors. Ultimately, determining the underlying cause of metabolic acidosis in the ICU is imperative in order to guide appropriate therapies. Understanding Winter's formula and the serum anion gap calculation are necessary when assessing the etiology of metabolic acidosis. The chapter then looks at the treatment of metabolic acidosis.

CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: Acid-base Disturbances in the Intensive Care Unit: Metabolic Acidosis

2006 ◽  
Vol 19 (6) ◽  
pp. 492-495 ◽  
Author(s):  
Anton C. Schoolwerth ◽  
Thomas M. Kaneko ◽  
Martin Sedlacek ◽  
Clay A. Block ◽  
Brian D. Remillard
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Acid Base ◽  
Critical Care Issues

scholarly journals  Acute pancreatitis, azotaemia, cholestasis and haemolytic anaemia in a dog: a case report

2013 ◽  
Vol 58 (No. 1) ◽  
pp. 44-49 ◽  
Author(s):  
M. Guadarrama-Olhovich ◽  
LE Garcia Ortuno ◽  
JA Ruiz Remolina ◽  
C. Lopez Buitrago ◽  
J. Ramirez Lezama ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Acute Pancreatitis ◽  
Haemolytic Anaemia ◽  
Clinical Pathology ◽  
Respiratory Alkalosis ◽  
Acid Base ◽  
Mixed Acid ◽  
Left Shift ◽  
Immune Mediated ◽  
Base Disorder

We here report acute pancreatitis with multiorganic complications in a female Cocker Spaniel. The most important alterations in clinical pathology were renal azotaemia, hyperbilirubinaemia with a prevalence of conjugated bilirrubin and increased alkaline phosphatase by cholestasis; hyperamylasaemia due to pancreatitis; dehydration, hyponatraemia, hypochloraemia and hypokalaemia related to vomiting; metabolic acidosis and respiratory alkalosis corresponding to mixed acid-base disorder; markedly regenerative anaemia with spherocytes and agglutination due to immune-mediated haemolytic anaemia and intravascular haemolysis; leukocytosis with a left shift. Proteinuria, glucosuria, bilirubinuria and haemoglobinuria were detected in the urine. Severe suppurative pancreatitis with peripancreatic necrosis and suppurative esteatitis, tubulorrhectic nephrosis, severe hepatitis and intrahepatic cholestasis corresponded with alterations described by clinical pathology. In order to diagnose acute pancreatitis in dogs with multiple complications, it is very important to integrate the results of clinical pathology with the anamnesis and physical examination of the animal. It is especially important to note that the serum activity of amylase correlates with time after the pancreatic attack.

scholarly journals Acid-base status and electrolyte concentrations in 32 dogs with parvoviral enteritis

2018 ◽  
Vol 50 (4) ◽  
pp. 305
Author(s):  
A. F. KOUTINAS (Α.Φ. ΚΟΥΤΙΝΑΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
T. RALLIS (Τ. ΡΑΛΛΗΣ) ◽  
M. KRITSEPI (Μ. ΚΡΙΤΣΕΠΗ) ◽  
K. ADAMAMA-MORAITOU (Κ. ΑΔΑΜΑΜΑ-ΜΩΡΑΪΤΟΥ)
Keyword(s):  
Partial Pressure ◽  
Venous Blood ◽  
Clinical Signs ◽  
Respiratory Alkalosis ◽  
Common Finding ◽  
Acid Base ◽  
Compensatory Mechanisms ◽  
Mixed Acid ◽  
Blood Ph ◽  
Base Disorder

A total of 32 dogs with clinical signs compatible with parvoviral enteritis were collected and blood pH, 02 and C02 partial pressure, bicarbonate and hemoglobin concentrations and hemoglobin saturation were measured. Sodium and potassium concentrations were also determined by photometry in the serum of venous blood samples. Acidemia, due to metabolic acidosis, was the most common abnormality, found in 17/32 animals. Alkalemia, attributed to respiratory alkalosis, was seen only in 3 dogs. Nine animals with atrerial blood pH found to be within normal limits had low bicarbonate concetration and reduced C02 partial pressure. This discrepancy could be attributed to the development of compensatory mechanisms or a mixed acid-base disorder. Hypokalemia (2/32) or hyperkalemia (2/32) were not a common finding, compared to hyponatremia (5/32) and hypernatremia (12/32).

Infectious diseases as a trigger in thrombotic microangiopathies in intensive care unit (ICU) patients?

2003 ◽  
Vol 29 (4) ◽  
pp. 564-569 ◽  
Author(s):  
Paul Coppo ◽  
Christophe Adrie ◽  
Elie Azoulay ◽  
Ghislaine Leleu ◽  
Eric Oksenhendler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infectious Diseases ◽  
Thrombotic Microangiopathies ◽  
Icu Patients

scholarly journals Acid-base status in canine babesiosis caused by Babesia canis

2020 ◽  
Vol 90 (6) ◽  
pp. 603-610
Author(s):  
Marin Torti ◽  
◽  
Josipa Kuleš ◽  
Vesna Matijatko ◽  
Mirna Brkljačić ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Metabolic Alkalosis ◽  
Strong Ion Difference ◽  
Canine Babesiosis ◽  
Acid Base ◽  
Mixed Acid ◽  
Naturally Occurring ◽  
Base Disorder ◽  
Acid Base Status ◽  
Healthy Dogs

Acid-base disturbances have been reported in severe canine babesiosis caused by Babesia rossi (B. rossi), but they have not been studied in babesiosis caused by B. canis. The objective of this study was to determine the acid-base status, blood gases and electrolyte concentrations in naturally occurring canine babesiosis caused by B. canis, and to compare the results to those in healthy dogs. Two groups of animals were used: group 1 consisted of 10 healthy dogs, and group 2 consisted of 14 dogs naturally infected with B. canis. The following acid-base disturbances occurred in the dogs with naturally occurring babesiosis: half of the dogs had a mixed acid-base disorder, and the other half a simple acid-base disorder. The most common mixed disorder was metabolic acidosis with metabolic alkalosis. It may be said that a variety of acid-base disorders occurs in canine babesiosis. The dogs in the present study had metabolic acidosis due to hyperlactemia and hyperchloremia, metabolic alkalosis due to hypochloremia and hypoalbuminemia, and respiratory alkalosis due to hypoxemia. With the use of the strong-ion difference approach clearer recognition of mixed acid-base disorders and their better understanding is possible.

Sign in / Sign up

Export Citation Format

Share Document