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.

scholarly journals Metabolic and volume status evaluation of hemodialysis patients with and without residual renal function in the long interdialytic interval

2019 ◽  
Vol 41 (4) ◽  
pp. 481-491 ◽  
Author(s):  
Lenina Ludimila Sampaio de Almeida ◽  
Luís Henrique Bezerra Cavalanti Sette ◽  
Fernando Luiz Affonso Fonseca ◽  
Leila Silveira Vieira da Silva Bezerra ◽  
Francisco Hélio Oliveira Júnior ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Potassium ◽  
Ph Value ◽  
Residual Renal Function ◽  
Acid Base ◽  
Serum Samples ◽  
Cross Sectional ◽  
Interdialytic Weight Gain ◽  
Base Disorder ◽  
Acid Base Status

Abstract Introduction: It is unclear whether residual renal function (RRF) in dialysis patients can attenuate the metabolic impact of the long 68-hour interdialytic interval, in which water, acid, and electrolyte accumulation occurs. Objective: to evaluate serum electrolyte levels, water balance, and acid-base status in dialytic patients with and without RRF over the long interdialytic interval (LII). Methodology: this was a single-center, cross-sectional, and analytical study that compared patients with and without RRF, defined by diuresis above 200 mL in 24 hours. Patients were weighed and serum samples were collected for biochemical and gasometric analysis at the beginning and at the end of the LII. Results: 27 and 24 patients with and without RRF were evaluated, respectively. Patients without RRF had a higher increase in serum potassium during the LII (2.67 x 1.14 mEq/L, p < 0.001), reaching higher values at the end of the study (6.8 x 5.72 mEq/L, p < 0.001) and lower pH value at the beginning of the interval (7.40 x 7.43, p = 0.018). More patients with serum bicarbonate < 18 mEq/L (50 x 14.8%, p = 0.007) and mixed acid-base disorder (57.7 x 29.2%, p = 0.042), as well as greater interdialytic weight gain (14.67 x 8.87 mL/kg/h, p < 0.001) and lower natremia (137 x 139 mEq/L, p = 0.02) at the end of the interval. Calcemia and phosphatemia were not different between the groups. Conclusion: Patients with RRF had better control of serum potassium, sodium, acid-base status, and volemia throughout the LII.

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.

Rapid Saline Infusion Produces Hyperchloremic Acidosis in Patients Undergoing Gynecologic Surgery 

1999 ◽  
Vol 90 (5) ◽  
pp. 1265-1270 ◽  
Author(s):  
Stefan Scheingraber ◽  
Markus Rehm ◽  
Christiane Sehmisch ◽  
Udilo Finsterer
Keyword(s):  
Metabolic Acidosis ◽  
Total Protein ◽  
Gynecologic Surgery ◽  
Strong Ion Difference ◽  
Serum Bicarbonate ◽  
Bicarbonate Concentration ◽  
Stewart Approach ◽  
Ringer’S Solution ◽  
Lactated Ringer's Solution ◽  
Hasselbalch Equation

Background Changes in acid-base balance caused by infusion of a 0.9% saline solution during anesthesia and surgery are poorly characterized. Therefore, the authors evaluated these phenomena in a dose-response study. Methods Two groups of 12 patients each who were undergoing major intraabdominal gynecologic surgery were assigned randomly to receive 0.9% saline or lactated Ringer's solution in a dosage of 30 ml x kg(-1) x h(-1). The pH, arterial carbon dioxide tension, and serum concentrations of sodium, potassium, chloride, lactate, and total protein were measured in 30-min intervals. The serum bicarbonate concentration was calculated using the Henderson-Hasselbalch equation and also using the Stewart approach from the strong ion difference and the amount of weak plasma acid. The strong ion difference was calculated as serum sodium + serum potassium - serum chloride - serum lactate. The amount of weak plasma acid was calculated as the serum total protein concentration in g/dl x 2.43. Results Infusion of 0.9% saline, but not lactated Ringer's solution, caused a metabolic acidosis with hyperchloremia and a concomitant decrease in the strong ion difference. Calculating the serum bicarbonate concentration using the Henderson-Hasselbalch equation or the Stewart approach produced equivalent results. Conclusions Infusion of approximately 30 ml x kg(-1) x h(-1) saline during anesthesia and surgery inevitably leads to metabolic acidosis, which is not observed after administration of lactated Ringer's solution. The acidosis is associated with hyperchloremia.

Plasma Acid-base Changes in Chronic Renal Failure: A Stewart Analysis

2005 ◽  
Vol 28 (10) ◽  
pp. 961-965 ◽  
Author(s):  
D.A. Story ◽  
A. Tosolini ◽  
R. Bellomo ◽  
M. Leblanc ◽  
L. Bragantini ◽  
...  
Keyword(s):  
Renal Failure ◽  
Metabolic Acidosis ◽  
Chronic Renal Failure ◽  
Base Excess ◽  
Chloride Ions ◽  
Minor Role ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Failure Group ◽  
Stewart Approach

The bicarbonate centered approach to acid-base physiology involves complex explanations for the metabolic acidosis associated with chronic renal failure. We used the alternate Stewart approach to acid-base physiology to quantify the acid-base chemistry of patients with chronic renal failure. We examined the plasma and urine chemistry of 19 patients with chronic renal failure who were predialysis and 20 healthy volunteers. We compared the plasma strong-ion-difference due to sodium, potassium, and chloride ions as well as the weak acids albumin and phosphate. We used a simplified Fencl-Stewart approach to quantify the effects of sodium-chloride, albumin, and unmeasured ions on base-excess. The chronic renal failure group had a greater metabolic acidosis, with a base-excess that differed from the healthy group by a mean of −2.7 mmol/L, p= 0.04. This was associated with a strong ion acidosis due to both increased chloride and decreased sodium. The anion gap, strong-ion-gap, and base-excess effect of unmeasured ions were similar in both groups suggesting that unmeasured ions had only a minor role in the acid-base status in this group of patients.

scholarly journals Profile of Skin pH in Leukaemia’s Children with Chemotherapy Treatments at Haji Adam Malik General Hospital, Medan

2017 ◽  
Vol 5 (7) ◽  
pp. 945-947
Author(s):  
Radha Siregar ◽  
Sri Purnama ◽  
Salia Lakswinar
Keyword(s):  
General Hospital ◽  
Ph Value ◽  
Skin Surface ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Skin Ph ◽  
Chemotherapy Side Effects ◽  
Mucous Membranes ◽  
The Mean

BACKGROUND: One of the treatments for leukaemia is chemotherapy. Side effects and toxicity of this treatment can be seen on the skin, adnexal, and mucous membranes. They might increase potential hydrogen (pH) value on the skin surface, therefore, disrupting epidermal barrier defences.AIM: To describe the pH of the skin in children with leukaemia who received chemotherapy.SUBJECT AND METHOD: This study was an observational descriptive, cross-sectional study, conducted from March until December 2016 with 32 children with leukaemia who treated at Haji Adam Malik General Hospital, Medan as subjects. Skin pH was measured by a pH meter.RESULT: We found mean skin pH in ALL (6.28 ± 0.58), CML (5.9 ± 0) and AML (6.5 ± 0.50). The mean skin pH after 1-5 weeks of chemotherapy was 6.13 ± 0.49, at 6-10 weeks (6.32 ± 0.51), and at 11-15 weeks (7.12 ± 0.36). The mean skin pH of patients with two drugs (5.98 ± 0.44), four drugs (6.28 ± 0.55), and six drugs (6.63 ± 0.56).CONCLUSION: The highest mean of skin pH were obtained in AML group, 11-15 weeks length of chemotherapy and group with six drugs regimen.

scholarly journals Non-lactate strong ion difference and cardiovascular, cancer and all-cause mortality

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ashish Verma ◽  
Rehan Qayyum
Keyword(s):  
Cancer Mortality ◽  
Adult Population ◽  
Continuous Variable ◽  
Community Dwelling ◽  
Strong Ion Difference ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
All Cause Mortality ◽  
Study Population ◽  
The Mean

AbstractObjectivesNon-lactate strong ion difference (SID) has been shown to be associated with predictors of mortality in intensive care unit. However, the existence of any association between non-lactate SID (nlSID) and all cause, cardiovascular and cancer mortality has not been explored before in community dwelling US adults.MethodsIn a nationally representative cross-sectional survey of the US non-institutionalized population, all adult participants (≥20 years of age) using National Health and Nutrition Examination Survey data (1999–2010) combined with National Death Index for mortality status through December 2011. Cox proportional hazard models were built to estimate the hazard ratios for cardiovascular, cancer, and all-cause mortality for each unit increase in non-lactate SID. The models were adjusted for demographic and confounder variablesResultsIn the study population the mean (SD) age was 49.6 (18.4) years. Of the study population, 31,475 (91.5%) were alive and 2,893 (8.4%) died during the mean (SD) follow-up period of 5.5 (3.5) years. In univariate regression model using nlSID as continuous variable, we found 2% (unadjusted hazard ratio, HR=1.02; 95% CI, 1.004–1.05) increase in all-cause but not in cardiovascular and cancer mortality (HR=1.03; 95% CI, 0.99–1.08, HR=1.01; 95% CI, 0.97–1.06). After adjusting for potential confounders, we found 7% (adjusted HR=1.07; 95% CI, 1.04–1.10), 5% (HR=1.05; 95% CI, 1.00–1.11) and 7% (HR=1.07; 95% CI, 1.02–1.12) increase in all-cause, cardiovascular, and cancer mortality.ConclusionsA high nlSID is associated with an increase in cardiovascular, cancer and all-cause mortality and may be a prognostic indicator of mortality in general adult population. These findings may provide a point of reference for further studies.

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.

scholarly journals Does varying the ingestion period of sodium citrate influence blood alkalosis and gastrointestinal symptoms?

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251808
Author(s):  
Charles S. Urwin ◽  
Rodney J. Snow ◽  
Liliana Orellana ◽  
Dominique Condo ◽  
Glenn D. Wadley ◽  
...  
Keyword(s):  
Experimental Design ◽  
Mixed Models ◽  
Sodium Citrate ◽  
Venous Blood ◽  
Gastrointestinal Symptoms ◽  
The Other ◽  
Strong Ion Difference ◽  
Blood Samples ◽  
Blood Ph ◽  
The Mean

Objectives To compare blood alkalosis, gastrointestinal symptoms and indicators of strong ion difference after ingestion of 500 mg.kg-1 BM sodium citrate over four different periods. Methods Sixteen healthy and active participants ingested 500 mg.kg-1 BM sodium citrate in gelatine capsules over a 15, 30, 45 or 60 min period using a randomized cross-over experimental design. Gastrointestinal symptoms questionnaires and venous blood samples were collected before ingestion, immediately post-ingestion, and every 30 min for 480 min post-ingestion. Blood samples were analysed for blood pH, [HCO3-], [Na+], [Cl-] and plasma [citrate]. Linear mixed models were used to estimate the effect of the ingestion protocols. Results For all treatments, blood [HCO3-] was significantly elevated above baseline for the entire 480 min post-ingestion period, and peak occurred 180 min post-ingestion. Blood [HCO3-] and pH were significantly elevated above baseline and not significantly below the peak between 150–270 min post-ingestion. Furthermore, blood pH and [HCO3-] were significantly lower for the 60 min ingestion period when compared to the other treatments. Gastrointestinal symptoms were minor for all treatments; the mean total session symptoms ratings (all times summed together) were between 9.8 and 11.6 from a maximum possible rating of 720. Conclusion Based on the findings of this investigation, sodium citrate should be ingested over a period of less than 60 min (15, 30 or 45 min), and completed 150–270 min before exercise.

Relationship of Sense of Coherence to Other Psychosocial Indices

2004 ◽  
Vol 20 (4) ◽  
pp. 227-236 ◽  
Author(s):  
Sara Holmberg ◽  
Anders Thelin ◽  
Eva-Lena Stiernström
Keyword(s):  
Social Support ◽  
Psychosocial Factors ◽  
Sense Of Coherence ◽  
Living Conditions ◽  
Strong Negative Correlation ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Work Related ◽  
Job Demand ◽  
The Mean

Summary: The concept of “sense of coherence” (SOC) has been widely recognized since it was first introduced by Antonovsky. The originality and usefulness of the SOC scale and its relation to other psychosocial measures has been the subject of lively debate. The aim of this paper was to test for associations between SOC and work-related psychosocial factors (mainly the Job Demand-Control model), general living conditions, education, and social network factors. Cross-sectional data from a population-based sample of 1782 rural males from nine counties in Sweden were analyzed with a multiple regression technique. The subjects were occupationally active at inclusion and the mean age was 50 years (range 40-60). SOC was assessed with the original 29-item questionnaire. Psychosocial variables and lifestyle factors were assessed using questionnaires and structured interviews. The mean SOC among the subjects was 152.3 (standard deviation, 19.4). A strong negative correlation was found between SOC and job demand, whereas a positive correlation with job control was demonstrated. A positive correlation with general living conditions and with social support was also found. However, there was no correlation to education and occupation. Thus, SOC was shown to be strongly correlated to work-related psychosocial factors and social support, but independent of sociodemographic factors.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

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