scholarly journals Safety of epidural analgesia in an orthotopic liver transplantation

2021 ◽  
Vol 1 (6) ◽  
pp. 69-74
Author(s):  
A. N. Shmakov ◽  
N. L. Elizar’eva ◽  
A. N. Kolosov ◽  
K. A. Gryaznov ◽  
K. Yu. Beloborodov ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Sodium Bicarbonate ◽  
Orthotopic Liver Transplantation ◽  
Ph Value ◽  
Lactate Concentration ◽  
Initial Assessment ◽  
Inhalation Anesthesia ◽  
Arterial Blood ◽  
Bicarbonate Infusion ◽  
Sodium Bicarbonate Infusion

In the literature devoted to the problems of liver transplantation, there is no clearly indicated attitude of the authors to intraoperative epidural blocks, although theoretically the benefits of a sympathetic block are considered. Some sources recommend prophylactic sodium bicarbonate infusion to alleviate post-reperfusion syndrome, but its effectiveness is questionable.Purpose: to present the physiological, biochemical and hematological characteristics of recipients at the stages of orthotopic liver transplantation with an assessment of the feasibility of using sodium bicarbonate for the prevention of reperfusion complications.Materials and methods. An observational study, contains an analysis of data from 39 participants operated on in 2020 in the volume of: hepatectomy, an orthotopic liver transplantation, with an initial assessment on the Child- Turcott- Pugh scale of 11 points. All participants were operated on under general inhalation anesthesia with sevoflurane and thoracic epidural three- component anesthesia according to the Breivik- Niemi method. There are 3 stages of data registration: the beginning of the anhepatic stage; the beginning of the neohepatic stage; the end of the operation.Results and discussion. Significant fluctuations in hemodynamics, violations of the acid-base state and energy metabolism were not revealed; a decrease in hepatic protein synthesis, a shift of the P50 point to the left, and moderate metabolic acidosis did not exceed the levels described in the literature. The dynamics of acidosis, РСО2 and natremia did not depend on the infusion of soda. There was no close correlation between arterial blood pH and lactate concentration.Conclusion. The benefits and safety of epidural anesthesia in orthotopic liver transplants are obvious and make it possible to recommend this component as a routine element of anesthesia during these operations. The indications for sodium bicarbonate infusion should be narrowed and consensus is needed to determine the critical pH value for sodium bicarbonate infusion.

scholarly journals Patterns in the Parathyroid Response to Sodium Bicarbonate Infusion Test in Healthy Volunteers

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Theodossis S. Papavramidis ◽  
Olympia E. Anastasiou ◽  
Ioannis Pliakos ◽  
Nick Michalopoulos ◽  
Mike Polyzonis ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sodium Bicarbonate ◽  
Healthy Volunteers ◽  
Infusion Test ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Low Levels ◽  
Bicarbonate Infusion ◽  
Sodium Bicarbonate Infusion

Background. The sodium bicarbonate infusion test evaluates the function of the parathyroid glands. The present study aims to evaluate the range of parathyroid response in healthy individuals and the potential influence of various factors.Methods. Fifty healthy volunteers were subjected to the test. Levels of vitamin D, calcium, albumin, and PTH were measured before infusion. PTH was measured at 3, 5, 10, 30, and 60 minutes after infusion.Results. A curve describing the response of parathyroids to the test was drawn. Twenty percent of the subjects had blunted PTH response. No significant difference was observed between normal and blunted responders concerning age, BMI, baseline PTH, or calcium levels. Nonetheless, there was a significant difference in vitamin D levels (P=0.024).Interpretation. The test is easy to perform and may be used for everyday screening. It has to be clarified whether our observations are, at least partly, produced due to the presence of individuals with a constitutively blunted response or if low levels of vitamin D decrease the ability of the parathyroids to respond. Whichever the case, PTH response of normal individuals to sodium bicarbonate infusion test is more varied than previously thought and vitamin D levels influence it.

Extracorporeal bicarbonate space after bicarbonate or a bicarbonate-carbonate mixture in acidotic dogs

1989 ◽  
Vol 67 (6) ◽  
pp. 2331-2334 ◽  
Author(s):  
N. B. Kindig ◽  
D. S. Sherrill ◽  
J. I. Shapiro ◽  
G. F. Filley
Keyword(s):  
Animal Model ◽  
Sodium Bicarbonate ◽  
Volume Of Distribution ◽  
Serum Bicarbonate ◽  
Bicarbonate Infusion ◽  
Co2 Excretion ◽  
Sodium Bicarbonate Infusion

The effects of sodium bicarbonate and a bicarbonate-carbonate mixture on expired CO2 and the volume of distribution of bicarbonate were studied in eight anesthetized, paralyzed, and ventilated dogs made acidotic with HCl (5 mmol/kg) infused over 90 min. Both sodium bicarbonate and Carbicarb resulted in systemic alkalinization and comparable increases in the serum bicarbonate at 50 min (7.07 +/- 0.91 vs. 7.99 +/- 0.77, respectively; P = NS). Sodium bicarbonate infusion resulted in an increase in CO2 excretion that accounted for a fractional CO2 excretion of 0.20 +/- 0.09, whereas infusion of a bicarbonate-carbonate mixture resulted in a fractional CO2 excretion of -0.06 +/- 0.09 (P less than 0.01). The uncorrected volume of distribution of bicarbonate after sodium bicarbonate infusion was higher than that seen with the bicarbonate-carbonate mixture (0.60 +/- 0.07 vs. 0.34 +/- 0.03 l/kg; P less than 0.01). However, when the volume of bicarbonate distribution was corrected for expired CO2, there was no difference between treatment with sodium bicarbonate and the bicarbonate-carbonate mixture (0.44 +/- 0.07 vs. 0.38 +/- 0.04 l/kg; P = NS). These data demonstrate that, in this animal model of acidosis, sodium bicarbonate treatment of systemic acidosis is accompanied by a generation of a considerable amount of CO2, whereas treatment with a bicarbonate-carbonate mixture is not. This suggests that in states of impaired ventilation, a bicarbonate-carbonate mixture may offer more efficient systemic alkalinization and may be associated with less CO2 generation than sodium bicarbonate.

scholarly journals Crack Cocaine-Induced Cardiac Conduction Abnormalities Are Reversed by Sodium Bicarbonate Infusion

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Carlos Henrique Miranda ◽  
Antônio Pazin-Filho
Keyword(s):  
Cardiac Arrest ◽  
Sodium Bicarbonate ◽  
Crack Cocaine ◽  
Tricyclic Antidepressant ◽  
Cardiac Conduction ◽  
Clinical Complications ◽  
Bicarbonate Infusion ◽  
Electrocardiographic Abnormalities ◽  
Intravenous Sodium ◽  
Sodium Bicarbonate Infusion

We report a dramatic case of a 19-year-old man with crack cocaine overdose with important clinical complications as cardiac arrest due to ventricular fibrillation andepileptics status. During this intoxication, electrocardiographic abnormalities similar to those found in tricyclic antidepressant poisoning were observed, and they were reversed by intravenous sodium bicarbonate infusion.

The effects of intravenous theophylline infusion versus intravenous Sodium Bicarbonate infusion on Lithium clearance in normal subjects

1988 ◽  
Vol 25 (2) ◽  
pp. 203-211 ◽  
Author(s):  
Sheldon G. Holstad ◽  
Paul J. Perry ◽  
Roger G. Kathol ◽  
Richard W. Carson ◽  
Stephen J. Krummel
Keyword(s):  
Sodium Bicarbonate ◽  
Normal Subjects ◽  
Lithium Clearance ◽  
Bicarbonate Infusion ◽  
Intravenous Sodium ◽  
Sodium Bicarbonate Infusion
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