scholarly journals Acid-base and Electrolyte Disturbances in Children Presenting with Acute Watery Diarrhoea in Emergency Observation and Referral Unit of Dhaka Shishu (Children) Hospital

2021 ◽  
Vol 36 (2) ◽  
pp. 120-124
Author(s):  
Md Abu Tayab ◽  
Md Ariful Hoq
Keyword(s):  
Serum Sodium ◽  
Statistical Significance ◽  
Acute Diarrhoea ◽  
Watery Diarrhoea ◽  
Severe Dehydration ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Arterial Blood ◽  
Significant Difference ◽  
Sodium And Potassium

Background: Acute watery diarrhoea (AWD) is a leading cause of illness and death amongst children in developing countries. Electrolyte and acid-base disturbances play an important role in the associated morbidity and mortality. Objectives: To observe the acid-base and electrolyte changes in moderate and severe dehydration in AWD in children. Methods: This cross sectional study was carried out in the Observation and Referral Unit of Dhaka Shishu (Children) Hospital from July 2018 to December 2018. Children below five years of age who came with acute diarrhoea with moderate to severe dehydration were included in the study. After admission 2ml of whole blood was collected with all aseptic measures at the time of insertion of intravenous cannula before giving intravenous fluids to measure serum levels of Na and K while arterial blood was also taken for analysis. The data was analyzed by using SPSS version 20. Results: Total 125 AWD cases were admitted among them 98(78.4%) had moderate dehydration whereas 27(21.6%) had severe dehydration. Hyponatremic dehydration was present in 41(32.8%) cases. Among them 30(30.6%) had moderate dedydration and 11(40.4%) had severe dehydration, hypernatremic dehydration was present in 11.11% cases, hypokalemia was present in 54(43.2%) cases. Among them 42(42.86%) had moderate dedydration and 12(44.44%) had severe dehydration. Metabolic acidosis was present in 38(30.4%) cases [28(28.57%) in moderate dedydration and 10(37.04%) in severe dehydration]. The comparison of mean serum sodium and potassium value of the children with moderate and severe degrees of dehydration did not attain statistical significance, but there was a significant difference in bicarbonate concentration among moderate and severe dehydration cases (p=0.02). Conclusion: Hyponatremia and hypokalamia was the commonest electrolyte abnormality among moderate to severe dehydration with AWD. Mean serum sodium and potassium of the children with moderate and severe degrees of dehydration did not attain statistical significance, but bicarbonate concentration was significantly low among severe dehydration cases. DS (Child) H J 2020; 36(2): 120-124

scholarly journals The effects of post-operative oxygen supply on blood oxygenation and acid-base status in rats anaesthetized with fentanyl/fluanisone and midazolam

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255829
Author(s):  
Leander Gaarde ◽  
Stefanie Kolstrup ◽  
Peter Bollen
Keyword(s):  
Oxygen Saturation ◽  
Oxygen Supply ◽  
Respiratory Acidosis ◽  
Blood Oxygenation ◽  
Acid Base ◽  
Blood Oxygen Saturation ◽  
Arterial Blood ◽  
Post Operative Period ◽  
Significant Difference ◽  
Acid Base Status

In anaesthetic practice the risk of hypoxia and arterial blood gas disturbances is evident, as most anaesthetic regimens depress the respiratory function. Hypoxia may be extended during recovery, and for this reason we wished to investigate if oxygen supply during a one hour post-operative period reduced the development of hypoxia and respiratory acidosis in rats anaesthetized with fentanyl/fluanisone and midazolam. Twelve Sprague Dawley rats underwent surgery and were divided in two groups, breathing either 100% oxygen or atmospheric air during a post-operative period. The peripheral blood oxygen saturation and arterial acid-base status were analyzed for differences between the two groups. We found that oxygen supply after surgery prevented hypoxia but did not result in a significant difference in the blood acid-base status. All rats developed respiratory acidosis, which could not be reversed by supplemental oxygen supply. We concluded that oxygen supply improved oxygen saturation and avoided hypoxia but did not have an influence on the acid-base status.

scholarly journals Time-dependent variation of ionized calcium in serum samples

2019 ◽  
Vol 29 (3) ◽  
pp. 570-578 ◽  
Author(s):  
Antonija Perović ◽  
Marina Njire Bratičević
Keyword(s):  
Clinical Significance ◽  
Statistical Significance ◽  
Wilcoxon Test ◽  
Time Dependent ◽  
Ionized Calcium ◽  
Anova Analysis ◽  
Serum Samples ◽  
Arterial Blood ◽  
Significant Difference ◽  
Clinically Significant

Introduction: The aim of this study was to compare ionized calcium (iCa) concentrations in arterial heparinized blood and venous serum and to investigate time-dependent variation of iCa in serum samples centrifuged and analysed at different times. Materials and methods: Ionized calcium was measured (N = 25) in arterial blood within 20 min after puncture, and in serum within 10 min after centrifugation conducted 30 min after sampling. Effect of time between sampling and centrifugation was examined in three tubes (N = 30) centrifuged 15, 30 and 60 min after sampling, and analysed within 10 min. Effect of time between centrifugation and analysis was investigated in three tubes (N = 31) centrifuged 30 min after sampling and analysed: 0-10, 30-40 and 90-100 min after centrifugation. Ionized calcium was measured on the Siemens RapidLab 348EX analysers. Statistical significance was tested using Wilcoxon test and ANOVA analysis. Clinical significance was judged against reference change values (RCV). Results: No statistically significant difference was found between iCa in arterial blood and serum (P = 0.274). A statistically significant decrease was found: in tubes centrifuged 60 and 15 min after sampling versus 30 min (P = 0.005, P = 0.003); and in tubes analysed 30-40 and 90-100 min after centrifugation versus 0-10 min (P = 0.021, P = 0.027). Clinically significant changes were observed: 60 versus 30 min (centrifugation) and 90-100 versus 0-10 and 30-40 min (analysis). Conclusions: Timely analysed arterial blood and serum samples can be used interchangeably. To avoid clinically significant variations, serum tubes should be centrifuged within 30 min after sampling, and analysis should be performed within 30 min after centrifugation.

scholarly journals Acid-base regulation and ion transfers in the carp (Cyprinus carpio): pH compensation during graded long- and short-term environmental hypercapnia, and the effect of bicarbonate infusion

1986 ◽  
Vol 126 (1) ◽  
pp. 41-61 ◽  
Author(s):  
J. B. Claiborne ◽  
N. Heisler
Keyword(s):  
Cyprinus Carpio ◽  
Respiratory Acidosis ◽  
Exposure Period ◽  
Environmental Water ◽  
Ambient Water ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Plasma Bicarbonate ◽  
Arterial Blood ◽  
Carp Cyprinus Carpio

To study both temporal and quantitative effects of hypercapnia on the extent of pH compensation in the arterial blood, specimens of carp (Cyprinus carpio) were exposed to a PCO2 of about 7.5 mmHg (1 mmHg = 133.3 Pa) (1% CO2) in the environmental water for several weeks, and a second group of animals was subjected to an environmental PCO2 of about 37 mmHg (5% CO2) for up to 96 h. A third series of experiments was designed to test the possibility that infusion of bicarbonate would increase the extent of plasma pH compensation. Dorsal aortic plasma pH, PCO2 and [HCO3-], as well as net transfer of HCO3- -equivalent ions, NH4+, Cl- and Na+, between fish and ambient water, were monitored throughout the experiments. Exposure to environmental PCO2 of 7.5 mmHg resulted in the expected respiratory acidosis with the associated drop in plasma pH, and subsequent compensatory plasma [HCO3-] increase. The compensatory increase of plasma bicarbonate during long-term hypercapnia continued during 19 days of exposure with plasma bicarbonate finally elevated from 13.0 mmoll-1 during control conditions to 25.9 mmoll-1 in hypercapnia, an increase equivalent to 80% plasma pH compensation. Exposure to 5% hypercapnia elicited much larger acid-base effects, which were compensated to a much lesser extent. Plasma pH recovered to only about 45% of the pH depression expected at constant bicarbonate concentration. At the end of the 96-h exposure period, plasma [HCO3-] was elevated by a factor of 2.5 to about 28.2 mmoll-1. The observed increase in plasma bicarbonate concentration during 5% hypercapnic exposure was attributable to net gain of bicarbonate equivalent ions from (or release of H+-equivalent ions to) the environmental water. Quantitatively, the gain of 15.6 mmol kg-1 was considerably larger than the amount required for compensation of the extracellular space, suggesting that acid-base relevant ions were transferred for compensation of the intracellular body compartments. The uptake of bicarbonate-equivalent ions from the water was accompanied by a net release of Cl-and, to a smaller extent, by a net uptake of Na+, suggesting a 75% contribution of the Cl-/HCO-3 exchange mechanism. Infusion of bicarbonate after 48 h of exposure to 7.5 mmHg PCo2 had only a transient effect on further pH compensation. The infused bicarbonate was lost to the ambient water, and pre-infusion levels of bicarbonate were reattained within 24 h. Repetition of the infusion did not result in a notable improvement of the acid-base status.(ABSTRACT TRUNCATED AT 400 WORDS)

Influence of chronic metabolic acid-base disorders on the acute CO2 titration curve

1983 ◽  
Vol 55 (4) ◽  
pp. 1187-1195 ◽  
Author(s):  
N. E. Madias ◽  
H. J. Adrogue
Keyword(s):  
Titration Curve ◽  
Respiratory Acidosis ◽  
Whole Body ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Hydrogen Ion Concentration ◽  
Plasma Bicarbonate ◽  
Arterial Blood ◽  
Acid Base Equilibrium ◽  
Body Response

Previous studies from this laboratory have characterized the “whole-body” response to acute hypercapnia in normal dog and humans. A more recent investigation has demonstrated that this response is markedly altered by graded degrees of chronic respiratory acidosis. The present studies were carried out to assess the influence, if any, of chronic metabolic acid-base disturbances on the acute CO2 titration curve in the dog. To this purpose we first produced a broad range of chronic plasma bicarbonate concentration of metabolic nature. Metabolic acidosis (n = 14) was produced by prolonged HCl-feeding and metabolic alkalosis (n = 11) by diuretics and a chloride-free diet. Animals with normal acid-base status (n = 4) were also studied. After the establishment of a chronic steady state of acid-base equilibrium, we then performed an acute CO2 titration of the unanesthetized dogs within a large environmental chamber. Three levels of inspired CO2 fraction (FICO2) were employed ranging from 4 to 15%. The results indicate that chronic metabolic acid-base disturbances exert a dramatic influence on the whole-body response to acute hypercapnia. The acute change in plasma bicarbonate for a given change in partial pressure of CO2 in arterial blood (PaCO2) or plasma pH decreases as a function of the chronic level of plasma bicarbonate concentration. Yet the ability of the organism to defend plasma hydrogen ion concentration is progressively strengthened as the chronic level of plasma bicarbonate increases.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Evaluation of Lyophilized Heparin Syringes for the Collection of Arterial Blood for Acid Base Analysis

1981 ◽  
Vol 9 (1) ◽  
pp. 40-42 ◽  
Author(s):  
A. J. Crockett ◽  
E. McIntyre ◽  
R. Ruffin ◽  
J. H. Alpers
Keyword(s):  
Acid Base ◽  
Glass Syringe ◽  
Arterial Blood ◽  
Significant Difference ◽  
Base Analysis ◽  
Acid Base Status

The effects of liquid heparin on the analysis of acid/base status of arterial blood include a reduction in Pco2 and an increase in Po2. A study was performed to compare a lyophilised heparin syringe with a liquid heparin glass syringe for collection of blood for acid/base analysis. No significant difference between the variables measured in blood taken in the two syringes was demonstrated.

Cerebrospinal fluid acid-base balance during a changing ventilatory state in man

1963 ◽  
Vol 18 (4) ◽  
pp. 712-716 ◽  
Author(s):  
Vincent J. Fisher ◽  
Lynn C. Christianson
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Fluid ◽  
Acid Base Balance ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Rates Of Change ◽  
Arterial Blood ◽  
Base Balance ◽  
Lumbar Spinal ◽  
Made In

Comparison of the rate and magnitude of changes in pH, CO2 tension, and bicarbonate concentration in arterial blood, cisternal spinal fluid, and lumbar spinal fluid was made in man during hyperventilation and recovery. CO2 tension changes in cisternal fluid were rapid and significant, although less in magnitude than those in arterial blood, whereas changes in lumbar fluid CO2 tension were minimal and slow, lagging behind cisternal changes by 10–20 min. The different rates of change following altered ventilation explain some of the reported reversals of the normal lumbar spinal fluid to arterial blood CO2 tension gradients. It also suggests that the choroid plexus is one site of removal of CO2 from spinal fluid. Submitted on December 13, 1962

Comparison of Controlled Hypotension Due to the Use of Dexmedetomidine, Magnesium Sulfate, and Esmolol in Craniotomy Surgery

2021 ◽  
Vol 19 (12) ◽  
pp. 44-49
Author(s):  
Seyed Ali Ahmadi ◽  
Behnam Mahmodiyeh ◽  
Alireza Farsi ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Magnesium Sulfate ◽  
Statistical Significance ◽  
The Other ◽  
Controlled Hypotension ◽  
Double Blind ◽  
Arterial Blood ◽  
Significant Difference ◽  
Bleeding Score

Introduction: Craniotomy includes the temporary removal of bone flap from calvarium to access the intracranial contents, which is usually used to reduce intracranial pressure. Induced or controlled hypotension is a method by which arterial blood pressure is predictably reduced, thus reducing bleeding. Therefore, the present study aimed to compare the dexmedetomidine, magnesium sulfate, and esmolol in controlled hypotension in craniotomy of patients with brain injury. Materials and methods: In this randomized double-blind clinical trial, 45 patients entered into study based on inclusion criteria. All patients were monitored when entering operating room. The questionnaire was completed by all groups, in which PR, MAP (Mean Arterial Pressure), mean bleeding score, mean of received packed cells, controlled hypotension and bradycardia, and survival of patients were recorded. Data were analyzed using spss software version 19, and ANOVA and T-Test were used for statistical significance analysis. Results: The mean age and standard deviations of the three groups of dexmedetomidine, esmolol and magnesium sulfate were 36.78±10.32, 34.47±10.58, and 39.67±11.99 years, respectively. There was no significant difference between the three groups in terms of age, gender, initial heart rate and baseline blood pressure (BP). The MAP and bleeding score (P=0.04 and P=0.0001) was significantly lower in the dexmedetomidine group than in the other two groups. Although the heart rate in the esmolol group was lower than the other two groups, the difference was not significant (P = 0.128). Unlike esmolol and magnesium sulfate groups, GOS did not decrease in the dexmedetomidine group. Conclusion: Comparison of the three groups in controlled hypotension in craniotomy surgery showed that the MAP and bleeding score of dexmedetomidine group was significantly lower than the other two groups, and the GOS didn’t decrease in this group. In general, dexmedetomidine would be a better choice for controlled hypotension in craniotomy.

scholarly journals Study of electrolyte disturbances and renal parameters in acute gastroenteritis under 5 years of age in a tertiary care hospital of Bengaluru, India

2020 ◽  
Vol 7 (9) ◽  
pp. 1910
Author(s):  
Poornima Shankar ◽  
Shajna Mahamud ◽  
Anjum Aara C. A.
Keyword(s):  
Serum Sodium ◽  
Acute Gastroenteritis ◽  
Fluid Replacement ◽  
Electrolyte Imbalance ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Serum Electrolytes ◽  
Female Ratio ◽  
Electrolyte Disturbances ◽  
Sodium And Potassium

Background: Diarrhoea still continues to be a major cause of hospitalization and death in under fives. Electrolyte disturbances play an important role in the associated morbidity and mortality.  Acute renal failure is one of the important complications of acute gastroenteritis (AGE) in children. Early intervention and proper fluid replacement may lessen this risk. This study was designed to find out the incidence of acute gastroenteritis and the status of associated electrolyte derangements and renal involvement.Methods: This was a cross sectional study conducted at KIMS, Bengaluru in which 117 children from the age of 1 month to 5 years with acute diarrhea were included based on a predefined inclusion and exclusion criteria. Demographic profile of the patients, details of diarrhea, clinical examination and accompanying degree of dehydration (defined as per WHO criteria) were recorded. Serum electrolytes along with renal parameters were investigated.Results: Total 117 children with acute gastroenteritis were enrolled in the study as per the inclusion criteria which constituted 5% of total paediatric admissions. Children aged 1-12 months had the highest incidence of diarrhea (50%). Male to female ratio is 1.3:1. 65% had some dehydration, 19% no dehydration and 16% had severe dehydration. Isonatremia was seen in 58% followed by hyponatremia in 35% and hypernatremia in only 7%. 83% had isokalemia, hypokalemia in 12%, hyperkalemia in 5%. Levels of serum sodium and potassium decreased with the severity of dehydration. Serum urea and creatinine were significantly high in severe dehydration (p value 0.001). Out of 28 children who were given diluted ORS before admission, majority had hyponatremia (39%) and all of them who received concentrated ORS had hypernatremia.Conclusions: Hyponatremic dehydration is the second most common type of dehydration next to isonatremic dehydration, but it is more common in children who took diluted ORS. Increased awareness regarding ORS preparation may help in preventing electrolyte imbalance in AGE. The levels of serum sodium and potassium decreased and urea and creatinine increased with severity of dehydration. Measurements of serum electrolytes and renal parameters early can help to predict the complications due to AGE and may help in the prevention of diarrhea related complications in children.

scholarly journals Clinical verification of vimentin/EpCAM immunolipid magnetic sorting system in monitoring CTCs in arterial and venous blood of advanced tumor

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Liu ◽  
Qiuying Li ◽  
Tingsong Chen ◽  
Tianhao Shen ◽  
Xufeng Zhang ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Venous Blood ◽  
Gene Mutations ◽  
Dominant Factor ◽  
Positive Group ◽  
Arterial Blood ◽  
Significant Difference ◽  
Targeted Drug ◽  
Sorting System ◽  
Advanced Tumors

Abstract Background Circulating tumor cells (CTCs) are the dominant factor leading to tumor metastasis. This study aims to investigate the effect of disparate sources of CTCs on the treatment and prognosis of patients with advanced tumors by analyzing the number and gene mutations change of CTCs in arterial and venous blood in patients with advanced tumors. Results A CTCs sorting system was constructed based on Vimentin-immunolipid magnetic balls (Vi-IMB) and EpCAM immunolipid magnetic balls (Ep-IMB). Results showed that the prepared Ep-IMB and Vi-IMB had lower cytotoxicity, better specificity and sensitivity. The number of arterial CTCs was higher than that of venous CTCs, with a statistically significant difference (P < 0.05). Moreover, the prognosis of the low positive group of total CTCs in arterial blood and venous blood was higher than that of the high positive group, with a statistical significance (P < 0.05). The genetic testing results showed that the targeted drug gene mutations in tissues, arterial CTCs and venous CTCs showed a complementary trend, indicating that there was heterogeneity among different tumor samples. Conclusions CTCs in blood can be efficiently captured by the CTCs sorting system based on Vi-LMB/Ep-LMB, and CTCs detection in arterial blood can be utilized to more accurately evaluate the prognosis and predict postoperative progress. It is further confirmed that tumor samples from disparate sources are heterogeneous, providing a reference basis for gene mutation detection before clinical targeted drug treatment, and the detection of CTCs in arterial blood has more potential clinical application value. Trial registration: The Ethics Committee of Putuo Hospital, PTEC-A-2019-18-1. Registered 24 September 2019. Graphic abstract

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

2020 ◽  
Vol 66 (1) ◽  
pp. 19-22
Author(s):  
Melania Macarie ◽  
Simona Maria Bataga ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
Simona Mocan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Ratio ◽  
Hiatal Hernia ◽  
Statistical Significance ◽  
Erosive Esophagitis ◽  
Male Gender ◽  
Consecutive Series ◽  
Study Group ◽  
Entire Study ◽  
Significant Difference

AbstractObjective: This study aims to determine the correlation between risk factors and erosive esophagitis development.Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

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