scholarly journals Acute liver damage in Hyperemesis gravidarum — case report

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Liudmila Tofan-Scutaru ◽  
◽  
Eugen Tcaciuc ◽  
Viorica Coshpormac ◽  
Zinaida Sarbu ◽  
...  
Keyword(s):  
Liver Damage ◽  
Total Bilirubin ◽  
Hyperemesis Gravidarum ◽  
Acute Liver Damage ◽  
Acid Base Balance ◽  
Antithrombotic Treatment ◽  
Acid Base ◽  
Arterial Ph ◽  
Base Balance ◽  
Cholestatic Syndrome

Hyperemesis gravidarum (HG) involves severe, persistent, intractable nausea and vomiting, which subsequently leads to weight loss>5% of weight until pregnancy, in the absence of other causes, accompanied by dehydration, nutritional deficiency with ketosis, abnormalities electrolyte and/or acid-base balance disorders. in the paper we present the case of a 26-year-old woman, G2N1, in week 10 of gestation, who developed in the context of HG severe abnormalities, namely acute liver damage, with hepatopriv syndrome (Prothrombin after Quick 53%, INR -1, 42, total protein 46.91 /l, cholestatic syndrome (total bilirubin 39 mcmol/l) and cytolytic syndrome (ALT — 140.25 IU / L and AST -125.42 IU / L); alkalemia (arterial pH 7.51) , hyponatremia (serum sodium 132 mmol/l), hypokalemia (serum potassium 2.72 mmol/l). The diagnosis of HG, complicated by acute liver failure, has been confirmed. All laboratory symptoms and abnormalities were resolved by targeted administration of intravenous fluids, antiemetic treatment, and prophylactic antithrombotic treatment.

Acid-base balance and plasma composition in the aestivating lungfish (Protopterus)

1977 ◽  
Vol 232 (1) ◽  
pp. R10-R17 ◽  
Author(s):  
R. G. DeLaney ◽  
S. Lahiri ◽  
R. Hamilton ◽  
P. Fishman
Keyword(s):  
Plasma Osmolality ◽  
Respiratory Acidosis ◽  
Electrolyte Balance ◽  
Plasma Composition ◽  
Total Plasma ◽  
Acid Base Balance ◽  
Acid Base ◽  
Plasma Bicarbonate ◽  
Arterial Ph ◽  
Base Balance

Upon entering into aestivation, Protopterus aethiopicus develops a respiratory acidosis. A slow compensatory increase in plasma bicarbonate suffices only to partially restore arterial pH toward normal. The cessation of water intake from the start of aestivation results in hemoconcentration and marked oliguria. The concentrations of most plasma constituents continue to increase progressively, and the electrolyte ratios change. The increase in urea concentration is disproportionately high for the degree of dehydration and constitutes an increasing fraction of total plasma osmolality. Acid-base and electrolyte balance do not reach a new equilibrium within 1 yr in the cocoon.

Effects of temperature on acid-base balance and ventilation in desert iguanas

1981 ◽  
Vol 51 (2) ◽  
pp. 452-460 ◽  
Author(s):  
P. E. Bickler
Keyword(s):  
Steady State ◽  
Pulmonary Ventilation ◽  
Respiratory Acidosis ◽  
Lung Ventilation ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Ph ◽  
Blood Relative ◽  
Base Balance ◽  
History Of

The effects of constant and changing temperatures on blood acid-base status and pulmonary ventilation were studied in the eurythermal lizard Dipsosaurus dorsalis. Constant temperatures between 18 and 42 degrees C maintained for 24 h or more produced arterial pH changes of -0.0145 U X degrees C-1. Arterial CO2 tension (PCO2) increased from 9.9 to 32 Torr plasma [HCO-3] and total CO2 contents remained constant at near 19 and 22 mM, respectively. Under constant temperature conditions, ventilation-gas exchange ratios (VE/MCO2 and VE/MO2) were inversely related to temperature and can adequately explain the changes in arterial PCO2 and pH. During warming and cooling between 25 and 42 degrees C arterial pH, PCO2 [HCO-3], and respiratory exchange ratios (MCO2/MO2) were similar to steady-state values. Warming and cooling each took about 2 h. During the temperature changes, rapid changes in lung ventilation following steady-state patterns were seen. Blood relative alkalinity changed slightly with steady-state or changing body temperatures, whereas calculated charge on protein histidine imidazole was closely conserved. Cooling to 17-18 degrees C resulted in a transient respiratory acidosis correlated with a decline in the ratio VE/MCO2. After 12-24 h at 17-18 degrees C, pH, PCO2, and VE returned to steady-state values. The importance of thermal history of patterns of acid-base regulation in reptiles is discussed.

Relationship between acid-base balance and the central respiratory mechanisms

1963 ◽  
Vol 204 (5) ◽  
pp. 867-872 ◽  
Author(s):  
R. L. Katz ◽  
S. H. Ngai ◽  
G. G. Nahas ◽  
S. C. Wang
Keyword(s):  
Periodic Breathing ◽  
Acid Base Balance ◽  
Acid Base ◽  
Respiratory Effects ◽  
Inspiratory Phase ◽  
Arterial Ph ◽  
Base Balance ◽  
Acid Base Status ◽  
Definition Of ◽  
Functional Components

To study the effect of changes in acid-base balance on respiratory patterns, 2-amino-2-hydroxymethyl-1,3-propanediol (THAM, an organic buffer) and sodium bicarbonate (NaHCO3) were infused into midcollicular decerebrate, pontile, and medullary cats. NaHCO3 increased the arterial pH, HCO–3, and pCO2. THAM increased the arterial pH and HCO–3. The arterial pCO2 fell initially and then rose gradually with time. In the midcollicular decerebrate preparation with eupnea, NaHCO3 increased while THAM decreased the rate and amplitude of respiration. In the vagotomized pontile preparation with apneustic breathing, NaHCO3 accelerated and THAM decelerated the apneustic cycling; neither produced a significant change in amplitude. Larger doses of THAM abolished the apneustic cycling either by producing expiratory apnea or by prolonging the inspiratory phase. In the medullary preparation with periodic breathing, THAM decreased the rate with minimal changes in amplitude. The findings suggest that the respiratory effects of NaHCO3 and THAM were due to changes in intracellular pH and pCO2 and that all functional components of the respiratory center are influenced by changes in the acid-base status of the animals. Finally it is pointed out that elucidation of neural respiratory mechanisms requires definition of the acid-base state of the animal.

Increasing P50 does not improve Do 2crit or systemicV˙o 2 in severe anemia

2002 ◽  
Vol 283 (1) ◽  
pp. H92-H101 ◽  
Author(s):  
Otto Eichelbrönner ◽  
Mark D'Almeida ◽  
Andreas Sielenkämper ◽  
William J. Sibbald ◽  
Ian H. Chin-Yee
Keyword(s):  
Binding Affinity ◽  
Lactate Production ◽  
Saline Control ◽  
Severe Anemia ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Lactate ◽  
Beneficial Effects ◽  
Arterial Ph ◽  
Base Balance

Reducing the hemolobin (Hb)-O2 binding affinity facilitates O2 unloading from Hb, potentially increasing tissue mitochondrial O2 availability. We hypothesized that a reduction of Hb-O2 affinity would increase O2extraction when tissues are O2 supply dependent, reducing the threshold of critical O2 delivery (Do 2 CRIT). We investigated the effects of increased O2 tension at which Hb is 50% saturated (P50) on systemic O2 uptake (V˙o 2 SYS), Do 2 CRIT, lactate production, and acid-base balance during isovolemic hemodilution in conscious rats. After infusion of RSR13, an allosteric modifier of Hb, P50increased from 36.6 ± 0.3 to 48.3 ± 0.6 but remained unchanged at 35.4 ± 0.8 mmHg after saline (control, CON). Arterial O2 saturations were equivalent between RSR13 and saline groups, but venous Po 2 was higher and venous O2 saturation was lower after RSR13. Convective O2 delivery progressively declined during hemodilution reaching the Do 2 CRIT at 3.4 ± 0.8 ml · min−1 · 100 g−1 (CON) and 3.6 ± 0.6 ml · min−1 · 100 g−1 (RSR13). At Hb of 8.1 g/lV˙o 2 SYS started to decrease (CON: 1.9 ± 0.1; RSR13: 1.8 ± 0.2 ml · min−1 · 100 g−1) and fell to 0.8 ± 0.2 (CON) and 0.7 ± 0.2 ml · min−1 · 100 g−1 (RSR13). Arterial lactate was lower in RSR13-treated than in control animals when animals were O2 supply dependent. The decrease in base excess, arterial pH, and bicarbonate during O2 supply dependence was significantly less after RSR13 than after saline. These findings demonstrate that during O2 supply dependence caused by severe anemia, reducing Hb-O2 binding affinity does not affect V˙o 2 SYS or Do 2 CRIT but appears to have beneficial effects on oxidative metabolism and acid base balance.

Dietary urea concentration and acid-base balance in feedlot steers fed a high concentrate steam-flaked corn-based diet

2004 ◽  
Vol 84 (4) ◽  
pp. 741-743
Author(s):  
C. R. Bailey ◽  
G. C. Duff ◽  
R. C. Cheatham ◽  
S. R. Sanders ◽  
T. W. Whitney ◽  
...  
Keyword(s):  
Beef Cattle ◽  
Key Words ◽  
Blood Gas ◽  
Serum Urea ◽  
Acid Base Balance ◽  
Acid Base ◽  
Urine Ph ◽  
Feedlot Steers ◽  
Arterial Ph ◽  
Base Balance

This experiment investigated the effects of dietary urea fed at 0, 0.5, 1.0 or 1.5% [dry mater (DM) basis] of the diet on systemic acid-base balance in feedlot steers. Results indicated that increasing urea concentrations in feedlot diets had no effect on arterial pH, blood gas profile, serum urea nitrogen, or urine pH. Key words: Acid-base balance, beef cattle, urea

Acid-base regulation during heating and cooling in the lizard, Varanus exanthematicus

1981 ◽  
Vol 50 (4) ◽  
pp. 779-783 ◽  
Author(s):  
S. C. Wood ◽  
K. Johansen ◽  
M. L. Glass ◽  
R. W. Hoyt
Keyword(s):  
Physiological Mechanism ◽  
Co2 Production ◽  
Acid Base Balance ◽  
Acid Base ◽  
Heating And Cooling ◽  
Arterial Blood ◽  
Arterial Ph ◽  
Base Balance ◽  
Response To Temperature ◽  
Induced Changes

Current concepts of acid-base balance in ectothermic animals require that arterial pH vary inversely with body temperature in order to maintain a constant OH-/H+ and constant net charge on proteins. The present study evaluates acid-base regulation in Varanus exanthematicus under various regimes of heating and cooling between 15 and 38 degrees C. Arterial blood was sampled during heating and cooling at various rates, using restrained and unrestrained animals with and without face masks. Arterial pH was found to have a small temperature dependence, i.e., pH = 7.66--0.005 (T). The slope (dpH/dT = -0.005), while significantly greater than zero (P less than 0.05), is much less than that required for a constant OH-/H+ or a constant imidazole alphastat (dpH/dT congruent to 0.018). The physiological mechanism that distinguishes this species from most other ectotherms is the presence of a ventilatory response to temperature-induced changes in CO2 production and O2 uptake, i.e., VE/VO2 is constant. This results in a constant O2 extraction and arterial saturation (approx. 90%), which is adaptive to the high aerobic requirements of this species.

Acid-base and ionic balance in Ambystoma tigrinum and Necturus maculosus during hypercapnia

1983 ◽  
Vol 245 (5) ◽  
pp. R689-R694 ◽  
Author(s):  
D. F. Stiffler ◽  
B. L. Tufts ◽  
D. P. Toews
Keyword(s):  
Prolonged Exposure ◽  
Epithelial Transport ◽  
Ambystoma Tigrinum ◽  
Ionic Balance ◽  
Acid Base Balance ◽  
Acid Base ◽  
Necturus Maculosus ◽  
Arterial Ph ◽  
Partial Pressure Of Co2 ◽  
Base Balance

The aquatic urodeles Ambystoma tigrinum and Necturus maculosus responded to hypercapnia quite differently. A. tigrinum, after 2-h exposure to 22 Torr partial pressure of CO2 (PCO2), decreased arterial pH (pHa) from 7.85 to 7.32 and increased arterial pressure of CO2 (PaCO2) to 26 Torr. Plasma [HCO-3] [( HCO-3]pl) remained constant at about 17 mM. Prolonged exposure (24 h) led to a 26% extracellular compensation as pHa rose to 7.46 while [HCO-3]pl increased to 24 mM. Plasma [K+] increased and [Cl-] decreased while [Na+] remained unchanged. Recovery in normocapnic water reversed these changes. N. maculosus did not display similar compensatory changes. Two-hour exposure to 17 Torr PCO2 resulted in a decline of pHa from 7.66 to 7.24, which was not compensated (pHa = 7.19) after 24 h. There were no significant changes in plasma [Na+], [K+], [Cl-], or [HCO-3]. The pHa decline reversed after recovery in normocapnic water, however. The fact that compensation for hypercapnic in A. tigrinum was accompanied by changes in Cl- and K+ concentrations may indicate the participation of epithelial transport mechanisms involving these ions in acid-base balance.

Effects of Altered Acid-Base Balance on Adrenocortical Function in Anesthetized Dogs

1956 ◽  
Vol 188 (1) ◽  
pp. 7-11 ◽  
Author(s):  
John B. Richards
Keyword(s):  
Venous Blood ◽  
Secretory Activity ◽  
Adrenocortical Function ◽  
Acid Base Balance ◽  
Bicarbonate Concentration ◽  
Acid Base ◽  
Arterial Ph ◽  
Base Balance ◽  
Anesthetized Dogs ◽  
Suitable Change

Effect of altered acid-base balance, induced by the intravenous infusion of either hydrochloric acid or sodium bicarbonate, on adrenocortical function in anesthetized dogs was studied. The secretory activity of the adrenal cortex was determined by measuring 17-hydroxycorticosteroids in adrenal venous blood. Adrenocortical stimulation occurred in dogs with a profound decrease in arterial ph and bicarbonate concentration in the presence of a normal arterial CO2 tension (acid infusions) and in dogs with increased arterial CO2 tension and bicarbonate concentration in the presence of a normal arterial ph (bicarbonate infusions). It is concluded that concomitant alterations in both arterial ph and CO2 tension are not required to initiate an adrenocortical response, and it is suggested that a suitable change in either of these factors may act as a pituitary-adrenocortical stimulus.

Investigation of Bilirubin Removal by NK-110 Resin Hemoperfusion in Jaundiced Dogs

1986 ◽  
Vol 9 (5) ◽  
pp. 327-330 ◽  
Author(s):  
S. Ji-Chang ◽  
Q. Shao-Cheng ◽  
Z. Chen-Yang ◽  
N. Fu-Hua ◽  
H. Shao-Ming ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Total Bilirubin ◽  
Vena Cava ◽  
Blood Gases ◽  
Adsorption Properties ◽  
Rubber Tube ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Flow Through

A jaundiced dog model was made by common bile duct-inferior vena cava shunt with a silicon rubber tube. Blood bilirubin levels increased from 0.25 ± 0.16 (SD) mg% to 15 ± 1.4 (SD) mg%. These dog models were treated with a column containing 200 gm of macroreticular resin NK-110 which was linked between the femoral artery and vein. The rate of blood flow through the column was 200 ml/min. It was shown that total bilirubin reduced from 15 ± 1.4 (SD) to 7.4 ± 0.61 (SD), conjugated bilirubin decreased from 6.97 ± 0.63 to 3.5 ± 0.33 (SD) and unconjugated bilirubin from 7.8 ± 2.1 to 4.2 ± 0.4 (SD). There were no significant changes in protein, electrolyte, blood gases and acid base balance. Results show that NK-110 resin has good blood-compatible and adsorption properties.

Effects of feeding on metabolism, gas transport, and acid-base balance in the bullfrog Rana catesbeiana

2000 ◽  
Vol 278 (1) ◽  
pp. R185-R195 ◽  
Author(s):  
Morten Busk ◽  
Frank B. Jensen ◽  
Tobias Wang
Keyword(s):  
Rana Catesbeiana ◽  
Sartorius Muscle ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Blood ◽  
Arterial Ph ◽  
Integrative Study ◽  
Base Balance ◽  
Arterial Blood Oxygen ◽  
Lactate Levels

Massive feeding in ectothermic vertebrates causes changes in metabolism and acid-base and respiratory parameters. Most investigations have focused on only one aspect of these complex changes, and different species have been used, making comparison among studies difficult. The purpose of the present study was, therefore, to provide an integrative study of the multiple physiological changes taking place after feeding. Bullfrogs ( Rana catesbeiana) partly submerged in water were fed meals (mice or rats) amounting to ∼[Formula: see text] of their body weight. Oxygen consumption increased and peaked at a value three times the predigestive level 72–96 h after feeding. Arterial[Formula: see text] decreased slightly during digestion, whereas hemoglobin-bound oxygen saturation was unaffected. Yet, arterial blood oxygen content was pronouncedly elevated because of a 60% increase in hematocrit, which appeared mediated via release of red blood cells from the spleen. Gastric acid secretion was associated with a 60% increase in plasma [Formula: see text]concentration[Formula: see text]]) 48 h after feeding. Arterial pH only increased from 7.86 to 7.94, because the metabolic alkalosis was countered by an increase in[Formula: see text] from 10.8 to 13.7 mmHg. Feeding also induced a small intracellular alkalosis in the sartorius muscle. Arterial pH and [Formula: see text] returned to control values 96–120 h after feeding. There was no sign of anaerobic energy production during digestion as plasma and tissue lactate levels remained low and intracellular ATP concentration stayed high. However, phosphocreatine was reduced in the sartorius muscle and ventricle 48 h after feeding.

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