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The fluid electrolyte acid base

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https://www.readbyqxmd.com/read/27908485/managing-fluid-and-electrolyte-disorders-in-kidney-disease
#1
REVIEW
Cathy Langston
Because of the role of the kidneys in maintaining homeostasis in the body, kidney disease leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, and repeated and frequent reassessment of fluid and electrolyte balance. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in kidney disease and some may be life-threatening...
November 28, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27900717/intravenous-fluids-balancing-solutions
#2
REVIEW
Ewout J Hoorn
The topic of intravenous (IV) fluids may be regarded as "reverse nephrology", because nephrologists usually treat to remove fluids rather than to infuse them. However, because nephrology is deeply rooted in fluid, electrolyte, and acid-base balance, IV fluids belong in the realm of our specialty. The field of IV fluid therapy is in motion due to the increasing use of balanced crystalloids, partly fueled by the advent of new solutions. This review aims to capture these recent developments by critically evaluating the current evidence base...
November 29, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27783275/a-new-peritoneal-dialysis-fluid-for-japanese-patients-a-randomized-non-inferiority-clinical-trial-of-safety-and-efficacy
#3
Masaaki Nakayama, Yoshindo Kawaguchi, Takashi Akiba, Masao Kim, Hidemune Naito, Shigeko Hara, Teruhiko Maeba, Noriaki Yorioka, James A Sloand, Mark R Marshall
BACKGROUND: We report here two new peritoneal dialysis fluids (PDFs) for Japan [BLR 250, BLR 350 (Baxter Limited, Japan)]. The PDFs use two-chamber systems, and have bicarbonate and lactate buffer to a total of 35 mmol/L. In separate trials, the new PDFs were compared to two "standard" systems [PD-4, PD-2 (Baxter Limited, Japan)]. The trials aimed to demonstrate non-inferiority of peritoneal creatinine clearance (pCcr), peritoneal urea clearance (pCurea) and ultrafiltration volume (UF), and compare acid-base and electrolyte balance...
October 25, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27747968/perioperative-intravenous-fluid-therapy-in-children-guidelines-from-the-association-of-the-scientific-medical-societies-in-germany
#4
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27720664/pharmacological-management-of-acute-kidney-injury-and-chronic-kidney-disease-in-neonates
#5
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27667396/textile-organic-electrochemical-transistors-as-a-platform-for-wearable-biosensors
#6
I Gualandi, M Marzocchi, A Achilli, D Cavedale, A Bonfiglio, B Fraboni
The development of wearable chemical sensors is receiving a great deal of attention in view of non-invasive and continuous monitoring of physiological parameters in healthcare applications. This paper describes the development of a fully textile, wearable chemical sensor based on an organic electrochemical transistor (OECT) entirely made of conductive polymer (PEDOT:PSS). The active polymer patterns are deposited into the fabric by screen printing processes, thus allowing the device to actually "disappear" into it...
September 26, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27639981/impact-of-chloride-and-strong-ion-difference-on-icu-and-hospital-mortality-in-a-mixed-intensive-care-population
#7
Niels Van Regenmortel, Walter Verbrugghe, Tim Van den Wyngaert, Philippe G Jorens
BACKGROUND: Abnormal chloride levels are commonly observed in critically ill patients, but their clinical relevance remains a matter of debate. We examined the association between abnormal chloremia and ICU and hospital mortality. To further refine findings and integrate them into the ongoing discussion on the detrimental effects of chloride-rich solutions, the impact of strong ion difference (SID) on the same end points was assessed. METHODS: Retrospective cohort study in an academic tertiary intensive care unit on 8830 adult patients who stayed at least 24 h in the ICU was carried out...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27627089/-the-difference-and-ratio-between-serum-concentrations-of-natrium-and%C3%A2-chlorides-in-patients-with-hyponatremia
#8
Otto Schück, Miroslava Horáčková
UNLABELLED: The differential diagnosis of hyponatremia is often difficult. This most frequently occurring disorder of the water and electrolyte metabolism is frequently connected with deviations relating to the acid-base balance (ABB). This survey analyzes the relationship between the changes of the volume of body fluids and ABB and infers to what extent the analysis of combinations of the two disorders can support the differential diagnosis of different forms of hyponatremia (differentiation between the dilution vs...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27599629/approach-to-the-treatment-of-diabetic-ketoacidosis
#9
Kamel S Kamel, Martin Schreiber, Ana P C P Carlotti, Mitchell L Halperin
Diabetic ketoacidosis (DKA), a common cause of severe metabolic acidosis, remains a life-threatening condition due to complications of both the disease and its treatment. This Acid-Base and Electrolyte Teaching Case discusses DKA management, emphasizing complications of treatment. Because cerebral edema is the most common cause of mortality and morbidity, especially in children with DKA, we emphasize its pathophysiology and implications for therapy. The risk for cerebral edema may be minimized by avoiding a bolus of insulin, excessive saline resuscitation, and a decrease in effective plasma osmolality early in treatment...
September 3, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27590096/assessing-acid-base-status-physiologic-versus-physicochemical-approach
#10
Horacio J Adrogué, Nicolaos E Madias
The physiologic approach has long been used in assessing acid-base status. This approach considers acids as hydrogen ion donors and bases as hydrogen ion acceptors and the acid-base status of the organism as reflecting the interaction of net hydrogen ion balance with body buffers. In the physiologic approach, the carbonic acid/bicarbonate buffer pair is used for assessing acid-base status and blood pH is determined by carbonic acid (ie, Paco2) and serum bicarbonate levels. More recently, the physicochemical approach was introduced, which has gained popularity, particularly among intensivists and anesthesiologists...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27579560/minimally-invasive-strip-craniectomy-simplifies-anesthesia-practice-in-patients-with-isolated-sagittal-synostosis
#11
Daan P F van Nunen, Bart M Stubenitsky, Peter A Woerdeman, Kuo Sen Han, Corstiaan C Breugem, Aebele B Mink van der Molen, Jurgen C de Graaff
BACKGROUND: Traditional open corrective surgery for isolated sagittal synostosis entails significant blood loss, transfusion rates, morbidity, and a lengthy hospitalization. Minimally invasive strip craniectomy (MISC) was introduced to avoid the disadvantages of open techniques. OBJECTIVES: The aim of the study was, first, to compare the anesthesia practice in MISC and open extended strip craniectomy (OESC), and, second, to evaluate the incidence of perioperative complications in both surgical procedures...
August 31, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27562336/precision-fluid-management-in-continuous-renal-replacement-therapy
#12
Raghavan Murugan, Eric Hoste, Ravindra L Mehta, Sara Samoni, Xiaoqiang Ding, Mitchell H Rosner, John A Kellum, Claudio Ronco
Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on 'Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient...
2016: Blood Purification
https://www.readbyqxmd.com/read/27516689/salt-and-its-role-in-health-and-disease-prevention-from-the-perspectives-of-iranian-medicine-and-modern-medicine
#13
Masoud Mokhtari, Hamide Vahid
BACKGROUND: Salt in Iranian medical sources is mentioned as Malh and has a special place in people's nutrition. The purpose of this study was to investigate the effect of correct use of salt on health and disease prevention in the context of Iranian medicine and its comparison with modern medicine. METHODS: This article reviews Iranian medicine references on the usage of salt and its benefits. Additionally, modern medicine references were searched to identify the dos and don'ts of salt consumption...
May 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27506603/criteria-for-assigning-laboratory-measurands-to-models-for-analytical-performance-specifications-defined-in-the-1st-eflm-strategic-conference
#14
Ferruccio Ceriotti, Pilar Fernandez-Calle, George G Klee, Gunnar Nordin, Sverre Sandberg, Thomas Streichert, Joan-Lluis Vives-Corrons, Mauro Panteghini
This paper, prepared by the EFLM Task and Finish Group on Allocation of laboratory tests to different models for performance specifications (TFG-DM), is dealing with criteria for allocating measurands to the different models for analytical performance specifications (APS) recognized in the 1st EFLM Strategic Conference Consensus Statement. Model 1, based on the effect of APS on clinical outcome, is the model of choice for measurands that have a central role in the decision-making of a specific disease or clinical situation and where cut-off/decision limits are established for either diagnosing, screening or monitoring...
August 9, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27502170/normal-saline-versus-lower-chloride-solutions-for-kidney-transplantation
#15
REVIEW
Susan Wan, Matthew A Roberts, Peter Mount
BACKGROUND: The ideal intravenous fluid for kidney transplantation has not been defined, despite the common use of normal saline during the peri-operative period. The high chloride content of normal saline is associated with an increased risk of hyperchloraemic metabolic acidosis, which may in turn increase the risk of hyperkalaemia and delayed graft function. Balanced electrolyte solutions have a lower chloride content which may decrease this risk and avoid the need for dialysis due to hyperkalaemia in the immediate post-transplant period...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27458380/the-extracellular-calcium-sensing-receptor-in-the-intestine-evidence-for-regulation-of-colonic-absorption-secretion-motility-and-immunity
#16
REVIEW
Lieqi Tang, Catherine Y Cheng, Xiangrong Sun, Alexandra J Pedicone, Mansour Mohamadzadeh, Sam X Cheng
Different from other epithelia, the intestinal epithelium has the complex task of providing a barrier impeding the entry of toxins, food antigens, and microbes, while at the same time allowing for the transfer of nutrients, electrolytes, water, and microbial metabolites. These molecules/organisms are transported either transcellularly, crossing the apical and basolateral membranes of enterocytes, or paracellularly, passing through the space between enterocytes. Accordingly, the intestinal epithelium can affect energy metabolism, fluid balance, as well as immune response and tolerance...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27453712/confronting-practical-problems-for-initiation-of-on-line-hemodiafiltration-therapy
#17
REVIEW
Yang Wook Kim, Sihyung Park
Conventional hemodialysis, which is based on the diffusive transport of solutes, is the most widely used renal replacement therapy. It effectively removes small solutes such as urea and corrects fluid, electrolyte and acid-base imbalance. However, solute diffusion coefficients decreased rapidly as molecular size increased. Because of this, middle and large molecules are not removed effectively and clinical problem such as dialysis amyloidosis might occur. Online hemodiafiltration which is combined by diffusive and convective therapies can overcome such problems by removing effectively middle and large solutes...
June 2016: Electrolyte & Blood Pressure: E & BP
https://www.readbyqxmd.com/read/27387839/the-validity-of-discharge-billing-codes-reflecting-severe-maternal-morbidity
#18
Matthew J G Sigakis, Lisa R Leffert, Hooman Mirzakhani, Nadir Sharawi, Baskar Rajala, William M Callaghan, Elena V Kuklina, Andreea A Creanga, Jill M Mhyre, Brian T Bateman
BACKGROUND: Discharge diagnoses are used to track national trends and patterns of maternal morbidity. There are few data regarding the validity of the International Classification of Diseases (ICD) codes used for this purpose. The goal of our study was to try to better understand the validity of administrative data being used to monitor and assess trends in morbidity. METHODS: Hospital stay billing records were queried to identify all delivery admissions at the Massachusetts General Hospital for the time period 2001 to 2011 and the University of Michigan Health System for the time period 2005 to 2011...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27319095/-kidney-fluid-and-acid-base-balance
#19
REVIEW
Naohiro Shioji, Masao Hayashi, Hiroshi Morimatsu
Kidneys play an important role to maintain human homeostasis. They contribute to maintain body fluid, electrolytes, and acid-base balance. Especially in fluid control, we, physicians can intervene body fluid balance using fluid resuscitation and diuretics. In recent years, one type of fluid resuscitation, hydroxyl ethyl starch has been extensively studied in the field of intensive care. Although their effects on fluid resuscitation are reasonable, serious complications such as kidney injury requiring renal replacement therapy occur frequently...
May 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27319087/-physiology-in-relation-to-anesthesia-practice-preface-and-comments
#20
Yoshitsugu Yamada
It has been long recognized that anesthesia practice is profoundly based in physiology. With the advance of the technology of imaging, measurement and information, a serious gap has emerged between anesthesia mainly handling gross systemic parameters and molecular physiology. One of the main reasons is the lack of establishment of integration approach. This special series of reviews deals with systems physiology covering respiratory, cardiovascular, and nervous systems. It also includes metabolism, and fluid, acid-base, and electrolyte balance...
May 2016: Masui. the Japanese Journal of Anesthesiology
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