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alkalosis guidelines

F John Gennari
Acid-base assessment of patients receiving conventional hemodialysis (HD) has been based solely on predialysis serum [total CO2 ], and treatment is currently driven by the KDOQI guideline from 2000. This guideline was directed solely at minimizing metabolic acidosis and thereby improving bone and muscle metabolism. In 2000, no data were available to assess the effects of acid-base status on morbidity and mortality. Since then, new data have emerged from several large cohort studies about the association between variations in predialysis serum [total CO2 ], as well as blood pH, and morbidity and mortality risk...
March 1, 2018: Seminars in Dialysis
Josef Finsterer, Fulvio Alexandre Scorza
The aim of the present review was to summarize and discuss previous findings concerning renal manifestations of primary mitochondrial disorders (MIDs). A literature review was performed using frequently used databases. The study identified that primary MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) at onset or in the later course of the MID. Occasionally, the kidneys are affected in MIDs. Renal manifestations of MIDs include renal insufficiency, nephrolithiasis, nephrotic syndrome, renal cysts, renal tubular acidosis, Bartter-like syndrome, Fanconi syndrome, focal segmental glomerulosclerosis, tubulointerstitial nephritis, nephrocalcinosis, and benign or malign neoplasms...
May 2017: Biomedical Reports
C Voiculeț, O Zară, C Bogeanu, I Văcăroiu, G Aron
Background: Major acid-base variations during dialysis and the imbalances in serum calcium levels intensified by them play a role in cardiovascular damage of hemodialysis patients. Early vascular walls modifications can be objectified by determining the pulse wave velocity (PWV) - a marker of vascular stiffness that is associated with increased risk of cardiovascular events. Material and methods: This was a prospective study conducted on 63 chronic hemodialysis patients with diuresis above 500 mL/ 24 hours and predialysis blood pressure below 160 mmHg (treatment controlled) randomized in two groups for 12 months - the study group receiving interdialitic oral sodium bicarbonate doses and control group, without oral sodium bicarbonate supplementation, but receiving higher bicarbonate prescriptions in dialysis...
October 2016: Journal of Medicine and Life
Philip S Mehler, Kristine Walsh
OBJECTIVE: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors...
March 2016: International Journal of Eating Disorders
Santo Morabito, Valentina Pistolesi, Luigi Tritapepe, Elio Vitaliano, Laura Zeppilli, Francesca Polistena, Enrico Fiaccadori, Alessandro Pierucci
BACKGROUND: Recent guidelines suggest the adoption of regional citrate anticoagulation (RCA) as first choice CRRT anticoagulation modality in patients without contraindications for citrate. Regardless of the anticoagulation protocol, hypophosphatemia represents a potential drawback of CRRT which could be prevented by the adoption of phosphate-containing CRRT solutions. The aim was to evaluate the effects on acid-base status and phosphate supplementation needs of a new RCA protocol for Continuous Venovenous Hemodiafiltration (CVVHDF) combining the use of citrate with a phosphate-containing CRRT solution...
October 25, 2013: BMC Nephrology
Stephanie Ohlraun, Tobias Wollersheim, Claudia Weiß, Peter Martus, Steffen Weber-Carstens, Dietmar Schmitz, Markus Schuelke
BACKGROUND: 2-8% of all children aged between 6 months and 5 years have febrile seizures. Often these seizures cease spontaneously, however depending on different national guidelines, 20-40% of the patients would need therapeutic intervention. For seizures longer than 3-5 minutes application of rectal diazepam, buccal midazolam or sublingual lorazepam is recommended. Benzodiazepines may be ineffective in some patients or cause prolonged sedation and fatigue. Preclinical investigations in a rat model provided evidence that febrile seizures may be triggered by respiratory alkalosis, which was subsequently confirmed by a retrospective clinical observation...
June 27, 2013: Journal of Translational Medicine
Horacio Márquez-González, Jesús Pámanes-González, Horacio Márquez-Flores, Alonso Gómez-Negrete, Mireya C Muñoz-Ramírez, Antonio Rafael Villa-Romero
Gasometry is the measurement of dissolved gases in the blood, by measuring pH, carbon dioxide pressure (pCO(2)), serum bicarbonate (HCO(3-)), and lactate and serum electrolytes: sodium, potassium and chlorine you can make a diagnosis, etiology and treatment in the critically ill patient. The aim is to provide five steps for the interpretation of blood gases by: 1. The definition of acidemia or acidosis, or alkalemia or alkalosis. 2. Defining the metabolic component or respiratory. 3. To determine the anion gap; levels above 15 ± 2 determine other likely causes of excess anions (methanol, uremia, diabetic ketoacidosis, paraldehyde, ionized, lactic acidosis, ethylene glycol and salicylates...
July 2012: Revista Médica del Instituto Mexicano del Seguro Social
Florian M Trefz, Annette Lorch, Melanie Feist, Carola Sauter-Louis, Ingrid Lorenz
BACKGROUND: The aim of the present prospective study was to investigate whether a decision tree based on basic clinical signs could be used to determine the treatment of metabolic acidosis in calves successfully without expensive laboratory equipment. A total of 121 calves with a diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital were included in the study. The dosages of sodium bicarbonate administered followed simple guidelines based on the results of a previous retrospective analysis...
2012: BMC Veterinary Research
Xu-feng Yang, Hai-rong Wang, Jin-hua Gu, Jian Jiang, Shu-ming Pan
OBJECTIVE: To analyze the value of automated acid-base mapping on diagnose and treatment of patients with community acquired pneumonia (CAP) in emergency department. METHODS: According to medical history, pulmonary function test, diagnosing guideline of chronic obstructive pulmonary disease (COPD), 111 patients with CAP were divided into two groups: single CAP group (n=56) and COPD complicated with CAP group [acute exacerbation of chronic obstructive pulmonary disease (AECOPD) group, n=55]...
October 2012: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
S Wedenoja, P Höglund, C Holmberg
BACKGROUND: Congenital chloride diarrhoea in a newborn is a medical emergency, requiring early diagnostics and treatment to prevent severe dehydration and infant mortality. While most of the 250 cases reported arise from Finland, Poland and Arab countries, single cases with this autosomal recessive disorder appear worldwide. Such congenital chloride diarrhoea rarity makes diagnosis difficult. Life-long salt substitution with NaCl and KCl stabilizes fluid, electrolyte and acid-base balance diagnosis...
February 15, 2010: Alimentary Pharmacology & Therapeutics
Nasira Tasnim, Ghazala Mahmud, Sadia Akram
OBJECTIVE: To find out the predictive value of intrapartum Cardiotocograph (CTG) in terms of fetal acid base status at birth in women undergoing emergency caesarean section for a suboptimal CTG trace. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: At the MCH Centre, Pakistan Institute of Medical Sciences, Islamabad, from June 2004 to July 2005. METHODOLOGY: All women undergoing emergency caesarean section for a suboptimal intrapartum CTG were recruited in the study...
October 2009: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Daniel Foy, Helio Autran de Morais
This article serves as a quick reference for metabolic alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.
May 2008: Veterinary Clinics of North America. Small Animal Practice
Rebecca A Johnson
This article serves as a quick reference for respiratory alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.
May 2008: Veterinary Clinics of North America. Small Animal Practice
Jacob Atsmon, Eran Dolev
Nearly 50 medications have been implicated as inducing hypomagnesaemia, sometimes based on insufficient data regarding clinical significance and frequency of occurrence. In fact, clinical effects attributed to hypomagnaesemia have been reported in only 17 of these drugs. A considerable amount of literature relating to individual drugs has been published, yet a comprehensive overview of this issue is not available and the hypomagnesaemic effect of a drug could be either overemphasised or under-rated. In addition, there are neither guidelines regarding treatment, prevention and monitoring of drug-induced hypomagnesaemia nor agreement as to what serum level of magnesium may actually be defined as 'hypomagnesaemia'...
2005: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
L Frassetto, R C Morris, D E Sellmeyer, K Todd, A Sebastian
Theoretically, we humans should be better adapted physiologically to the diet our ancestors were exposed to during millions of years of hominid evolution than to the diet we have been eating since the agricultural revolution a mere 10,000 years ago, and since industrialization only 200 years ago. Among the many health problems resulting from this mismatch between our genetically determined nutritional requirements and our current diet, some might be a consequence in part of the deficiency of potassium alkali salts (K-base), which are amply present in the plant foods that our ancestors ate in abundance, and the exchange of those salts for sodium chloride (NaCl), which has been incorporated copiously into the contemporary diet, which at the same time is meager in K-base-rich plant foods...
October 2001: European Journal of Nutrition
T Dybvik, T Strand, P A Steen
The effects of infusing a buffer solution on resuscitability and outcome was tested in patients during out-of-hospital cardiac arrest. A number (502) of adults with asystole or ventricular fibrillation with failure of first defibrillation attempt were entered into a prospective, randomized, double-blind, controlled trial. Of these, 245 patients received 250 ml of sodium bicarbonate-trometamol- phosphate mixture with buffering capacity 500 mmol/l and 257 patients received 250 ml 0.9% saline. Except for the investigational infusion, all patients were resuscitated according to international guidelines...
April 1995: Resuscitation
G J Kost
The technique of muscle surface pH measurement used clinically was refined for application in animal experimentation. Guidelines for electrode utilization were developed, and sources of error were investigated. In pentobarbital sodium-anesthetized rabbits, during steady-state conditions, the surface pH of the medial gastrocnemius [7.39 +/- 0.05 (SD)] was equal to that of the soleus, and both were lower than femoral venous outflow pH (7.42 +/- 0.04, P less than 0.001), which was lower than arterial pH (7.46 +/- 0...
January 1982: Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology
W J Martin, G R Matzke
The pathophysiology, symptomatology, and treatment of metabolic alkalosis are reviewed, with emphasis on treatment with intravenous hydrochloric acid. Three buffering systems are used by the body to correct an arterial pH above 7.45--tissue, respiratory, and renal systems. The kidneys have the primary responsibility for correcting a severe metabolic alkalosis, but several conditions (e.g., severe volume contraction) can interfere with the renal mechanisms. No unique symptoms are associated with metabolic alkalosis...
January 1982: Clinical Pharmacy
D A Goodkin, G G Krishna, R G Narins
Mixed metabolic-respiratory acid-base disorders may be diagnosed when the respiratory compensation for a primary metabolic acidosis or alkalosis is inappropriate or when there is inappropriate metabolic compensation for a primary respiratory disorder. The magnitude of the primary change in HCO3 concentration (in metabolic disorders) defines the limits of compensation. We emphasized the importance of the equality of the increment in the anion gap (delta AG) and the decrement in the serum bicarbonate concentration (delta HCO3) in diagnosing a simple high AG metabolic acidosis...
July 1984: Clinics in Endocrinology and Metabolism
C Werning, W Siegenthaler
No abstract text is available yet for this article.
March 6, 1970: Deutsche Medizinische Wochenschrift
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