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PCO2 gap

Kartik Ganesh, R N Sharma, Jaicob Varghese, M G K Pillai
CONTEXT: Metabolic acidosis is frequently found in patients with severe sepsis. An understanding of types of acidosis in sepsis and their evolution over the course of treatment may give us insight into the behavior of acid-base balance in these patients. AIMS: To describe at Intensive Care Unit (ICU) admission and over the first 5 days the composition of metabolic acidosis in patients with sepsis and to evaluate and compare acidosis patterns in survivors and nonsurvivors...
October 2016: International Journal of Critical Illness and Injury Science
C Langdon Fielding, Chloe A Meier, Greg K Fellers, K Gary Magdesian
OBJECTIVE To compare results of point-of-care laboratory testing with standard veterinary clinical examination findings at a single time point during endurance competition to identify horses at risk for elimination. ANIMALS 101 endurance horses participating in the 2013 Western States 160-km (100-mile) endurance ride. PROCEDURES At the 58-km checkpoint, blood samples were collected from all horses. Samples were analyzed for pH, Pco2, base excess, anion gap, PCV, and whole blood concentrations of sodium, potassium, chloride, total carbon dioxide, BUN, glucose, and bicarbonate...
January 2017: American Journal of Veterinary Research
Karel Matoušovic, Jan Havlín, Otto Schück
Two approaches have been used in clinical evaluation the acid-base status: traditional (bicarbonate-centered) is based on the Henderson-Hasselbalch equation complemented by calculation of the anion gap, and more recent quantitative approach proposed by Stewart and Fencl. The latter method defines the three independent variables, which regulate pH. These include: the difference between the sum of charges carried by strong plasma cations and anions termed the strong ion difference - SID (decrease causes acidosis, and vice versa); the total concentration of the weak non-volatile acids [Atot] (inorganic phosphate and albumin, decrease causes alkalosis and vice versa), and pCO2...
2016: Casopís Lékar̆ů C̆eských
Carolina López, Andrés José Alcaraz, Blanca Toledo, Lucía Cortejoso, Maite Augusta Gil-Ruiz
OBJECTIVE: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. DESIGN: Retrospective, observational study. SETTING: A tertiary care children's hospital PICU. PATIENTS: Children receiving at least a 2-day course of enteral acetazolamide...
December 2016: Pediatric Critical Care Medicine
Remy R Okazaki, Erica K Towle, Ruben van Hooidonk, Carolina Mor, Rivah N Winter, Alan M Piggot, Ross Cunning, Andrew C Baker, James S Klaus, Peter K Swart, Chris Langdon
Anthropogenic climate change compromises reef growth as a result of increasing temperatures and ocean acidification. Scleractinian corals vary in their sensitivity to these variables, suggesting species composition will influence how reef communities respond to future climate change. Because data are lacking for many species, most studies that model future reef growth rely on uniform scleractinian calcification sensitivities to temperature and ocean acidification. To address this knowledge gap, calcification of twelve common and understudied Caribbean coral species was measured for two months under crossed temperatures (27, 30...
August 26, 2016: Global Change Biology
Marie Bulathsinghala, Kimberly Keefer, Andry Van de Louw
Propylene glycol (PG) is used as a solvent in numerous medications, including trimethoprim/sulfamethoxazole (TMP/SMX) and lorazepam, and is metabolized in the liver to lactic acid. Cases of lactic acidosis related to PG toxicity have been described and always involved large doses of benzodiazepines and PG. We present the first case of severe lactic acidosis after a 3-day course of TMP/SMX alone, involving allegedly safe amounts of PG.A 31-year-old female with neurofibromatosis and pilocytic astrocytoma, receiving temozolomide and steroids, was admitted to the intensive care unit for pneumonia and acute respiratory failure requiring intubation...
April 2016: Medicine (Baltimore)
Zili Zhang, Jian Wang, Meihua Guo, Mingmei Xiong, Qipeng Zhou, Defu Li, Jiaze Shu, Wenju Lu, Dejun Sun
Exposure to elevated levels of ambient air pollutants can lead to adverse cardiovascular effects. Perturbation of the coagulation balance is one of the potential mechanisms. However, evidence regarding the impact of improvement in air pollution on blood coagulability in COPD patients has never been reported. Coagulation processes are known to be of relevance for cardiovascular pathology; therefore, this study aimed to investigate the association of short-term air pollution exposure with blood marker (D-dimer) of coagulation...
April 2016: Environmental Science and Pollution Research International
Caleb T Hasler, David Butman, Jennifer D Jeffrey, Cory D Suski
Rising atmospheric carbon dioxide (CO2) has caused a suite of environmental issues, however, little is known about how the partial pressure of CO2 (pCO2) in freshwater will be affected by climate change. Freshwater pCO2 varies across systems and is controlled by a diverse array of factors, making it difficult to make predictions about future levels of pCO2. Recent evidence suggests that increasing levels of atmospheric CO2 may directly increase freshwater pCO2 levels in lakes, but rising atmospheric CO2 may also indirectly impact freshwater pCO2 levels in a variety of systems by affecting other contributing factors such as soil respiration, terrestrial productivity and climate regimes...
January 2016: Ecology Letters
D E Gomez, N M Biermann, L C Sanchez
BACKGROUND: The quantitative effect of strong electrolytes, unmeasured strong anions (UAs), pCO2, and plasma protein concentrations in determining plasma pH can be demonstrated using the physicochemical approach. Plasma anion gap (AG) and strong ion gap (SIG) are used to assess UAs in different species. HYPOTHESES: Strong ions are a major factor influencing changes in plasma pH of hospitalized foals. AG and SIG accurately predict severe hyper-L-lactatemia ([L-lac(-)] > 7 mmol/L)...
September 2015: Journal of Veterinary Internal Medicine
Sara M Gardhouse, David Eshar, Nora Bello, Diane Mason
OBJECTIVE: To describe changes in venous blood gas analytes during isoflurane anesthesia in black-tailed prairie dogs (Cynomys ludovicianus). DESIGN: Prospective study. ANIMALS: 16 black-tailed prairie dogs. PROCEDURES: Black-tailed prairie dogs were placed in an anesthesia chamber for induction of general anesthesia, which was maintained with isoflurane in oxygen delivered via mask. Immediately following anesthetic induction, a venous blood sample was obtained from the medial saphenous vein; a second venous blood sample was obtained just prior to anesthetic gas shutoff...
August 15, 2015: Journal of the American Veterinary Medical Association
Jen Kok, Jimmy Ng, Stephen C Li, John Giannoutsos, Vineet Nayyar, Jonathan R Iredell, Dominic E Dwyer, Sharon C-A Chen
Data on the performance of point-of-care (POC) or near-patient devices in the management of critically unwell patients are limited, meaning that there are demands for confirming POC test results in the routine clinical laboratory and so potentially leading to delay in treatment provision. We evaluated the performance of the i-STAT CHEM 8+ and CG4+, Hemochron Signature Elite, HemoCue Hb 201+ and WBC Diff Systems on whole blood collected from medical and surgical patients admitted to the intensive care unit at an Australian tertiary care hospital...
August 2015: Pathology
Eugene M Tan, Ejaaz Kalimullah, M Rizwan Sohail, Kannan Ramar
The approach to the patient with acute renal failure and elevated anion and osmolal gap is difficult. Differential diagnoses include toxic alcohol ingestion, diabetic or starvation ketoacidosis, or 5-oxoproline acidosis. We present a 76-year-old female with type 2 diabetes mellitus, who was found at home in a confused state. Laboratory analysis revealed serum pH 6.84, bicarbonate 5.8 mmol/L, pCO2 29 mmHg, anion gap 22.2 mmol/L, osmolal gap 17.4 mOsm/kg, elevated beta-hydroxybutyrate (4.2 mmol/L), random blood sugar 213 mg/dL, creatinine 2...
2015: Case Reports in Critical Care
Jörn O Streefkerk, Albertus Beishuizen, A B Johan Groeneveld
BACKGROUND: Gastric mucosal ischemia may be a risk factor for gastrointestinal intolerance to early feeding in the critically ill. AIMS: To study intragastric PCO2 air tonometry and gastric residual volumes (GRV) before and after the start of gastric feeding. METHODS: This is a two-center study in intensive care units of a university and teaching hospital. Twenty-nine critically ill, consecutive and consenting patients scheduled to start gastric feeding were studied after insertion of a gastric tonometry catheter and prior to and after start of gastric feeding (500 ml over 1 h), when clinically indicated...
June 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
H A Olanrewaju, J L Purswell, S D Collier, S L Branton
Light-emitting diode (LED) lighting is being used in the poultry industry to reduce energy usage in broiler production facilities. However, limited data are available comparing efficacy of different spectral distribution of LED bulbs on blood physiological variables of broilers grown to heavy weights (>3 kg). The present study evaluated the effects of color temperature (Kelvin) of LED bulbs on blood physiological variables of heavy broilers in 2 trials with 4 replicates/trial. The study was a randomized complete block design...
August 2015: Poultry Science
Emmanuel Robin, Emmanuel Futier, Oscar Pires, Maher Fleyfel, Benoit Tavernier, Gilles Lebuffe, Benoit Vallet
INTRODUCTION: The purpose of this study was to evaluate the clinical relevance of high values of central venous-to-arterial carbon dioxide difference (PCO2 gap) in high-risk surgical patients admitted to a postoperative ICU. We hypothesized that PCO2 gap could serve as a useful tool to identify patients still requiring hemodynamic optimization at ICU admission. METHODS: One hundred and fifteen patients were included in this prospective single-center observational study during a 1-year period...
2015: Critical Care: the Official Journal of the Critical Care Forum
P Sławuta, K Glińska-Suchocka, A Cekiera
UNLABELLED: Apart from the HH equation, the acid-base balance of an organism is also described by the Stewart model, which assumes that the proper insight into the ABB of the organism is given by an analysis of: pCO2, the difference of concentrations of strong cations and anions in the blood serum - SID, and the total concentration of nonvolatile weak acids - Acid total. The notion of an anion gap (AG), or the apparent lack of ions, is closely related to the acid-base balance described according to the HH equation...
2015: Polish Journal of Veterinary Sciences
M Bednarski, R Kupczyński, P Sobiech
The aim of this study was to analyze disorders of acid-base balance in calves with chronic diarrhea caused by mixed, viral, bacterial and Cryptosporydium parvum infection. We compared results ob- tained with the classic model (Henderson-Hasselbalch) and strong ion approach (the Steward model). The study included 36 calves aged between 14 and 21 days. The calves were allocated to three groups: I - (control) non-diarrheic calves, group II - animals with compensated acid-base imbalance and group III calves with compensated acid-base disorders and hypoalbuminemia...
2015: Polish Journal of Veterinary Sciences
Tyler G Evans, Jacqueline L Padilla-Gamiño, Morgan W Kelly, Melissa H Pespeni, Francis Chan, Bruce A Menge, Brian Gaylord, Tessa M Hill, Ann D Russell, Stephen R Palumbi, Eric Sanford, Gretchen E Hofmann
Advances in nucleic acid sequencing technology are removing obstacles that historically prevented use of genomics within ocean change biology. As one of the first marine calcifiers to have its genome sequenced, purple sea urchins (Strongylocentrotus purpuratus) have been the subject of early research exploring genomic responses to ocean acidification, work that points to future experiments and illustrates the value of expanding genomic resources to other marine organisms in this new 'post-genomic' era. This review presents case studies of S...
July 2015: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
Norma Guerra-Hernández, Mario Matos-Martínez, Karen Verónica Ordaz-López, María Dolores Camargo-Muñiz, Mara Medeiros, Laura Escobar-Pérez
INTRODUCTION: Renal tubular acidosis (RTA) is a rare disease characterized by a normal serum anion gap, sustained metabolic acidosis, low concentration of plasma bicarbonate, variable hyperchloremia and hypokalemia and conserved glomerular filtration rate. RTA is developed during the first year of life and produces failure to thrive and anorexia. Primary distal RTA (type 1) is a renal syndrome with a reduced ability to excrete the acid load through the collecting ducts and impairment to concentrate the urine causing polyuria and dehydration...
September 2014: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Jasna Todorović, Jelena Nešovic-Ostojić, Aleksandar Milovanović, Predrag Brkić, Mihailo Ille, Dušan Čemerikić
Three distinct approaches are currently used in assessing acid-base disorders: the traditional - physiological or bicarbonate-centered approach, the base-excess approach, and the "modern" physicochemical approach proposed by Peter Stewart, which uses the strong ion difference (particularly the sodium chloride difference) and the concentration of nonvolatile weak acids (particularly albumin) and partial pressure of carbon dioxide (pCO(2)) as independent variables in the assessment of acid-base status. The traditional approach developed from the pioneering work of Henderson and Hasselbalch and the base-excess are still most widely used in clinical practice, even though there are a number of problems identified with this approach...
February 2015: Medicinski Glasnik
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