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Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
May 2018: Perfusion
Juan J Sánchez-Canel, Julio Hernández-Jaras, Ramón Pons-Prades
Metabolic acidosis correction is achieved by the transfer of bicarbonate and other buffer anions in dialysis. The aim of this study was to evaluate changes in the main anions of intermediary metabolism on standard hemodiafiltration (HDF) and on acetate-free biofiltration (AFB). A prospective, in-center, crossover study was carried out with 22 patients on maintenance dialysis. Patients were randomly assigned to start with 12 successive sessions of standard HDF with bicarbonate (34 mmol/L) and acetate dialysate (3 mmol/L) or 12 successive sessions of AFB without base in the dialysate...
February 2015: Therapeutic Apheresis and Dialysis
Xiaolei Shi, Dan Yao, Chi Chen
The influence of ethanol on the small molecule metabolome and the role of CYP2E1 in ethanol-induced hepatotoxicity were investigated using liquid chromatography-mass spectrometry (LC-MS)-based metabolomics platform and Cyp2e1-null mouse model. Histological and biochemical examinations of ethanol-exposed mice indicated that the Cyp2e1-null mice were more resistant to ethanol-induced hepatic steatosis and transaminase leakage than the wild-type mice, suggesting CYP2E1 contributes to ethanol-induced toxicity. Metabolomic analysis of urinary metabolites revealed time- and dose-dependent changes in the chemical composition of urine...
February 24, 2012: Journal of Biological Chemistry
E Coll, R Pérez-García, A L Martín de Francisco, J Galcerán, R García-Osuna, A Martín-Malo, A Martínez-Castelao, B Sánchez, R Llopis, M A Alvarez de Lara
SUMMARY BACKGROUND: The small quantity of acetate present in the dialysis fluid exposes patient's blood to an acetate concentration 30-40 times the physiological levels. This amount is even greater in hemodiafiltration on-line. Our purpose was to evaluate the clinical-analytical effects using three different dialysis techniques in the same patient. METHODS: 35 patients on hemodialysis were included. All patients were treated with conventional bicarbonate dialysate for 3 months, after randomization were switched to first be treated with PHF online with standard bicarbonate dialysate for 6 months and then switched to PHF on-line acetate-free dialysate for the other 6 months or to invert the two last periods...
2009: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
G Fournier, J Potier, H E Thébaud, G Majdalani, H Ton-That, N K Man
In a multicenter study including 5 dialysis units, blood acetate changes during 4 h dialysis sessions in 141 patients treated with a 4 mM acetate-containing bicarbonate dialysate (ABD) were evaluated and compared to the values of 114 patients using an acetate-free bicarbonate dialysate (AFD). Acetate-free bicarbonate dialysate was delivered by a dialysis machine from the mixing with water for dialysis of a 1/26.2 bicarbonate concentrate, and a 1/35 acid-concentrate in which acetic acid was substituted for hydrochloric acid (Soludia, Fourquevaux, France)...
July 1998: Artificial Organs
V Wizemann, R Soetanto, J Thormann, F Lübbecke, W Kramer
Two approaches were chosen to assess the controversially debated influence of acetate on the heart in dialysis patients: (1) To separate acetate effects from influences of dialysis, acetate was infused in 12 chronic dialysis patients with normal systolic function on a dialysis-free day, and left ventricular (LV) function was assessed by LV pressure/volume loops. Hyperacetatemia (3-5 mmol/l) resulted in a decrease in LV preload (LV end-diastolic pressure decreased from 16 +/- 3 to 10 +/- 4 mm Hg, p < 0.01) but had no influence on LV contractility...
1993: Nephron
M A Mansell, A Crowther, M F Laker, A J Wing
We used impedance cardiography to monitor changes in cardiac output in 22 adult patients with terminal renal failure during hemodialysis against a dialyzate containing acetate. In 7 patients arterial acetate levels rose progressively during dialysis while in the remainder they remained low and steady. Patients who developed hyperacetatemia were able to maintain an elevated cardiac output during dialysis in contrast to the patients with stable acetate levels in whom cardiac output fell. These results strengthen our previous conclusion that acetate as used in conventional regular hemodialysis does not have a cardiodepressant action...
September 1982: Clinical Nephrology
J Torrente, F Coronel, J A Herrero, M Macia, A Barrientos
To the authors knowledge, lactate (LA) has never been used in hemodialysis concentrates. A new concentrate has been designed in which a low acetate (AC) concentration is complemented with LA up to standard quantities of buffer with the aim of minimizing the side effects of AC. In 14 classically AC-intolerant hemodialysis patients (low body surface area of 1.47 +/- 0.15 m2, decrease of serum bicarbonate level during hemodialysis by 2 mmol/L or more, and postdialysis hyperacetatemia of greater than 7.0 mmol/L) a concentrate with LA was used (Na, 138; K, 1...
February 1990: Artificial Organs
F K Port, R E Easterling
Acetate clearance was found to approximate bicarbonate clearance and to be 10% lower than urea clearance under single pass in vitro conditions. Plasms acetate concentrations were significanlty higher in pre-dialysis samples than in control subjects and rose during hemodialysis to a wide range of post-dialysis levels. In 17% of patients plasma acetate exceeded 9.5 mM/L and range to 21.6 mM/L. The cause for this apparent acetate intolerance is probably multifactorial, since severe hyperacetatemia is not a constant finding for any specific patient...
November 1975: Proceedings of the Clinical Dialysis and Transplant Forum
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