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"Strong ion difference"

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https://www.readbyqxmd.com/read/28833697/effect-of-intravenously-administered-crystalloid-solutions-on-acid-base-balance-in-domestic-animals
#1
REVIEW
W Muir
Intravenous fluid therapy can alter plasma acid-base balance. The Stewart approach to acid-base balance is uniquely suited to identify and quantify the effects of the cationic and anionic constituents of crystalloid solutions on plasma pH. The plasma strong ion difference (SID) and weak acid concentrations are similar to those of the administered fluid, more so at higher administration rates and with larger volumes. A crystalloid's in vivo effects on plasma pH are described by 3 general rules: SID > [HCO3-] increases plasma pH (alkalosis); SID < [HCO3-] decreases plasma pH (alkalosis); and SID = [HCO3-] yields no change in plasma pH...
September 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28814306/blood-acid-base-status-in-impala-aepyceros-melampus-immobilised-and-maintained-under-total-intravenous-anaesthesia-using-two-different-drug-protocols
#2
Gareth E Zeiler, Leith C R Meyer
BACKGROUND: In mammals, homeostasis and survival are dependent on effective trans-membrane movement of ions and enzyme function, which are labile to extreme acid-base changes, but operate efficiently within a narrow regulated pH range. Research in patients demonstrating a pH shifts outside the narrow regulated range decreased the cardiac output and systemic vascular resistance and altered the oxygen binding to haemoglobin. These cardiopulmonary observations may be applicable to the risks associated with anaesthesia and performance of wildlife ungulates on game farms...
August 16, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28693594/the-impact-of-phosphate-balanced-crystalloid-infusion-on-acid-base-homeostasis-palance-study-study-protocol-for-a-randomized-controlled-trial
#3
Judith-Irina Pagel, Nikolai Hulde, Tobias Kammerer, Michaela Schwarz, Daniel Chappell, Alexander Burges, Klaus Hofmann-Kiefer, Markus Rehm
BACKGROUND: This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. METHODS/DESIGN: This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28553873/does-fluid-resuscitation-with-balanced-solutions-induce-electrolyte-and-metabolic-abnormalities-an-in-vitro-assessment
#4
Łukasz J Krzych, Piotr F Czempik
BACKGROUND: Popular intravenous fluids in clinical use may have an impact on electrolyte concentration and metabolic balance and should be considered as powerful pharmacological agents. There is a growing body of evidence that fluid therapy should be more individualised and preferably based on balanced solutions. AIM: We sought to investigate the impact of three commonly used balanced fluids on electrolytes and metabolic equilibrium in an in vitro setting. METHODS: Study group comprised 32 healthy male volunteers (without history of any acute/chronic disorder or known metabolic abnormality), aged 21-35 (29 ± 4) years, weight 59-103 (81...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28420042/determination-of-reference-intervals-of-acid-base-parameters-in-clinically-healthy-dogs
#5
Ivana Vanova-Uhrikova, Leona Rauserova-Lexmaulova, Kristina Rehakova, Peter Scheer, Jaroslav Doubek
OBJECTIVE: To establish reference intervals for traditionally- and Stewart's approach-determined acid-base parameters in a population of clinically healthy dogs. DESIGN: Prospective study (June 2011-September 2012). SETTING: Veterinary teaching hospital. ANIMALS: Two hundred twenty-four client-owned, clinically healthy dogs. INTERVENTIONS: Blood was collected from the jugular vein and the dorsal pedal artery...
May 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28380062/different-effects-of-fluid-loading-with-saline-gelatine-hydroxyethyl-starch-or-albumin-solutions-on-acid-base-status-in-the-critically-ill
#6
RANDOMIZED CONTROLLED TRIAL
Angélique M E Spoelstra-de Man, Annemieke Smorenberg, A B Johan Groeneveld
INTRODUCTION: Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. METHODS: We studied the effect of fluid resuscitation of normal saline and the colloids gelatine 4%, hydroxyethyl starch (HES) 6%, and albumin 5% on acid-base balance in 115 clinically hypovolemic critically ill patients during a 90 minute filling pressure-guided fluid challenge by a post-hoc analysis of a prospective randomized clinical trial...
2017: PloS One
https://www.readbyqxmd.com/read/28298660/hyperlactatemia-and-cardiac-surgery
#7
REVIEW
Jonathon Minton, David A Sidebotham
The normal blood lactate level is 0-2 mmol/L, and a value above 3-5 mmol/L is variably used to define hyperlactatemia. In cardiac surgical patients, hyperlactatemia can arise from both hypoxic and non-hypoxic mechanisms. The major non-hypoxic mechanism is likely stress-induced accelerated aerobic metabolism, in which elevated lactate results from a mass effect on the lactate/pyruvate equilibrium. The lactate/pyruvate ratio is normal (<20) in this circumstance. Hyperlactatemia can also result from impaired global or regional oxygen delivery, in which case the lactate/pyruvate ratio is typically elevated (>20)...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28289910/acid-base-disturbances-in-nephrotic-syndrome-analysis-using-the-co2-hco3-method-traditional-boston-model-and-the-physicochemical-method-stewart-model
#8
Tomomichi Kasagi, Hirokazu Imai, Naoto Miura, Keisuke Suzuki, Masabumi Yoshino, Hironobu Nobata, Takuhito Nagai, Shogo Banno
BACKGROUND: The Stewart model for analyzing acid-base disturbances emphasizes serum albumin levels, which are ignored in the traditional Boston model. We compared data derived using the Stewart model to those using the Boston model in patients with nephrotic syndrome. METHODS: Twenty-nine patients with nephrotic syndrome and six patients without urinary protein or acid-base disturbances provided blood and urine samples for analysis that included routine biochemical and arterial blood gas tests, plasma renin activity, and aldosterone...
March 13, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28078858/use-of-lactated-ringer%C3%A2-s-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#9
LETTER
T Jovaisa, V Vicka, G Linkaitė, J Guseinovaitė, D Ringaitienė, I Norkienė
There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28028530/acid-base-and-hemodynamic-status-of-patients-with-intraoperative-hemorrhage-using-two-solution-types-crystalloid-ringer-lactate-and-1-3-sodium-bicarbonate-in-half-normal-saline-solution
#10
Sayed Jalal Hashemi, Sayed Morteza Heidari, Ahmad Yaraghi, Reza Seirafi
BACKGROUND: Intraoperative hemorrhage is one of the problems during surgery and, if it happens in a high volume without an immediate action to control, it can be fatal. Nowadays, various injectable solutions are used. The aim of this study was to compare the acid-base and hemodynamic status of the patient using two solutions, Ringer lactate and 1.3% sodium bicarbonate, in half saline solution. MATERIALS AND METHODS: This clinical trial was performed at the Al-Zahra Hospital in 2013 on 66 patients who were randomly selected and put in two studied groups at the onset of hemorrhage...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/27990831/-clinical-evaluation-of-acid-base-status-henderson-hasselbalch-or-stewart-fencl-approach
#11
REVIEW
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...
December 0: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27746547/a-comparative-study-of-sterofundin-and-ringer-lactate-based-infusion-protocol-in-scoliosis-correction-surgery
#12
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27639981/impact-of-chloride-and-strong-ion-difference-on-icu-and-hospital-mortality-in-a-mixed-intensive-care-population
#13
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/27590096/assessing-acid-base-status-physiologic-versus-physicochemical-approach
#14
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/27562561/chloride-content-of-solutions-used-for-regional-citrate-anticoagulation-might-be-responsible-for-blunting-correction-of-metabolic-acidosis-during-continuous-veno-venous-hemofiltration
#15
Rita Jacobs, Patrick M Honore, Marc Diltoer, Herbert D Spapen
BACKGROUND: Citrate, the currently preferred anticoagulant for continuous veno-venous hemofiltration (CVVH), may influence acid-base equilibrium. METHODS: The effect of 2 different citrate solutions on acid-base status was assessed according to the Stewart-Figge approach in two consecutive cohorts of critically ill adult patients. The first group received Prismocitrate 10/2 (PC10/2; 10 mmol citrate/L). The next group was treated with Prismocitrate 18/0 (PC18; 18 mmol citrate/L)...
August 26, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27447787/real-time-urinary-electrolyte-monitoring-after-furosemide-administration-in-surgical-icu-patients-with-normal-renal-function
#16
Luca Zazzeron, Davide Ottolina, Eleonora Scotti, Michele Ferrari, Paola Bruzzone, Silvio Sibilla, Cristina Marenghi, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Although the loop-diuretic furosemide is widely employed in critically ill patients with known long-term effects on plasma electrolytes, accurate data describing its acute effects on renal electrolyte handling and the generation of plasma electrolyte alterations are lacking. We hypothesized that the long-term effects of furosemide on plasma electrolytes and acid-base depend on its immediate effects on electrolyte excretion rate and patient clinical baseline characteristics...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27366324/a-comparison-of-prognostic-significance-of-strong-ion-gap-sig-with-other-acid-base-markers-in-the-critically-ill-a-cohort-study
#17
Kwok M Ho, Norris S H Lan, Teresa A Williams, Yusra Harahsheh, Andrew R Chapman, Geoffrey J Dobb, Sheldon Magder
BACKGROUND: This cohort study compared the prognostic significance of strong ion gap (SIG) with other acid-base markers in the critically ill. METHODS: The relationships between SIG, lactate, anion gap (AG), anion gap albumin-corrected (AG-corrected), base excess or strong ion difference-effective (SIDe), all obtained within the first hour of intensive care unit (ICU) admission, and the hospital mortality of 6878 patients were analysed. The prognostic significance of each acid-base marker, both alone and in combination with the Admission Mortality Prediction Model (MPM0 III) predicted mortality, were assessed by the area under the receiver operating characteristic curve (AUROC)...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27312130/hyperchloremic-acidosis-is-associated-with-acute-kidney-injury-after-abdominal-surgery
#18
Yosuke Toyonaga, Mutsuhito Kikura
AIM: Hyperchloremic acidosis may have an important role as a precursor of acute kidney injury (AKI) in the hyperchloremic environment induced by chloride-rich fluids, but this remains unclear. We tested the hypothesis that hyperchloremic acidosis assessed by the Stewart approach is associated with postoperative AKI. METHODS: A historical cohort study was conducted in adult patients who had normal renal function preoperatively and required admission to the intensive care unit after elective abdominal surgery...
September 2017: Nephrology
https://www.readbyqxmd.com/read/27289617/use-of-ringer-s-lactate-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#19
I Norkiene, G Linkaite, J Guseinovaite, V Vicka, D Ringaitiene, T Jovaisa
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27258049/urinary-strong-ion-difference-as-a-marker-of-renal-dysfunction-a-retrospective-analysis
#20
Paolo Balsorano, Stefano Romagnoli, Samuel Kagan Evans, Zaccaria Ricci, Angelo Raffaele De Gaudio
INTRODUCTION: The kidneys play a crucial role in the regulation of electrolytes and acid-base homeostasis. Urinary Strong Ion Difference (SIDu = NaU + KU-ClU) represents an important aspect of renal acid-base regulation. We evaluated the role of SIDu as a marker of renal dysfunction in critically ill patients. MATERIALS AND METHODS: Patients admitted to the Medical Intensive Care Unit with a diagnosis of AKI for whom concomitant urinary samples available for SIDu calculation were retrospectively reviewed and staged according to KDIGO criteria for 3 days from inclusion...
2016: PloS One
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