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"Strong ion difference"

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
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
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...
August 30, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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)...
2016: BMC Nephrology
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
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
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...
June 16, 2016: Nephrology
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
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
Judit Viu, Lara Armengou, José Ríos, Anna Muñoz, Eduard Jose-Cunilleras
OBJECTIVE: To determine the strong ion difference (SIDa ) and total nonvolatile weak buffers (ATOT ) in healthy foals during the first year of life and to compare reference biochemistry laboratory with analyzers available during emergency hours. DESIGN: Prospective study performed over 2 years. SETTING: University teaching hospital. ANIMALS: Two hundred thirty-six healthy foals distributed in 6 groups: A (21 days-2 months), B (2-3 months), C (3-6 months), D (6-9 months), E (9-12 months), and 33 neonatal foals (< 21 days old)...
July 2016: Journal of Veterinary Emergency and Critical Care
Thiago Gomes Romano, Mario Diego Teles Correia, Pedro Vitale Mendes, Fernando Godinho Zampieri, Alexandre Toledo Maciel, Marcelo Park
OBJECTIVE: Hypercapnia resulting from protective ventilation in acute respiratory distress syndrome triggers metabolic pH compensation, which is not entirely characterized. We aimed to describe this metabolic compensation. METHODS: The data were retrieved from a prospective collected database. Variables from patients' admission and from hypercapnia installation until the third day after installation were gathered. Forty-one patients with acute respiratory distress syndrome were analyzed, including twenty-six with persistent hypercapnia (PaCO2 > 50mmHg > 24 hours) and 15 non-hypercapnic (control group)...
January 2016: Revista Brasileira de Terapia Intensiva
Ríona G Sayers, Aideen Kennedy, Lea Krump, Gearóid P Sayers, Emer Kennedy
An observational study was conducted on dairy calves (51 healthy, 31 with neonatal diarrhea) during outbreaks of diarrhea on 4 dairy farms. Clinical assessment scores (CAS) were assigned to each healthy and diarrheic calf [from 0 (healthy) to 4 (marked illness)]. Blood gas analysis [pH, base excess (BE), Na(+), K(+), Ca(2+), Cl(-), glucose, total hemoglobin, standard HCO3(-), strong ion difference (SID), and anion gap (AG)] was completed for each calf. Repeated measurements were taken in healthy animals, and pre- and postintervention measurements were taken for diarrheic calves...
June 2016: Journal of Dairy Science
Bulent Gucyetmez, Hakan Korkut Atalan
PURPOSE: The recommended method for elucidating the effects of strong ions other than lactate on acid-base balance is to calculate the non-lactate strong ion difference (SIDnl). A relationship between HCO3 (-) and SIDnl in hyperchloremic patients has already been demonstrated; in the present study, the relationships between SIDnl, the apparent strong ion difference (SIDa), and mortality at intensive care unit (ICU) admission were investigated. METHODS: In our two-center study, 2691 patients admitted to the ICU were retrospectively evaluated, including 1069 critically ill patients...
June 2016: Journal of Anesthesia
J Viu, L Armengou, J Ríos, C Cesarini, E Jose-Cunilleras
REASONS FOR PERFORMING STUDY: Acid-base imbalances observed in human paediatric patients are associated with outcome. Likewise, neonatal foals may have different acid-base imbalances associated with diagnosis or prognosis. OBJECTIVES: To determine acid-base imbalances by the quantitative method in ill neonatal foals and to assess their association with diagnosis and prognosis. STUDY DESIGN: Observational prospective clinical study. METHODS: This study included 65 ill neonatal foals (32 septic, 33 non-septic) admitted to an equine referral hospital from 2005 to 2011with acid-base parameters determined on admission and a control group of 33 healthy neonatal foals...
November 23, 2015: Equine Veterinary Journal
Hernando Gomez, John A Kellum
The concentration of hydrogen ions is regulated in biologic solutions. There are currently 3 recognized approaches to assess changes in acid base status. First is the traditional Henderson-Hasselbalch approach, also called the physiologic approach, which uses the relationship between HCO3(-) and Pco2; the second is the standard base excess approach based on the Van Slyke equation. The third approach is the quantitative or Stewart approach, which uses the strong ion difference and the total weak acids. This article explores the origins of the current concepts framing the existing methods to analyze acid base balance...
October 2015: Critical Care Clinics
Lu Ke, Paolo Calzavacca, Michael Bailey, Wei-Qin Li, Rinaldo Bellomo, Clive N May
OBJECTIVES: This study aims to test the hypothesis that fluid loading with sodium chloride (150 mmol Na and 150 mmol Cl) or sodium octanoate (150 mmol Na, 100 mmol Cl, and 50 mmol octanoate) would lead to different acid-base changes. DESIGN: We performed a double-blind crossover experimental study. SETTING: The study was done at a University Physiology Laboratory. SUBJECTS: Eight Merino ewes were used as subjects. MEASUREMENTS AND MAIN RESULTS: We randomly assigned animals to a rapid intravenous infusion (1 L over 30 min) of either normal saline (NS) or sodium octanoate solution (OS)...
December 2013: Intensive Care Medicine Experimental
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
Karthik Raghunathan, Patrick Nailer, Ryan Konoske
PURPOSE OF REVIEW: We discuss the importance of the composition of intravenous crystalloid solutions. On the basis of current physiologic principles, evidence from basic science and clinical experiments, recent observational studies, and clinical trials, we conclude that the 'ideal crystalloid' depends on clinical context. We make recommendations on solutions that may be used during critical illness, major surgery, and certain clinical situations. RECENT FINDINGS: The routine use of solutions with a supraphysiologic chloride content and a low strong ion difference (SID), such as isotonic saline solution, may be associated with adverse outcomes, especially among critically ill patients...
August 2015: Current Opinion in Critical Care
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
Fabio D Masevicius, Arnaldo Dubin
The Stewart approach-the application of basic physical-chemical principles of aqueous solutions to blood-is an appealing method for analyzing acid-base disorders. These principles mainly dictate that pH is determined by three independent variables, which change primarily and independently of one other. In blood plasma in vivo these variables are: (1) the PCO2; (2) the strong ion difference (SID)-the difference between the sums of all the strong (i.e., fully dissociated, chemically nonreacting) cations and all the strong anions; and (3) the nonvolatile weak acids (Atot)...
February 4, 2015: World Journal of Critical Care Medicine
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