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lactate acidosis

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https://www.readbyqxmd.com/read/29148290/single-centre-experience-with-the-impella-cp-5-0-and-rp-in-109-consecutive-patients-with-profound-cardiogenic-shock
#1
Peter Blom Jensen, Sigrun Høegholm Kann, Karsten Tange Veien, Ole Kristian Møller-Helgestad, Jordi Sanchez Dahl, Charlotte Svejstrup Rud, Marianne Kjær Jensen, Lisette Okkels Jensen, Henrik Schmidt, Jacob Eifer Møller
RATIONALE: Short-term mechanical circulatory support is increasingly used in the management of cardiogenic shock, but data from controlled studies are sparse. Thus, real-life data on complication rates and predictors of adverse outcome are important. OBJECTIVE: The objective of this study was to analyse the experience with Impella devices in the management of profound cardiogenic shock. METHODS AND RESULTS: A retrospective study of 109 consecutive patients with severe shock after myocardial infarction, acute heart failure, or cardiac surgery...
November 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#2
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...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29125081/-metformin-associated-lactic-acidosis-an-insufficiently-recognised-problem
#3
M Manders, M van Luin, C Kramers, F H Bosch
Metformin-associated lactic acidosis (MALA) is a rare but potentially fatal condition that can easily be avoided. As metformin is known to facilitate the production of lactate, predisposing factors can accelerate this process. In situations of infection or dehydration, metformin can accumulate due to kidney failure, hereby increasing the risk of MALA. Despite controversy in the literature about the presence of a relationship between metformin and lactic acidosis, the severity of the condition is cause for concern and allows for preventive measurements...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29117615/safety-of-metformin-therapy-in-patients-with-type-2-diabetes-living-on-an-oxygen-deficient-plateau-tibet-china
#4
Xuemei Lv, Qian Ren, Lingli Zhou, Yanyan Geng, Jia Song, A Mina, Basang Puchi, Senlin Yang, Shuyou Meng, Lihui Yang
Background In the general population, the absolute risk of lactic acidosis in patients treated with metformin appears to be low. However, in the Tibetan plateau, an extreme oxygen-deficient environment, there are no data available concerning the safety of metformin. The aim of our study is to assess the safety of metformin in people of the plateau area. Methods We conducted an observational cross-sectional study in Tibet. All the 166 subjects were divided into two groups: T2DM+metformin group and T2DM group...
November 8, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/29103717/effects-of-supplementing-yeast-culture-to-diets-differing-in-starch-content-on-performance-and-feeding-behavior-of-dairy-cows
#5
A L G Dias, J A Freitas, B Micai, R A Azevedo, L F Greco, J E P Santos
The objectives were to evaluate the effects of a culture of Saccharomyces cerevisiae (YC) on lactation performance of cows fed diets differing in starch content. Fifty-six Holstein cows at 42 d postpartum were blocked by parity and milk production and randomly assigned to 1 of 4 treatments, low starch (23% diet DM) and no YC (LS-control), low starch and 15 g/d of YC (LS-YC), high starch (29% diet DM) and no YC (HS-control), and high starch and 15 g/d of YC (HS-YC). The experiment lasted 14 wk. Blood was sampled twice weekly during the first 5 wk in the experiment...
November 2, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/29103282/effects-of-low-dietary-cation-anion-difference-induced-by-ruminal-ammonium-chloride-infusion-on-performance-serum-and-urine-metabolites-of-lactating-dairy-cows
#6
Kun Wang, Xuemei Nan, Puyi Zhao, Wei Liu, James Drackley, Shijie Liu, Kaizhan Zhang, Dengpan Bu
Objective: The objective of the present study was to determine ammonium chloride tolerance of lactating dairy cows, by examining effects of negative DCAD induced by ruminal ammonium chloride infusion on performance, serum and urine minerals, serum metabolites and enzymes of lactating dairy cows. Methods: Four primiparous lactating Chinese Holstein cows fitted with ruminal cannulas were infused with increasing amounts (0, 150, 300, or 450 g/d) of ammonium chloride in a crossover design...
November 3, 2017: Asian-Australasian Journal of Animal Sciences
https://www.readbyqxmd.com/read/29102604/fluorometric-determination-of-d-lactate-in-biological-fluids
#7
Torben Larsen
OBJECTIVE: D-lactic acid in the mammalian body is mainly of microbiological origin and is often located somewhere along the digestive tract. Surgical, extensive re-sectioning of the small bowel may be one of the risk factors for altered balance in the microbiological environment. Higher levels in the body may lead to D-lactate acidosis and neurotoxicity; consequently, the possibility of diagnosis of this condition is important. Several analytical procedures for D-lactate have been introduced, but it is absolutely mandatory to distinguish this metabolite from the much more abundant and naturally occurring stereoisomer L-lactate...
November 3, 2017: Analytical Biochemistry
https://www.readbyqxmd.com/read/29080515/quantitative-relationships-among-plasma-lactate-inorganic-phosphorus-albumin-unmeasured-anions-and-the-anion-gap-in-lactic-acidosis
#8
James Figge, Rinaldo Bellomo, Moritoki Egi
BACKGROUND: Quantitative relationships among plasma [Lactate], [Pi], [Albumin], unmeasured anions ([UA]) and the anion gap (AGK) in lactic acidosis (LA) are not well defined. METHODS: A mathematical model featuring compensatory potassium and chloride shifts and respiratory changes in LA demonstrated: (1) AGK=[Lactate]+Zp×[Pi]+2.4×[Albumin]+constant1+e, where Zp is a function of pH, and e reflects unmeasured anions and cations plus pH-related variations. Eq. (1) can be algebraically rearranged to incorporate the albumin-corrected anion gap, cAGK: (2) cAGK=[Lactate]+Zp×[Pi]+constant2+e...
October 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29069465/ethylene-glycol-teratogenicity-a-role-for-embryonic-acidosis
#9
Helen E Ritchie, Nigel P Moore, William S Webster
Ethylene glycol (EG) is a developmental toxicant in pregnant rats and mice. A suggested mechanism for this toxicity is that the EG metabolite, glycolic acid (GA), causes acidosis which may affect the embryonic heart rate. This inhibition would cause periods of embryonic bradycardia and arrhythmia resulting in increased embryonic death and malformation in surviving embryos. This hypothesis was investigated using gestational day (GD) 11 and 13 rat embryos in vitro . Increasing concentrations of GA or lactic acid (LA) in the incubation medium caused a decrease in external pH (pH e ) and a concentration-dependent decrease in embryonic heart rate (HR)...
October 23, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29058235/risk-of-metformin-associated-lactic-acidosis-mala-in-patients-after-gastric-bypass-surgery
#10
Laura N Deden, Edo O Aarts, Stephanie C W Aelfers, Marcel M G J van Borren, Ignace M C Janssen, Frits J Berends, Hans de Boer
BACKGROUND: Pharmacokinetic data suggest that the risk of metformin-associated lactic acidosis (MALA) may be increased after Roux-en-Y gastric bypass (RYGB) surgery. The aim of this study was to examine the impact of metformin on plasma lactate levels before and after RYGB surgery. METHODS: Retrospective study of plasma lactate levels before and 3 months after RYGB surgery in patients with type 2 diabetes mellitus (T2DM) not using metformin (MET-0, N = 58), on a stable dose (MET-S, N = 138), or on a decreasing dose (MET-D, N = 85) of metformin...
October 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29043143/focal-segmental-glomerulosclerosis-associated-with-mitochondrial-disease
#11
Kenneth Lim, David Steele, Andrew Fenves, Ravi Thadhani, Eliot Heher, Amel Karaa
Primary mitochondrial diseases (MD) are complex, heterogeneous inherited diseases caused by mutations in either the mitochondrial or nuclear DNA. Glomerular diseases in MD have been reported with tRNA mutation m.3243A>G causing a syndrome of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). We describe here a case of focal segmental glomerulosclerosis (FSGS) associated with a new tRNA mutation site. A 34-year-old man with a history of living related kidney transplantation, diabetes, hearing loss, and developmental delay presented to the outpatient clinic with complaints of new behavioral difficulties, worsening symptoms, and brain involvement on imaging...
2017: Clin Nephrol Case Stud
https://www.readbyqxmd.com/read/29038192/two-gaps-too-many-three-clues-too-few-do-elevated-osmolal-and-anion-gaps-with-crystalluria-always-mean-ethylene-glycol-poisoning
#12
Maneesh Gaddam, Ravi Kanth Velagapudi, Emad Abu Sitta, Abed Kanzy
A 60-year-old African-American man with a medical history significant for heavy alcohol abuse, hypertension, delirium tremens, nephrolithiasis and seizure disorder was brought to the hospital with altered mental status. He was found to have high anion gap metabolic acidosis with significantly elevated lactate along with an elevated osmolal gap and calcium oxalate crystals in his urine. With this combination of findings, ethylene glycol poisoning was high in the differential. This case report describes why ethylene glycol poisoning was not the diagnosis in this patient despite the presence of these three classic laboratory findings, therefore emphasising the fact that these findings should not be taken at face value because they can be seen collectively in a patient yet each have a different cause...
October 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29030856/mitochondrial-3-hydroxy-3-methylglutaryl-coa-synthase-deficiency-unique-presenting-laboratory-values-and-a-review-of-biochemical-and-clinical-features
#13
Erin Conboy, Filippo Vairo, Matthew Schultz, Katherine Agre, Ross Ridsdale, David Deyle, Devin Oglesbee, Dimitar Gavrilov, Eric W Klee, Brendan Lanpher
We report an 8-month-old infant with decreased consciousness after a febrile episode and reduced oral intake. He was profoundly acidotic but his lactate was normal. Serum triglycerides were markedly elevated and HDL cholesterol was very low. The urine organic acid analysis during the acute episode revealed a complex pattern of relative hypoketotic dicarboxylic aciduria, suggestive of a potential fatty acid oxidation disorder. MRI showed extensive brain abnormalities concerning for a primary energy deficiency...
October 14, 2017: JIMD Reports
https://www.readbyqxmd.com/read/29026537/negative-effects-of-long-term-feeding-of-high-grain-diets-to-lactating-goats-on-milk-fat-production-and-composition-by-regulating-gene-expression-and-dna-methylation-in-the-mammary-gland
#14
Ping Tian, Yanwen Luo, Xian Li, Jing Tian, Shiyu Tao, Canfeng Hua, Yali Geng, Yingdong Ni, Ruqian Zhao
BACKGROUND: It is well known that feeding a high concentrate (HC) diet to lactating ruminants likely induces subacute ruminal acidosis (SARA) and leads to a decrease in milk fat production. However, the effects of feeding a HC diet for long periods on milk fatty acids composition and the mechanism behind the decline of milk fat still remains poorly understood. The aim of this study was to investigate the impact of feeding a HC diet to lactating dairy goats on milk fat yield and fatty acids composition with an emphasis on the mechanisms underlying the milk fat depression...
2017: Journal of Animal Science and Biotechnology
https://www.readbyqxmd.com/read/28991826/relationship-of-at-admission-lactate-unmeasured-anions-and-chloride-to-the-outcome-of-critically-ill-patients
#15
Fabio Daniel Masevicius, Paolo Nahuel Rubatto Birri, Alejandro Risso Vazquez, Facundo Emanuel Zechner, María Fernanda Motta, Emilio Daniel Valenzuela Espinoza, Sebastián Welsh, Ernesto Fidel Guerra Arias, Mariano Andrés Furche, Fernando Daniel Berdaguer, Arnaldo Dubin
OBJECTIVES: To investigate the association between the concentration of the causative anions responsible for the main types of metabolic acidosis and the outcome. DESIGN: Prospective observational study. SETTING: Teaching ICU. PATIENTS: All patients admitted from January 2006 to December 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Four thousand nine hundred one patients were admitted throughout the study period; 1,609 met criteria for metabolic acidosis and 145 had normal acid-base values...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28985713/patients-with-glycogen-storage-diseases-undergoing-anesthesia-a-case-series
#16
Carmelina Gurrieri, Juraj Sprung, Toby N Weingarten, Mary E Warner
BACKGROUND: Glycogen storage diseases are rare genetic disorders of glycogen synthesis, degradation, or metabolism regulation. When these patients are subjected to anesthesia, perioperative complications can develop, including hypoglycemia, rhabdomyolysis, myoglobinuria, acute renal failure, and postoperative fatigue. The objective of this study was to describe the perioperative course of a cohort of patients with glycogen storage diseases. METHODS: This is a retrospective review of patients with glycogen storage diseases undergoing anesthetic care at our institution from January 1, 1990, through June 30, 2015 to assess perioperative management and outcomes...
October 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28980449/high-volume-continuous-venovenous-hemodiafiltration-plus-resin-hemoperfusion-improve-severe-metformin-associated-toxicity
#17
Shuangxin Liu, Lixia Xu, Jianchao Ma, Renwei Huang, Ting Lin, Zhuo Li, Huabang Liang, Sijia Li, Ruizhao Li, Li Zhang, Yiming Tao, Zhilian Li, Yuanhan Chen, Zhiming Ye, Bin Zhang, Wenjian Wang, Houqing Xiao, Xinling Liang, Wei Shi
We present the case of a 42-year-old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and pH of 7.09. The patient was treated with high-volume continuous venovenous hemodiafiltration (CVVH) and resin-sorbent hemoperfusion. Metformin concentrations were measured by high-performance liquid chromatography (HPLC) during CVVH and hemoperfusion treatment. Before extracorporeal treatment, plasma metformin concentration was 208...
October 5, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28940961/perioperative-continuation-of-metformin-does-not-improve-glycemic-control-in-patients-with-type-2-diabetes-a-randomized-controlled-trial
#18
A H Hulst, J A W Polderman, E Ouweneel, A J Pijl, M W Hollmann, J H DeVries, B Preckel, J Hermanides
Historically, metformin was withheld before surgery in fear of metformin associated lactic acidosis. Now, this risk is deemed low and guidelines move towards continuation of metformin. We hypothesized that continuing metformin perioperatively would lower postoperative serum glucose without an effect on plasma lactate. We performed a single-blind multicenter RCT in type 2 diabetes mellitus patients scheduled for non-cardiac surgery and continued (MF+) or withheld (MF-) metformin before surgery. Main outcome parameters were the differences in perioperative plasma glucose and lactate levels...
September 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#19
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28930961/impact-of-a-novel-phosphoinositol-3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#20
George Edward Black, Kyle K Sokol, Donald M Moe, Jon D Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhaylo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental phosphoinositol-3 kinase (PI3-K) inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage-associated molecular patterns (DAMPs)...
October 2017: Journal of Trauma and Acute Care Surgery
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