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Acid base

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44 papers 25 to 100 followers
By M KKhan Pediatric Intensivist
https://www.readbyqxmd.com/read/28914359/changes-in-acid-base-and-ion-balance-during-exercise-in-normoxia-and-normobaric-hypoxia
#1
Olaf Lühker, Marc Moritz Berger, Alexander Pohlmann, Lorenz Hotz, Tilmann Gruhlke, Marcel Hochreiter
PURPOSE: Both exercise and hypoxia cause complex changes in acid-base homeostasis. The aim of the present study was to investigate whether during intense physical exercise in normoxia and hypoxia, the modified physicochemical approach offers a better understanding of the changes in acid-base homeostasis than the traditional Henderson-Hasselbalch approach. METHODS: In this prospective, randomized, crossover trial, 19 healthy males completed an exercise test until voluntary fatigue on a bicycle ergometer on two different study days, once during normoxia and once during normobaric hypoxia (12% oxygen, equivalent to an altitude of 4500 m)...
November 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29031353/regulation-of-acid-base-balance-in-chronic-kidney-disease
#2
REVIEW
Glenn T Nagami, L Lee Hamm
The kidneys play a major role in the regulation of acid-base balance by reabsorbing bicarbonate filtered by the glomeruli and excreting titratable acids and ammonia into the urine. In CKD, with declining kidney function, acid retention and metabolic acidosis occur, but the extent of acid retention depends not only on the degree of kidney impairment but also on the dietary acid load. Acid retention can occur even when the serum bicarbonate level is apparently normal. With reduced kidney function, acid transport processes in the surviving nephrons are augmented but as disease progresses ammonia excretion and, in some individuals, the ability to reabsorb bicarbonate falls, whereas titratable acid excretion is preserved until kidney function is severely impaired...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28883678/mobile-clinical-decision-support-system-for-acid-base-balance-diagnosis-and-treatment-recommendation
#3
Mensur Mandzuka, Edin Begic, Dusanka Boskovic, Zijo Begic, Izet Masic
INTRODUCTION: This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. MATERIAL AND METHODS: The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. RESULTS: The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment...
June 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#4
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/23833313/the-serum-anion-gap-in-the-evaluation-of-acid-base-disorders-what-are-its-limitations-and-can-its-effectiveness-be-improved
#5
REVIEW
Jeffrey A Kraut, Glenn T Nagami
The serum anion gap has been utilized to identify errors in the measurement of electrolytes, to detect paraproteins, and, most relevant to the nephrologist, to evaluate patients with suspected acid-base disorders. In regard to the latter purpose, traditionally an increased anion gap is identified when it exceeds the upper limit of normal for a particular clinical laboratory measurement. However, because there is a wide range of normal values (often 8-10 mEq/L), an increase in anion concentration can be present in the absence of an increased anion gap...
November 2013: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28673579/the-chloride-theory-a-unifying-hypothesis-for-renal-handling-and-body-fluid-distribution-in-heart-failure-pathophysiology
#6
Hajime Kataoka
Body fluid volume regulation is a complex process involving the interaction of various afferent (sensory) and neurohumoral efferent (effector) mechanisms. Historically, most studies focused on the body fluid dynamics in heart failure (HF) status through control of the balance of sodium, potassium, and water in the body, and maintaining arterial circulatory integrity is central to a unifying hypothesis of body fluid regulation in HF pathophysiology. The pathophysiologic background of the biochemical determinants of vascular volume in HF status, however, has not been known...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28684104/acid-base-disorders-in-liver-disease
#7
REVIEW
Bernhard Scheiner, Gregor Lindner, Thomas Reiberger, Bruno Schneeweiss, Michael Trauner, Christian Zauner, Georg-Christian Funk
Alongside the kidneys and lungs, the liver has been recognised as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. While the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model provides a more in-depth pathophysiological assessment for clinical judgement of acid-base disorders, in patients with liver diseases...
November 2017: Journal of Hepatology
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...
October 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/25909152/using-phosphate-supplementation-to-reverse-hypophosphatemia-and-phosphate-depletion-in-neurological-disease-and-disturbance
#9
REVIEW
Lena Håglin
Hypophosphatemia (HP) with or without intracellular depletion of inorganic phosphate (Pi) and adenosine triphosphate has been associated with central and peripheral nervous system complications and can be observed in various diseases and conditions related to respiratory alkalosis, alcoholism (alcohol withdrawal), diabetic ketoacidosis, malnutrition, obesity, and parenteral and enteral nutrition. In addition, HP may explain serious muscular, neurological, and haematological disorders and may cause peripheral neuropathy with paresthesias and metabolic encephalopathy, resulting in confusion and seizures...
June 2016: Nutritional Neuroscience
https://www.readbyqxmd.com/read/28114143/electrolyte-and-acid-base-disorders-in-chronic-kidney-disease-and-end-stage-kidney-failure
#10
REVIEW
Tsering Dhondup, Qi Qian
The kidneys play a pivotal role in the regulation of electrolyte and acid-base balance. With progressive loss of kidney function, derangements in electrolytes and acid-base inevitably occur and contribute to poor patient outcomes. As chronic kidney disease (CKD) has become a worldwide epidemic, medical providers are increasingly confronted with such problems. Adequate diagnosis and treatment will minimize complications and can potentially be lifesaving. In this review, we discuss the current understanding of the disease process, clinical presentation, diagnosis and treatment strategies, integrating up-to-date knowledge in the field...
2017: Blood Purification
https://www.readbyqxmd.com/read/28345066/correlation-of-central-venous-pressure-with-venous-blood-gas-analysis-parameters-a-diagnostic-study
#11
Sima Rahim-Taleghani, Alireza Fatemi, Mostafa Alavi Moghaddam, Majid Shojaee, Abdelrahman Ibrahim Abushouk, Mohammad Mehdi Forouzanfar, Alireza Baratloo
OBJECTIVE: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. MATERIAL AND METHODS: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28286047/effects-of-early-administration-of-acetazolamide-on-the-duration-of-mechanical-ventilation-in-patients-with-chronic-obstructive-pulmonary-disease-or-obesity-hypoventilation-syndrome-with-metabolic-alkalosis-a-randomized-trial
#12
G Rialp Cervera, J M Raurich Puigdevall, I Morán Chorro, M C Martín Delgado, G Heras la Calle, A Mas Serra, I Vallverdú Perapoch
BACKGROUND: Metabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO2-retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. This study evaluated the effects of ACTZ on the duration of MV in patients with MA and COPD or obesity hypoventilation syndrome (OHS) intubated with acute respiratory failure. METHODS: Multicenter, randomized, controlled, double-blind study, with COPD or OHS patients with MV < 72 h and initial bicarbonate >28 mmol/L and pH > 7...
June 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/25830425/molecular-physiology-of-water-balance
#13
REVIEW
Mark A Knepper, Tae-Hwan Kwon, Soren Nielsen
New England Journal of Medicine, Volume 372, Issue 14, Page 1349-1358, April 2015.
April 2, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/28149822/a-profile-of-metabolic-acidosis-in-patients-with-sepsis-in-an-intensive-care-unit-setting
#14
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
https://www.readbyqxmd.com/read/25651248/acid-base-problems-in-diabetic-ketoacidosis
#15
REVIEW
Kamel S Kamel, Mitchell L Halperin
New England Journal of Medicine, Volume 372, Issue 6, Page 546-554, February 2015.
February 5, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25494270/lactic-acidosis
#16
REVIEW
Jeffrey A Kraut, Nicolaos E Madias
New England Journal of Medicine, Volume 371, Issue 24, Page 2309-2319, December 2014.
December 11, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/26154934/association-of-hyperchloremia-with-hospital-mortality-in-critically-ill-septic-patients
#17
Javier A Neyra, Fabrizio Canepa-Escaro, Xilong Li, John Manllo, Beverley Adams-Huet, Jerry Yee, Lenar Yessayan
OBJECTIVES: Hyperchloremia is frequently observed in critically ill patients in the ICU. Our study aimed to examine the association of serum chloride (Cl) levels with hospital mortality in septic ICU patients. DESIGN: Retrospective cohort study. SETTING: Urban academic medical center ICU. PATIENTS: ICU adult patients with severe sepsis or septic shock who had Cl measured on ICU admission were included. Those with baseline estimated glomerular filtration rate less than 15 mL/min/1...
September 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/26776539/approach-to-the-treatment-of-chronic-metabolic-acidosis-in-ckd
#18
Kalani L Raphael
Chronic metabolic acidosis is not uncommon in patients with chronic kidney disease (CKD). Clinical practice guidelines suggest that clinicians administer alkali to maintain serum bicarbonate level at a minimum of 22 mEq/L to prevent the effects of acidosis on bone demineralization and protein catabolism. Small interventional studies support the notion that correcting acidosis slows CKD progression as well. Furthermore, alkaline therapy in persons with CKD and normal bicarbonate levels may also preserve kidney function...
April 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27140683/stewart-acid-base-a-simplified-bedside-approach
#19
David A Story
No abstract text is available yet for this article.
August 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28145212/-when-is-a-venous-blood-gas-analysis-sufficient-in-the-emergency-department
#20
J A J M van Exsel, S O Simons, C Kramers, Y F Heijdra
Blood gas analysis plays an important role in the initial assessment of a patient in the emergency ward. We present three different patient cases to illustrate when to opt for a venous or an arterial blood gas analysis. Arterial punctures are more painful and carry a higher risk of complications compared to venous punctures. It is possible to use a venous blood gas to screen for acute acid/base disturbances. Ventilatory compensation or anion gap cannot be calculated reliably with a venous blood gas. On the other hand, the diagnosis diabetic keto-acidosis can be made with a venous blood gas; this mode of sampling can also be used for lactate measurement at the emergency department as an independent prognostic marker for mortality...
2017: Nederlands Tijdschrift Voor Geneeskunde
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