Avaliação da acidose metabólica em pacientes graves: método de Stewart-Fencl-Figge versus a abordagem tradicional de henderson-hasselbalch

Barbosa, Manuela Borges Gavaza; Alves, Crésio de Aragão Dantas; Filho, Hélio Queiroz

doi:10.1590/s0103-507x2006000400010

Cited by 5 publications

(5 citation statements)

References 8 publications

(11 reference statements)

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“…Blood BE ecf values near to zero are desirable [ 43 ], as they reflect the maintenance of the required acid-base balance for better performance [ 44 ]. Alternatively, metabolic acidosis is characterized by reduced blood pH as a result of the accumulation of non-volatile acids or loss of serum bicarbonate [ 45 ]. In our experiment, results for pH, pCO 2 , HCO 3 - and BE ecf were not significantly different between treatments, suggesting that our challenge did not reach the level to disturb the acid-base balance of the animals.…”

Section: Discussionmentioning

confidence: 99%

Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets

et al. 2017

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BackgroundThe weaning pig is used as an experimental model to assess the impact of diet on intestinal health. Blood parameters (BP) are considered a useful tool in humans, but there is very scarce information of such indicators in the weaning pig. The objective of the present study is to evaluate the use of different BP as indicators in an experimental model of salmonellosis.MethodologySeventy-two 28-day-old piglets were divided into four groups in a 2x2 factorial arrangement, with animals receiving or not a probiotic combination based on B. infantis IM1® and B. lactis BPL6 (109 colony forming units (cfu)/d) and orally challenged or not a week later with Salmonella Typhimurium (5x108 cfu). Blood samples of one animal per pen (N = 24) were taken four days post-inoculation for the evaluation of different BP using an I-stat® System and of plasmatic concentrations of zinc, iron and copper.Principal findingsResults reported marginal deficiencies of zinc in piglets at weaning. Moreover, plasmatic zinc, copper and iron presented good correlations with weight gain (r 0.57, r -0.67, r 0.54 respectively; P < 0.01). Blood electrolytes (Na+, Cl- and K+) decreased (P < 0.01) only when the performance of the animals was seriously compromised and clinical symptoms were more apparent. Acid-base balance parameters such as HCO3-, TCO2 and BEecf significantly correlated with weight gain, but only in the challenged animals (r -0.54, r -0.55, and r -0.51, respectively; P < 0.05), suggesting metabolic acidosis depending on Salmonella infection. Glucose was affected by the challenge (P = 0.040), while Htc and Hgb increased with the challenge and decreased with the probiotic (P < 0.05). Furthermore, correlations of Glu, Htc and Hgb with weight gain were observed (P < 0.05). Overall, BP could be regarded as simple, useful indexes to assess performance and health of weaning piglets.

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Section: Discussionmentioning

confidence: 99%

Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets

et al. 2017

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“…Another complication which infl uenced the time on MV was metabolic acidosis, because when present it can be an important factor in causing depression of the myocardial function and it is a sensitive indicator of bad tissue perfusion (18) .…”

Section: Discussionmentioning

confidence: 99%

Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery

Fonseca

Vieira

Azzolin³

2014

Rev. Gaúcha Enferm.

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Our objective was to identify factors associated with the duration of mechanical ventilation (MV) postoperative to cardiac surgery and assess the association between duration of endotracheal intubation, length of stay in the Intensive Care Unit (ICU) and hospital. Longitudinal, retrospective study of medical records of 116 adults undergoing cardiac surgery from March 2012 to May 2013. The mean age was 57 +/- 14 years, predominantly male and coronary artery bypass grafting surgery (52.6%). The MV time was 15.25 (7.66 to 23.68) hours. Associated with longer MV was the age (r = 0.5, p < 0.001), comorbidities (r = 0.344, p < 0.001), cardiopulmonary bypass time (r = 0.244, p = 0.008), duration of continuous sedation (r = 0.607, p < 0.001), sedative doses (r = 0.4, p < 0.001), time of vasoconstrictors and vasodilators (r = 0.711, p < 0.001, r = 0.368, p < 0.001), drainage of the 1st time (r = 0.201, p < 0.031), presence of drains (r = 0.445, p < 0.001), postoperative complications (r=0.524, p< 0.001) and hospital stay. Our data confirms that both preoperative, transoperative and postoperative variables prolong the VM and therefore the hospital stay.

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“…The best method for the interpretation of acid-base disorders at the bedside remains to be defined. ( 4 ) Dubin et al have shown that the physicochemical approach offers no advantage over the traditional approach with corrected AG; in fact, the physicochemical approach allowed for an additional diagnosis of metabolic acidosis in only 1% of the cases. ( 12 ) Martin et al have shown that the results of the traditional approach (using anion gap) and the physicochemical approach yield different clinical interpretations in up to 28% of trauma patients, ( 1 ) while Kaplan et al have suggested that a physicochemical approach can improve the accuracy of acid-base disturbances in trauma and, therefore, reduce inappropriate fluid loading due to the suspicion of hypoperfusion-induced metabolic acidosis.…”

Section: Discussionmentioning

confidence: 99%

“…( 3 , 6 ) The two most common ways to estimate unmeasured anions are the anion gap (AG) calculation and the physicochemical approach of the strong ion gap (SIG) calculation, as described by Stewart. ( 4 , 7 )…”

Section: Introductionmentioning

confidence: 99%

Anion gap corrected for albumin, phosphate and lactate is a good predictor of strong ion gap in critically ill patients: a nested cohort study

Zampieri¹,

Park²,

Ranzani³

et al. 2013

Revista Brasileira De Terapia Intensiva

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ObjectiveCorrected anion gap and strong ion gap are commonly used to estimate unmeasured anions. We evaluated the performance of the anion gap corrected for albumin, phosphate and lactate in predicting strong ion gap in a mixed population of critically ill patients. We hypothesized that anion gap corrected for albumin, phosphate and lactate would be a good predictor of strong ion gap, independent of the presence of metabolic acidosis. In addition, we evaluated the impact of strong ion gap at admission on hospital mortality. MethodsWe included 84 critically ill patients. Correlation and agreement between the anion gap corrected for albumin, phosphate and lactate and strong ion gap was evaluated by the Pearson correlation test, linear regression, a Bland-Altman plot and calculating interclass correlation coefficient. Two subgroup analyses were performed: one in patients with base-excess <-2mEq/L (low BE group - lBE) and the other in patients with base-excess >-2mEq/L (high BE group - hBE). A logistic regression was performed to evaluate the association between admission strong ion gap levels and hospital mortality. ResultsThere was a very strong correlation and a good agreement between anion gap corrected for albumin, phosphate and lactate and strong ion gap in the general population (r2=0.94; bias 1.40; limits of agreement -0.75 to 3.57). Correlation was also high in the lBE group (r2=0.94) and in the hBE group (r2=0.92). High levels of strong ion gap were present in 66% of the whole population and 42% of the cases in the hBE group. Strong ion gap was not associated with hospital mortality by logistic regression. ConclusionAnion gap corrected for albumin, phosphate and lactate and strong ion gap have an excellent correlation. Unmeasured anions are frequently elevated in critically ill patients with normal base-excess. However, there was no association between unmeasured anions and hospital mortality.

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Avaliação da acidose metabólica em pacientes graves: método de Stewart-Fencl-Figge versus a abordagem tradicional de henderson-hasselbalch

Cited by 5 publications

References 8 publications

Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets

Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets

Factors associated to the length of time on mechanical ventilation in the postoperative period of cardiac surgery

Anion gap corrected for albumin, phosphate and lactate is a good predictor of strong ion gap in critically ill patients: a nested cohort study

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