Comparison of three different methods of evaluation of metabolic acid-base disorders*

Dubin, Arnaldo; Menises, María M.; Masevicius, Fabio Daniel; Moseinco, Miriam; Kutscherauer, Daniela Olmos; Ventrice, Elizabeth; Laffaire, Enrique; Bakker, Jan

doi:10.1097/01.ccm.0000259536.11943.90

Cited by 152 publications

(150 citation statements)

References 42 publications

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“…Our study revealed, that SID, SIG and AG Corr or AG were tightly correlated and showed excellent agreement in the examined calves with chronic diarrhea. Accordingly with previous studies SIG and AG Corr were correlated in intensive care patients, as well as in healthy volunteers (Kellum et al 1995, Dubin et al 2007, Fidkowski and Helstrom 2009. Moreover, Kellum et al (1995) found tight correlation between SIG and AG Corr , but not AG.…”

Section: Discussionsupporting

confidence: 87%

Acid-base disorders in calves with chronic diarrhea

Bednarski¹,

Kupczyński²,

Sobiech³

2015

Polish Journal of Veterinary Sciences

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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 obtained 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. Plasma concentrations of Na, P, albumin and lactate were measured. In the classic model, acid-base balance was determined on the basis of blood pH, pCO 2 , HCO 3 -, BE and anion gap. In the strong ion model, strong ion difference (SID), effective strong anion difference, total plasma concentration of nonvolatile buffers (A Tot ) and strong ion gap (SIG) were measured.The control calves and the animals from groups II and III did not differ significantly in terms of their blood pH. The plasma concentration of HCO 3 -, BE and partial pressure of CO2 in animals from the two groups with chronic diarrhea were significantly higher than those found in the controls. The highest BE (6.03 mmol/l) was documented in calves from group II. The animals from this group presented compensation resulted from activation of metabolic mechanisms. The calves with hypoalbuminemia (group III) showed lower plasma concentrations of albumin (15.37 g/L), Cl -(74.94 mmol/L), Mg 2+ (0.53 mmol/L), P (1.41 mmol/L) and higher value of anion gap (39.03 mmol/L). This group III presented significantly higher SID 3 (71.89 mmol/L), SID 7 (72.92 mmol/L) and SIG (43.53 mmol/L) values than animals from the remaining groups (P<0.01), whereas A Tot (6.82 mmol/L) were significantly lower. The main finding of the correlation study was the excellent relationship between the AG corr and SID 3 , SID 7 , SIG. In conclusion, chronic diarrhea leads to numerous water-electrolyte disorders. Characterization of acid-base disturbance in these cases suggests that classic model have some limitations. This model can not be recommended for use whenever serum albumin or phosphate concentrations are markedly abnormal.

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Section: Discussionsupporting

confidence: 87%

Acid-base disorders in calves with chronic diarrhea

Bednarski¹,

Kupczyński²,

Sobiech³

2015

Polish Journal of Veterinary Sciences

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“…Outra recomendação é a implementação de métodos específicos de análise para cada tipo de distúrbio, incluindo os valores de Base Excess (BE) e o cálculo de GAPS (anion-gap, delta anion-gap, anion-gap urinário e gap-osmolar) proposto na quarta etapa do primeiro método de análise de Rocco 1 . Dentre outros métodos de análise, os que incluem o cálculo do "Standard Base Excess" e o "método de Stewart" descritos por Rocco 1 como o segundo e o terceiro méto-dos, respectivamente, sendo este último citado como padrão-ouro em algumas temáticas [14][15][16][17][18][19][20] , mas impossibilitado de utilização por este trabalho por conta da rotina da UTI em pesquisa em relação aos exames laboratoriais, que muitas vezes não são requisitados por completo, impossibilitando a utilização do mesmo.…”

Section: Resultsunclassified

Desenvolvimento de software para interpretação de dados gasométricos aplicável em unidades de terapia intensiva

Fernandes¹,

Queiroz²,

Jesus³

et al. 2012

Fisioter. Pesqui.

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O objetivo deste estudo foi desenvolver um software para interpretação de dados gasométricos aplicável em UTIs. Trata-se de estudo de caráter experimental, sendo selecionada uma base teórica em Java com a IDE NetBeans 6.8 por meio de parceria com profissionais capacitados em Sistemas de Informação. O desenvolvimento do programa foi baseado na criação de um algoritmo, uma sequência de instruções bem definidas e não ambíguas a serem executadas mecanicamente com a finalidade de fornecer um diagnóstico desejado. Foi criado um software aplicável em UTIs denominado InterGas, que é um programa de fácil instalação, possui interface de fácil compreensão e utilização, além de processar os dados rapidamente e de forma precisa, oferecendo como resultado final o diagnóstico para o distúrbio do equilíbrio ácido-básico. O desconhecimento de outra ferramenta que reúna todos os componentes do InterGas o torna um software pioneiro que facilita a tomada de decisão à medida que caracteriza a ocorrência de distúrbios mistos utilizando fórmulas de compensação. Com isso, futuros estudos deverão ser feitos com o objetivo de avaliar aspectos relacionados à implementação e eficácia do software desenvolvido.

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“…There has been a considerable debate as to whether the modern or the traditional approach to modeling the acid-base of plasma provides a better diagnosis of patients with acidbase disturbances (McAuliffe et al, 1986;Severinghaus, 1993;Siggaard-Andersen et al, 1995;Constable, 2000;Fencl et al, 2000;Dubin et. al, 2007, Kurtz et al, 2008.…”

Section: Discussionmentioning

confidence: 99%

Independence of Variables in Stewarts Model of the Acid-Base Chemistry of the Blood Plasma

Matousek¹

2009

7th IFAC Symposium on Modelling and Control in Biomedical Systems

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Several approaches have been taken to modelling of the acid-base chemistry of blood. The Stewart approach includes three independent variables (SID, PCO2, Atot), which are postulated to completely describe causal mechanisms behind changes in acid-base status. This paper explores this postulate, simulating typical clinical examples using an online modeling tool. For changes in alveolar ventilation, production of strong acid, and selective removal of non-charged protein buffers, this postulate is true. However for non-selective protein buffer removal SID and Atot cannot be seen as independent. The paper discusses the implication of this on diagnosis of acid-base disturbances in patients with abnormal protein concentration.

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Comparison of three different methods of evaluation of metabolic acid-base disorders*

Abstract: In this large group of critically ill patients, diagnostic performance of the Stewart approach exceeded that of HCO3- and BE. However, when AGcorrected was included in the analysis, the Stewart approach did not offer any diagnostic or prognostic advantages.

Cited by 152 publications

References 42 publications

Acid-base disorders in calves with chronic diarrhea

Acid-base disorders in calves with chronic diarrhea

Desenvolvimento de software para interpretação de dados gasométricos aplicável em unidades de terapia intensiva

Independence of Variables in Stewarts Model of the Acid-Base Chemistry of the Blood Plasma

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Comparison of three different methods of evaluation of metabolic acid-base disorders*

Abstract: In this large group of critically ill patients, diagnostic performance of the Stewart approach exceeded that of HCO3- and BE. However, when AGcorrected was included in the analysis, the Stewart approach did not offer any diagnostic or prognostic advantages.

Cited by 152 publications

References 42 publications

Acid-base disorders in calves with chronic diarrhea

Acid-base disorders in calves with chronic diarrhea

Desenvolvimento de software para interpretação de dados gasométricos aplicável em unidades de terapia intensiva

Independence of Variables in Stewarts Model of the Acid-Base Chemistry of the Blood Plasma

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Independence of Variables in Stewarts Model of the Acid-Base Chemistry of the Blood Plasma