Quantitative Displacement of Acid-Base Equilibrium in Metabolic Acidosis

Albert, Morris S.

doi:10.7326/0003-4819-66-2-312

Cited by 163 publications

(55 citation statements)

References 8 publications

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“…In an interesting study, Fulop and Fulop [16] showed that ran dom pairs of blood pFL/PCCL (and calculated HCO3) gave essentially the same regression lines as that of Albert et al [4]. Adopting their methods, we assumed that blood pH varied between 6.8 and 7.1 for 'group 1 ' and between 7 .1 and 7.4 for 'group 2' in analogy to our actual patients.…”

Section: Mathematical Simulationmentioning

confidence: 99%

“…The refernce bands derived by Albert et al [4] were adopted because they are commonly used. As shown in figure 1, 35/83 (42.2%) of the patients had PCO2 levels beyond the PCO2/HCO3 band.…”

Section: Ventilatory Responses As Related To the Reference Bandsmentioning

confidence: 99%

“…In practice, most bedside 'rules of thumb' are derived from 'in vivo 95% confidence bands' of the relationship between arterial blood C 0 2 tension (PCO2) and bicarbonate (HCO3) or hydrogen ion concen tration (pH) [4][5][6][7][8]. However, the fact that most of the rules have been derived from cases with arterial pH > 7.10 is not explicitly described by most textbooks and mono graphs [1-3.…”

Section: Introductionmentioning

confidence: 99%

“…9-11]. Furthermore, most of them had been derived from patients in 'steady states' with metabolic acidosis of at least 12-24 h duration [4][5][6][7][8], Therefore, these bedside 'rules of thumb' have limited usefulness in various clinical settings, especially regarding critical care patients such as those with diabetic ketoacidosis (DKA) who are commonly not in 'steady states'.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Ventilatory Responses in Severe Acidemia in Diabetic Ketoacidosis

Guh

Lai

et al. 1997

Am J Nephrol

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Ventilatory response in patients with severe acidemia in diabetic ketoacidosis (DKA) was unresolved. Thus, 83 patients with uncomplicated DKA were studied for the relation between arterial blood pH, calculated bicarbonate concentration (HCO3) and carbon dioxide tension (PCO₂). The equation for the PCO₂/HCO₃ pair was: PCO₂ =1.58 × HCO₃ + 7.6 (SE 2.55, r = 0.95, p < 0.01); for the PCO₂/pH pair was: PC0₂ = 43.8 × pH-293 (SE 6.23, r = 0.66, p < 0.01). The correlation coefficient for the PCO₂/HCO₃ pair was significantly greater compared to the PCCVpH pair (p < 0.001). Multiple regression analysis showed that severe acidemia (pH ≤ 7.10) per se was independently associated with PCO₂ for the PCO₂/HCO₃ pair, but not for the PCO₂/pH pair. Thus, our patients were divided into 2 groups for the PCO₂/HCO₃ pair: group 1 with pH < 7.10 (n = 25) and group 2 with pH > 7.10 (n = 58). The equations were: group 1: PCO₂ = 3.18 × HCO3 + 2.88 (SE 1.72, r = 0.87, p < 0.01); group 2: PCO₂ = 1.65 × HCO₃ + 6.6 (SE 2.6, r = 0.95, p < 0.01). There was a significant difference between these 2 equations (p < 0.01). Mathematical simulations with 10 sets of 25 or 58 random pH/PCO₂ pairs (and calculated HCO₃) for ‘group 1’ and ‘group 2’ also showed similar results, albeit with less precision. Hence, ventilatory response in DKA varies between patients with severe acidemia and those with moderate acidemia by the PCO₂/HCO₃ pair, but not by the PCO₂/pH pair.

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Section: Mathematical Simulationmentioning

confidence: 99%

“…The refernce bands derived by Albert et al [4] were adopted because they are commonly used. As shown in figure 1, 35/83 (42.2%) of the patients had PCO2 levels beyond the PCO2/HCO3 band.…”

Section: Ventilatory Responses As Related To the Reference Bandsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Ventilatory Responses in Severe Acidemia in Diabetic Ketoacidosis

Guh

Lai

et al. 1997

Am J Nephrol

View full text Add to dashboard Cite

show abstract

“…The minimum PaCO 2 in patients with metabolic acidosis is about 10 torr, a level reached at blood pH (BpH) between about 7.10 and 7.00 [2][3][4][5][6][7]. Let us further asume, as an approximation, that PaCO 2 decreases in direct proportion to the decrease in BpH.…”

mentioning

confidence: 99%