scholarly journals Respiratory and metabolic acidosis correction with the ADVanced Organ Support system

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Aritz Perez Ruiz de Garibay ◽  
John A. Kellum ◽  
Johannes Honigschnabel ◽  
Bernhard Kreymann
Keyword(s):  
Blood Flow ◽  
Lactic Acid ◽  
Ex Vivo ◽  
Organ Support ◽  
Acid Base Balance ◽  
Acid Base ◽  
Ex Vivo Model ◽  
Acid Infusion ◽  
Blood Ph ◽  
Acid Load

Abstract Background The lung, the kidney, and the liver are major regulators of acid-base balance. Acidosis due to the dysfunction of one or more organs can increase mortality, especially in critically ill patients. Supporting compensation by increasing ventilation or infusing bicarbonate is often ineffective. Therefore, direct removal of acid may represent a novel therapeutic approach. This can be achieved with the ADVanced Organ Support (ADVOS) system, an enhanced renal support therapy based on albumin dialysis. Here, we demonstrate proof of concept for this technology. Methods An ex vivo model of either hypercapnic (i.e., continuous CO2 supply) or lactic acidosis (i.e., lactic acid infusion) using porcine blood was subjected to hemodialysis with ADVOS. A variety of operational parameters including blood and dialysate flows, different dialysate pH settings, and acid and base concentrate compositions were tested. Comparisons with standard continuous veno-venous hemofiltration (CVVH) using high bicarbonate substitution fluid and continuous veno-venous hemodialysis (CVVHD) were also performed. Results Sixty-one milliliters per minute (2.7 mmol/min) of CO2 was removed using a blood flow of 400 ml/min and a dialysate pH of 10 without altering blood pCO2 and HCO3− (36 mmHg and 20 mmol/l, respectively). Up to 142 ml/min (6.3 mmol/min) of CO2 was eliminated if elevated pCO2 (117 mmHg) and HCO3− (63 mmol/l) were allowed. During continuous lactic acid infusion, an acid load of up to 3 mmol/min was compensated. When acidosis was triggered, ADVOS multi normalized pH and bicarbonate levels within 1 h, while neither CVVH nor CVVHD could. The major determinants to correct blood pH were blood flow, dialysate composition, and initial acid-base status. Conclusions In conclusion, ADVOS was able to remove more than 50% of the amount of CO2 typically produced by an adult human. Blood pH was maintained stable within the physiological range through compensation of a metabolic acid load by albumin dialysate. These in vitro results will require confirmation in patients.

Changes in the tone of cerebral vessels in patients with bronchial asthma after glomectomy

1982 ◽  
Vol 63 (1) ◽  
pp. 56-56
Author(s):  
E. S. Karashurov ◽  
S. E. Karashurov
Keyword(s):  
Blood Flow ◽  
Bronchial Asthma ◽  
Cerebral Vessels ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
The Brain

Frequent complications of glomectomy are headaches and a mild, less-like state for several days or weeks after surgery, and sometimes hemi- and monoparesis. The reasons for these complications have not yet been revealed. In search of their explanation, we decided to study the volumetric blood flow of the brain and the acid-base state (ACS). Volumetric blood flow was studied by rheoencephalography (REG) in 43 patients, and acid base balance - in 100 patients (age from 22 to 67 years). The course of bronchial asthma before the operation in the examined patients was moderate and severe.

scholarly journals Isoflurane-induced acidosis depresses basal and PGE2-stimulated duodenal bicarbonate secretion in mice

2007 ◽  
Vol 292 (3) ◽  
pp. G899-G904 ◽  
Author(s):  
Markus Sjöblom ◽  
Olof Nylander
Keyword(s):  
Base Excess ◽  
Ringer Solution ◽  
Bicarbonate Secretion ◽  
Acid Base Balance ◽  
Acid Base ◽  
In Vivo Experiments ◽  
Arterial Blood ◽  
Blood Ph ◽  
Base Balance

When running in vivo experiments, it is imperative to keep arterial blood pressure and acid-base parameters within the normal physiological range. The aim of this investigation was to explore the consequences of anesthesia-induced acidosis on basal and PGE2-stimulated duodenal bicarbonate secretion. Mice (strain C57bl/6J) were kept anesthetized by a spontaneous inhalation of isoflurane. Mean arterial blood pressure (MAP), arterial acid-base balance, and duodenal mucosal bicarbonate secretion (DMBS) were studied. Two intra-arterial fluid support strategies were used: a standard Ringer solution and an isotonic Na2CO3 solution. Duodenal single perfusion was used, and DMBS was assessed by back titration of the effluent. PGE2 was used to stimulate DMBS. In Ringer solution-infused mice, isoflurane-induced acidosis became worse with time. The blood pH was 7.15–7.21 and the base excess was about −8 mM at the end of experiments. The continuous infusion of Na2CO3 solution completely compensated for the acidosis. The blood pH was 7.36–7.37 and base excess was about 1 mM at the end of the experiment. Basal and PGE2-stimulated DMBS were markedly greater in animals treated with Na2CO3 solution than in those treated with Ringer solution. MAP was slightly higher after Na2CO3 solution infusion than after Ringer solution infusion. We concluded that isoflurane-induced acidosis markedly depresses basal and PGE2-stimulated DMBS as well as the responsiveness to PGE2, effects prevented by a continuous infusion of Na2CO3. When performing in vivo experiments in isoflurane-anesthetized mice, it is recommended to supplement with a Na2CO3 infusion to maintain a normal acid-base balance.

Effect of ventilation on acid-base balance and oxygenation in low blood-flow states

1994 ◽  
Vol 22 (11) ◽  
pp. 1827-1834
Author(s):  
Ahamed H. Idris ◽  
Edward D. Staples ◽  
Daniel J. Oʼbrien ◽  
Richard J. Melker ◽  
William J. Rush ◽  
...  
Keyword(s):  
Blood Flow ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Flow States

scholarly journals DYNAMICS OF THE VENOUS BLOOD ACID-BASE BALANCE AND RELATIONSHIP BLOOD PH VS TUMOR IN LARYNGEAL CANCER PATIENTS

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
V. A. Kashirin ◽  
O. V. Khorolets ◽  
S. I. Andreev ◽  
A. A. Mikheev
Keyword(s):  
Laryngeal Cancer ◽  
Venous Blood ◽  
Combined Treatment ◽  
Control Group ◽  
Acid Base Balance ◽  
Acid Base ◽  
Tumor Ph ◽  
Blood Ph ◽  
Base Balance ◽  
Group 2

Abstract The characteristic for most solid tumors cells is the intracellular alkalinization and acidification of the extracellular milieu and this pH gradient inversion (pHe < pHi) is associated with tumor proliferation, invasion, metastasis, aggressiveness, and treatment resistance. However is there tumor pH (pHi and/or pHe) changes affect on venous blood plasma pH? Purpose of the study. The venous blood acid-base balance before and after the combined treatment, correlation of the venous blood pH indicators (pHb), relationship neoplasm and blood pH in patients with laryngeal cancer was study. Material and methods. Studies were performed in patients with laryngeal cancer categories T2–3 N0 M0 before and after the combined treatment. The patients were divided into four groups: Group 1 – 25 patients before the start of treatment; Group 2 – 21 patients (from Group 1) after completion of the combined treatment; Group 3 – 14 patients from Group 2 with positive results of treatment and Group 4 – 7 patients from Group 2 with a negative result of treatment (recurrence and/or metastasis of the neoplasm). The control group consisted of 15 practically healthy people (Group C). Examination of venous blood acid-base balance of patients, tumor pH and tumor cells pHi and pHe was carried. Results and discussion. The increase in pCO2 and HCO – concentration will result in decrease in the pH, but if these indicators have a clear correlation in the control group, then in patients groups there was a correlation for pHb & pCO2 and pO2 only. Besides, we marked increase in pCO2, HCO –, K+, while pO decreased in pHb after the combined treatment. It is necessary to point out the differences between some benchmarks and indicators of acid-base balance in the plasma of venous blood in primary patients and patients with recurrent laryngeal cancer. So, if pHb, pO2, and Cl– patients have statistically significant differences from control data, then differences with control pCO2 values are characteristic only for patients of Groups 1 and 3. On the contrary, differences in the HCO – indices are characteristic only for patients of Group 4. There are statistically significant differences from the control indicators K+, Na+, Ca2+, Glu, Lac, mOsm in patients of the first group and Cl– and Lac of patients in the third group. Among the indicators in the third and fourth groups of patients, statistically significant differences were noted in the values of pHb, HCO – and Glu.In patients of groups 1 and 4, the determination of pHt and the calculation of pHi, pHe revealed decrease in pHt and pHe with increasing pHi in patients with recurrence of the neoplasm.The final stage of the study was to determine the relationship (and not correlation) of blood pH and laryngeal tumors and the relationship was noted in the «pHb-tumor» system in primary patients, but in patients in 3 and 4 Groups, that «pHb-tumor» connection is rather contradictory. Conclusion. Acid-base balance indicators obviously cannot be considered as unconditional markers of carcinogenesis, but their monitoring and, in particular, venous blood pH, of patients after special treatment, can help determine the risk group of patients who may develop of a malignant neoplasm recurrence. Keywords: acid-base balance, laryngeal cancer, se, prognosis.

scholarly journals Photobiomodulation 30 min or 6 h Prior to Cycling Does Not Alter Resting Blood Flow Velocity, Exercise-Induced Physiological Responses or Time to Exhaustion in Healthy Men

2021 ◽  
Vol 11 ◽  
Author(s):  
Yago Medeiros Dutra ◽  
Gabriel Machado Claus ◽  
Elvis de Souza Malta ◽  
Daniela Moraes de Franco Seda ◽  
Anderson Saranz Zago ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Femoral Artery ◽  
Blood Flow Velocity ◽  
Time To Exhaustion ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Exercise Induced ◽  
Plasma Nitrite

PurposeThe aim of the current study was to investigate the effects of photobiomodulation therapy (PBMT) applied 30 min or 6 h prior to cycling on blood flow velocity and plasma nitrite concentrations at rest, time to exhaustion, cardiorespiratory responses, blood acid-base balance, and K+ and lactate concentrations during exercise.MethodsIn a randomized, crossover design, 13 healthy untrained men randomly completed four cycling bouts until exhaustion at the severe-intensity domain (i.e., above respiratory compensation point). Thirty minutes or 6 h prior to the cycling trials, participants were treated with PBMT on the quadriceps, hamstrings, and gastrocnemius muscles of both limbs using a multi-diode array (11 cm × 30 cm with 264 diodes) at doses of 152 J or a sham irradiation (with device turned off, placebo). Blood samples were collected before and 30 min or 6 h after treatments to measure plasmatic nitrite concentrations. Doppler ultrasound exams of the femoral artery were also performed at the same time points. Cardiorespiratory responses, blood acid-base balance, and K+ and lactate concentrations were monitored during exercise sessions.ResultsPBMT did not improve the time to exhaustion (p = 0.30). At rest, no differences were found in the peak systolic velocity (p = 0.97) or pulsatility index (p = 0.83) in the femoral artery, and in plasma nitrite concentrations (p = 0.47). During exercise, there were no differences for any cardiorespiratory response monitored (heart rate, p = 0.15; oxygen uptake, p = 0.15; pulmonary ventilation, p = 0.67; carbon dioxide output, p = 0.93; and respiratory exchange ratio, p = 0.32), any blood acid-base balance indicator (pH, p = 0.74; base excess, p = 0.33; bicarbonate concentration, p = 0.54), or K+ (p = 0.22) and lactate (p = 0.55) concentrations.ConclusionsPBMT at 152 J applied 30 min or 6 h before cycling at severe-intensity did not alter resting plasma nitrite and blood flow velocity in the femoral artery, exercise-induced physiological responses, or time to exhaustion in healthy untrained men.

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