scholarly journals Metabolic acid-base status in critically ill patients: is standard base excess correlated with serum lactate level?

2006 ◽  
Vol 18 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Danilo Teixeira Noritomi ◽  
Ricardo Reis Sanga ◽  
André Carlos Kajdaksi-Balla Amaral ◽  
Marcelo Park
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Lactate Level ◽  
Base Excess ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Acid Base ◽  
Standard Base Excess ◽  
Acid Base Status ◽  
Standard Base

Serum lactate level accurately predicts mortality in critically ill patients with cirrhosis with acute kidney injury

2018 ◽  
Vol 30 (11) ◽  
pp. 1361-1367 ◽  
Author(s):  
Dan-Qin Sun ◽  
Chen-Fei Zheng ◽  
Feng-Bin Lu ◽  
Sven Van Poucke ◽  
Xiao-Ming Chen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lactate Level ◽  
Kidney Injury ◽  
Serum Lactate ◽  
Serum Lactate Level

Effect of Paco2 variation on standard base excess value in critically ill patients

2009 ◽  
Vol 24 (4) ◽  
pp. 484-491 ◽  
Author(s):  
Marcelo Park ◽  
Alexandre Toledo Maciel ◽  
Danilo Teixeira Noritomi ◽  
Luciano Cesar Pontes de Azevedo ◽  
Leandro Utino Taniguchi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Base Excess ◽  
Standard Base Excess ◽  
Excess Value ◽  
Standard Base

scholarly journals Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers?

Clinics ◽  
2006 ◽  
Vol 61 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Marcelo Park ◽  
Luciano Cesar Pontes Azevedo ◽  
Alexandre Toledo Maciel ◽  
Vladimir Ribeiro Pizzo ◽  
Danilo Teixeira Noritomi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Base Excess ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Standard Base Excess ◽  
Standard Base ◽  
Sepsis And Septic Shock

scholarly journals Base-excess chloride; the best approach to evaluating the effect of chloride on the acid- base status: a retrospective study

2020 ◽  
Author(s):  
Bulent Gucyetmez ◽  
Filiz Tuzuner ◽  
Hakan Korkut Atalan ◽  
Ugur Sezerman ◽  
Kaan Gucyetmez ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Model ◽  
Linear Regression Model ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Standard Base Excess ◽  
Serum Chloride ◽  
Acid Base Status ◽  
Standard Base

Abstract Background: To determine the effect of chloride on the acid-base status, four approaches are currently used: 1) accepted ranges of serum chloride values; 2) chloride corrections, such as chloride deficiency/excess and chloride modification; 3) the Cl/Na ratio; and 4) the sodium- chloride difference, such as base-excess chloride. However, these approaches are governed by different concepts, and they can evaluate the effects of chloride on the acid-base status differently. Our aim is to investigate which approach to the evaluation of the effect of chloride is the best.Methods: In this retrospective cohort study, 2529 critically ill patients who were admitted to the tertiary care unit were evaluated between 2011 and 2018. Patient characteristics and blood gas parameters at the ICU admission and outcomes were recorded. The effects of chloride on the acid-base status according to each evaluative approach were validated by the standard base excess and apparent strong ion difference. To compare approaches, kappa and Bland-Altman tests and a linear regression model were used. Results: In the linear regression model for all patients, only base-excess chloride in all the chloride evaluation approaches was significantly related to the standard base excess. In the subgroup, the correlation and limits of agreement between base-excess chloride and the standard base excess were the strongest (r2=0.92 p<0.001 bias: 0.5mmol/L). Conclusions: For the evaluation of the effect of chloride on the acid-base status, base-excess chloride is a better approach than accepted ranges of serum chloride values, chloride corrections and the Cl/Na ratio.

scholarly journals Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

2008 ◽  
Vol 36 (6) ◽  
pp. 822-829 ◽  
Author(s):  
T. J. Morgan ◽  
G Power ◽  
B. Venkatesh ◽  
M. A. Jones
Keyword(s):  
Metabolic Acidosis ◽  
Cardiopulmonary Bypass ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Elective Cardiac Surgery ◽  
Standard Base Excess ◽  
Acid Base Status ◽  
Standard Base ◽  
Normal Acid

Fluid-induced metabolic acidosis can be harmful and can complicate cardiopulmonary bypass. In an attempt to prevent this disturbance, we designed a bicarbonate-based crystalloid circuit prime balanced on physico-chemical principles with a strong ion difference of 24 mEq/l and compared its acid-base effects with those of Plasma-Lyte 148, a multiple electrolyte replacement solution containing acetate plus gluconate totalling 50 mEq/l. Twenty patients with normal acid-base status undergoing elective cardiac surgery were randomised 1:1 to a 2 litre prime of either bicarbonate-balanced fluid or Plasma-Lyte 148. With the trial fluid, metabolic acid-base status was normal following bypass initiation (standard base excess 0.1 (1.3) mEq/l, mean, SD), whereas Plasma-Lyte 148 produced a slight metabolic acidosis (standard base excess -2.2 (2.1) mEq/l). Estimated group difference after baseline adjustment was 3.6 mEq/l (95% confidence interval 2.1 to 5.1 mEq/l, P=0.0001). By late bypass, mean standard base excess in both groups was normal (0.8 (2.2) mEq/l vs. -0.8 (1.3) mEq/l, P=0.5). Strong ion gap values were unaltered with the trial fluid, but with Plasma-Lyte 148 increased significantly on bypass initiation (15.2 (2.5) mEq/l vs. 2.5 (1.5) mEq/l, P <0.0001), remaining elevated in late bypass (8.4 (3.4) mEq/l vs. 5.8 (2.4) mEq/l, P <0.05). We conclude that a bicarbonate-based crystalloid with a strong ion difference of 24 mEq/l is balanced for cardiopulmonary bypass in patients with normal acid-base status, whereas Plasma-Lyte 148 triggers a surge of unmeasured anions, persisting throughout bypass. These are likely to be gluconate and/or acetate. Whether surges of exogenous anions during bypass can be harmful requires further study.

scholarly journals Peripheral venous blood gas analysis: An alternative to arterial blood gas analysis for resuscitation and monitoring of critically ill patients.

2016 ◽  
Vol 4 (2) ◽  
pp. 92-95
Author(s):  
ASM Areef Ahsan ◽  
Mohammad Omar Faruq ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Debasish Kumar Saha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Base Excess ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Acid Base ◽  
Venous Sample ◽  
Acid Base Status

Objective: This study was aimed to compare between arterial and peripheral venous samples for blood gases and acid base status in critically ill patients and to evaluate if venous sample is a better alternative for initial assessment and resuscitation.Methods: This prospective study was conducted on 50 patients of more than 18 years of age in the department of Critical Care Medicine, BIRDEM General Hospital. Arterial and peripheral venous samples were taken within five minutes of each other and analyzed immediately for blood gases and acid base status. Mean difference and Pearson's product moment correlation coefficient was used to compare the result.Results: Mean difference and correlation coefficient between arterial and peripheral venous sample for pH, bicarbonate, base excess, PaCO2 and TCO2 value showed high correlation (r > 0.9). Comparison of electrolyte and hematocrit between arterial and peripheral venous sample also showed high correlation (r > 0.9).Conclusion: Peripheral venous gas analysis for pH, bicarbonate, base excess, PCO2 and Electrolytes (Na+, K+) show good correlation with the respective arterial values. This result suggests that venous estimations can be an acceptable alternative to arterial measurements for managing critically ill patients.Bangladesh Crit Care J September 2016; 4 (2): 92-95

scholarly journals ASSOCIATION OF ACID-BASE PARAMETERS WITH LACTATE LEVEL IN CRITICALLY ILL PATIENTS WITH METABOLIC ACIDOSIS

2018 ◽  
Vol 24 (2) ◽  
pp. 141
Author(s):  
Donaliazarti Donaliazarti ◽  
Rismawati Yaswir ◽  
Hanifah Maani ◽  
Efrida Efrida
Keyword(s):  
Metabolic Acidosis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lactate Level ◽  
Linear Regression Analysis ◽  
P Value ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Parameters ◽  
Base Balance

Metabolic acidosis is prevalent among critically ill patients and the common cause of metabolic acidosis in ICU is lactic acidosis. However, not all ICUs can provide lactate measurement. The traditional method that uses Henderson-Hasselbach equation (completed with BE and AG) and alternative method consisting of Stewart and its modification (BDEgap and SIG), are acid-base balance parameters commonly used by clinicians to determine metabolic acidosis in critically ill patients. The objective of this study was to discover the association between acid-base parameters (BE, AGobserved, AGcalculated, SIG, BDEgap) with lactate level in critically ill patients with metabolic acidosis. This was an analytical study with a cross-sectional design. Eighty-four critically ill patients hospitalized in the ICU department Dr. M. Djamil Padang Hospital were recruited in this study from January to September 2016. Blood gas analysis and lactate measurement were performed by potentiometric and amperometric method while electrolytes and albumin measurement were done by ISE and colorimetric method (BCG). Linear regression analysis was used to evaluate the association between acid-base parameters with lactate level based on p-value less than 0.05. Fourty five (54%) were females and thirty-nine (46%) were males with participant’s ages ranged from 18 to 81 years old. Postoperative was the most reason for ICU admission (88%). Linear regression analysis showed that p-value for BE, AGobserved, AGcalculated, SIG and BDEgap were 119; 0.967; 0.001; 0.001; 0.689, respectively. Acid-base balance parameters which were mostly associated with lactate level in critically ill patients with metabolic acidosis were AGcalculated and SIG. 

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