Function of oxygen transport in the blood of patients in a state of alcohol deprivation in blood in vitro incubation with ethanol solution

Objective. To estimate the in vitro effect of ethanol on the function of oxygen transport in the blood of patients in a state of alcohol deprivation and in healthy donors.Materials and methods. We analyzed blood samples from 13 male patients aged 22–56 in a state of alcohol deprivation and 11 males aged 20-45 in whom this diagnosis was excluded. The blood was incubated with ethanol solution at a final concentration of 50 μmol/L. The parameters of the function of oxygen transport (р50, рО2, рСО2, рН, АВЕ, НСО3-, ТСО2,SВЕ, SBC) of the blood taken from the cubital vein using an ABL-330 “Radiometr” microgas analyzer were determined.Results. The patients in a state of alcohol deprivation reveal increased affinity of hemoglobin for oxygen, and their acid-base status of the blood becomes alkaline. When ethanol is added in vitro to the blood of patients, the affinity of hemoglobin for oxygen decreases.Conclusion. Decreased affinity of hemoglobin for oxygen upon the in vitro addition of ethanol in the examined patients indicates compensatory and adaptive changes in the oxygen transport of the blood in response to chronic ethanol consumption.

Effects of water acidification on immune responses of the gercacinid, Cardiosoma armatum (Herklots, 1851)

The biological response to chemical pollutants reflects the acid–base status of an aquatic ecosystem. The gercacinid, Cardiosoma armatum (75±0.1 g) was exposed to acidified waters to evaluate the effects on its immune parameters. The crabs were exposed to pH 4.0, 5.0, 6.0 and 7.8 (control) for 28 days. The hematological parameters of control crabs and crabs exposed to varied doses of acidified water indicated a marked reduction. Significant (p<0.05) higher alkaline phosphatase and albumen were obtained in pH 4.0, 5.0 and 6.0 compared to control; other values were mostly similar to control. The highest superoxide dismutase (SOD) (252.61±0.06 min/mg pro) was recorded in control group, while highest CAT activity (2.08±0.16 min/mg protein) was recorded in crabs exposed to pH 4 treatment. Furthermore, the control group's SOD activity was significantly higher than the exposed groups. With a lower pH, the quantities of malondialdehyde increased substantially and were significantly different from the control group. While these findings demonstrate that changes in pH have limited impact on energy use, decreasing immune system conditions show that C. armatum is susceptible to pH variations and may be influenced in aquaculture, where a pH drop is more prominent.

Metabolic alkalosis following mitral valvuloplasty in a dog with preoperative acute kidney injury

CASE DESCRIPTION An 11-year-old sexually intact male Shih Tzu diagnosed with acute kidney injury and left-sided congestive heart failure that had nonelective mitral valve surgery. CLINICAL FINDINGS Metabolic alkalosis developed postoperatively, and plasma bicarbonate concentration peaked 2 days after surgery (40.2 mmol/L; pH, 7.550). TREATMENT AND OUTCOME Acetazolamide administration increased the urinary excretion of bicarbonate and contributed to the improvement of the dog’s acid-base status and oxygenation capacity. Metabolic alkalosis persisted for 4 days after surgery, and no treatment was required after resolution. Plasma urea nitrogen and creatinine concentrations normalized 2 days after surgery. CLINICAL RELEVANCE Severe metabolic alkalosis can occur as a complication following mitral valve surgery. Acetazolamide may be suitable for the treatment of severe metabolic alkalosis.

Comparison of Phenylephrine and Ephedrine in the Treatment of Hypotension and Its Effects on the Foetus after Subarachnoid Block for Caesarean Section

BACKGROUND Subarachnoid block has been widely used for caesarean sections and is found to be safe. Hypotension being the most common complication may adversely affect both the mother and foetus. Different measures used to treat this hypotension include preloading with crystalloids/colloids and treatment with vasopressors. The standard choice of vasopressor agents such as ephedrine and phenylephrine is still a controversial issue. It is therefore important to compare the efficacy of the two drugs in the prevention and treatment of maternal hypotension after subarachnoid block and particularly assess their effect on the foetus. The purpose of this study was to assess and compare the foetal acid-base status and APGAR score following administration of bolus dose of ephedrine or phenylephrine that was given intravenously for maintenance of arterial blood pressure during lower segment caesarean section (LSCS) under a subarachnoid block. METHODS 100 parturients (18 to 35 years) scheduled for elective caesarean section under subarachnoid block were selected and divided into two groups of 50 each. Group P received 50 mcg i.v bolus of phenylephrine and Group E received 6 mg of ephedrine IV bolus whenever the blood pressure dropped 20 % from baseline or systolic blood pressure ˂ 90 mmHg. Haemodynamic parameters were measured in all patients. APGAR scores at 1 and 5 minutes following delivery of baby were assessed and cord blood was obtained for acid-base status analysis immediately following delivery. RESULTS Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure did not show any significant difference between the two groups, however, Group E showed higher heart rates. The difference in umbilical artery pH (P-value < 0.001) and base excess (P-value = 0.004) was statistically significant with Group E showing lower pH and higher base excess values than Group P. There was no statistically significant difference in neonatal APGAR scores between the two groups. CONCLUSIONS Phenylephrine and ephedrine are equally efficient in managing hypotension during subarachnoid block for caesarean delivery. Thus, either vasopressor can be used although phenylephrine may be a better choice. KEY WORDS Caesarean Section, Phenylephrine, Ephedrine.

Subclinical Hypoventilation in Dogs Undergoing Ventral Slot Decompressive Surgery for Cervical Myelopathy Due to Intervertebral Disc Herniation

The objective of this prospective cohort study was to document the occurrence of post-operative hypoventilation in dogs undergoing decompressive ventral slot or hemilaminectomy for the treatment of intervertebral disc herniation (IVDH). Twenty dogs undergoing ventral slot surgery and 20 dogs undergoing hemilaminectomy surgery for the treatment of IVDH that presented to XX between 2017 and 2020 were enrolled. Dogs were anesthetized using a standard protocol. Blood gas samples were taken at up to 11 time points beginning during anesthetic recovery and continuing for a maximum of 72 h post-operatively. Dogs with cervical lesions that were non-ambulatory before surgery had more evidence of subclinical hypoventilation in the immediate peri-extubation period than dogs with less severe injuries or those undergoing hemilaminectomy surgery. We found no difference in the ventilation status in dogs undergoing cervical or thoracolumbar decompressive surgery for IVDH from 8 to 72 h post-operatively. Other markers of acid-base status indicated that subclinical hypoventilation within the peri-extubation period was transient and self-limiting. There was a moderate positive correlation between sedation scores and estimated PaCO2. These data suggest that dogs with severe cervical spinal cord injuries may be at risk for subclinical hypoventilation in the immediate peri-extubation period. Increased sedation may be correlated with decreased ventilatory status in dogs recovering from decompressive vertebral column surgery.

Influence of acetate containing fluid versus lactate containing fluid on acid-base status, electrolyte level, and blood lactate level in dehydrated dogs

Background and Aim: Acetate or lactate buffered, balanced isotonic rehydration fluids are commonly used for fluid therapy in dogs and may influence acid-base and electrolyte status. This study aimed to assess acid-base status, electrolyte levels, and lactate levels in dehydrated dogs after receiving acetate or lactate-containing intravenous rehydration fluids. Materials and Methods: In this prospective, randomized study, 90 dehydrated dogs were included and randomized to receive acetate [Sterofundin® ISO B. Braun Vet Care (STERO), Germany) or lactate (Ringer-Lactat-Lösung nach Hartmann B. Braun Vet Care (RL), Germany] containing intravenous fluids for rehydration. The exclusion criteria were as follows: Age <6 months, liver failure, congestive heart failure, and extreme electrolyte deviation. Physical examination, venous blood gas, and lactate levels were analyzed before and after rehydration. The two groups were compared using t-test and Chi-square test. The significance level was set at p≤0.05. Results: Post-rehydration heart rate decreased in the STERO group (p<0.001) but not in the RL group (p=0.090). Lactate levels decreased in both groups STERO (p<0.001) and in group RL (p=0.014). Sodium and chloride levels increased during rehydration in group STERO (p<0.001; p<0.001) and group RL (p=0.002; p<0.001). There was a larger decrease in lactate levels in group STERO compared to group RL (p=0.047). Conclusion: Both solutions led to a mild increase in sodium and chloride levels and decreased lactate levels. The acetate-containing solution had an inferior effect on the decrease in lactate level.

The effects of post-operative oxygen supply on blood oxygenation and acid-base status in rats anaesthetized with fentanyl/fluanisone and midazolam

In anaesthetic practice the risk of hypoxia and arterial blood gas disturbances is evident, as most anaesthetic regimens depress the respiratory function. Hypoxia may be extended during recovery, and for this reason we wished to investigate if oxygen supply during a one hour post-operative period reduced the development of hypoxia and respiratory acidosis in rats anaesthetized with fentanyl/fluanisone and midazolam. Twelve Sprague Dawley rats underwent surgery and were divided in two groups, breathing either 100% oxygen or atmospheric air during a post-operative period. The peripheral blood oxygen saturation and arterial acid-base status were analyzed for differences between the two groups. We found that oxygen supply after surgery prevented hypoxia but did not result in a significant difference in the blood acid-base status. All rats developed respiratory acidosis, which could not be reversed by supplemental oxygen supply. We concluded that oxygen supply improved oxygen saturation and avoided hypoxia but did not have an influence on the acid-base status.

The Effect of Prearrest Acid-Base Status on Response to Sodium Bicarbonate and Achievement of Return of Spontaneous Circulation

Background The efficacy of sodium bicarbonate (SB) administration during in-hospital cardiac arrest (IHCA) for treatment of acidosis is not well described. The available literature has only evaluated out-of-hospital arrest events in patients with suspected acidosis caused by prolonged arrest. Objective This study evaluated SB and its effects on return of spontaneous circulation (ROSC) in patients experiencing IHCA, based on presence of acidosis at baseline as determined by prearrest bicarbonate levels. Methods We conducted a retrospective cohort study of patients who all received intravenous SB during IHCA. Patients with prearrest bicarbonate levels >21 mmol/L (nonacidotic group) were compared with those with prearrest bicarbonate levels ≤21 mmol/L (acidotic group) for the primary outcome of ROSC. Results A total of 225 patients (102 acidotic, 123 nonacidotic) were evaluated. Asystole (37.3% vs 34.1%; P = 0.63) and pulseless electrical activity (30.4% vs 29.3%; P = 0.85) were the most common presenting rhythms. There were no differences in ROSC in the overall population (53.9% vs 48.8%; P = 0.44) or between those who had early (within 20 minutes) or delayed (after 20 minutes) ROSC. Secondary outcomes, including cardiopulmonary resuscitation duration, epinephrine administration, and total SB, were similar between groups. Conclusions and Relevance In this cohort study, administration of SB for IHCA in patients with prearrest acidosis was not associated with increased incidence of ROSC compared with those without prearrest acidosis. Our data suggest that there may be no benefit to the administration of SB in the setting of IHCA, regardless of prearrest acidotic status. Further investigation into the effect of SB for treatment of acidosis in IHCA is warranted.