Acid-base status

Astrup, P. and Rorth, M., eds. Oxygen Affinity of Hemoglobin and Red Cell Acid Base Status. Academic Press, New York (1972). 

Acid-base status acidic amphoteric basic... 

The goals of dialysis are to remove toxic metabolites to decrease uremic symptoms, correct electrolyte abnormalities, restore acid-base status, and maintain volume status to ultimately improve quality of life and decrease the morbidity and mortality associated with ESRD. 

In summary, the approach to assessment of acid-base status involves four key steps (1) initial inspection of the pH,... 

All patients with significant disturbances in their acid-base status require continuous cardiovascular and hemodynamic monitoring. Because frequent assessment of the patient s response to treatment is critical, an arterial line is often placed to minimize patient discomfort with serial ABG collections. If... 

Acid-base status—pH, HC03y PC02, /3-hydroxybutyrate Renal function (creatinine, urine output)... 

Electrolytes Daily doses based on daily maintenance requirements, renal function, gastrointestinal losses, acid-base status, concomitant drug therapy, nutritional and anabolic status Pa lion I has hyponatremia, hypokalemia, hypomagnesemia, and hypophosphatemia, also has low serum bicarbonate concentration, could be component of metabolic acidosis due to sepsis... 

Victery W, Vander AJ, Mouw DR. 1979. Effect of acid-base status on renal excretion and accumulation of lead in dogs and rats. Am J Physiol 6 F398-F407. 

Arterial blood gases are measured to determine oxygenation and acid-base status (Fig. 74-1). Low pH values (less than 7.35) indicate acidemia, whereas high values (greater than 7.45) indicate alkalemia. The PaC02 value helps to determine if there is a primary respiratory abnormality, whereas the I IC( )3 concentration helps to determine if there is a primary metabolic abnormality. Steps in acid-base interpretation are described in Table 74-2. 

When considering the topic of acid-base balance, there are two key terms with which you should be familiar. These are pH and pKa. Calculations of a patient s acid-base status will utilize these terms. 

A3. Andersen, O. S., Sampling and storing of blood for deteimination of acid-base status. Scand. J. Clin. Lab. Invest. 13, 196-204 (1961). 

Less urgent forms of metabolic acidosis - Sodium bicarbonate injection may be added to other IV fluids. The amount of bicarbonate to be given to older children and adults over a 4- to 8-hour period is approximately 2 to 5 mEq/kg, depending on the severity of the acidosis as judged by the lowering of total CO2 content, blood pH, and clinical condition. Initially, an infusion of 2 to 5 mEq/kg over 4 to 8 hours will produce improvement in the acid-base status of the blood. 

G. H. Raymer, H. J. Green, D. A. Ranney, G. D. Marsh and R. T. Thompson, Muscle metabolism and acid-base status during exercise in forearm work-related myalgia measured with 31P-MRS. /. Appl. Physiol., 2009,106,1198-1206. 

MAC values for a particular volatile anaesthetic are highest in neonates and lowest in the elderly although the explanation for this is not clear. MAC values are unaffected by gender, duration of exposure, and acid-base status. MAC is reduced by induced hypotension, hypothermia and hypoxia. Drugs... 

Nitrogen Assimilation. Nitrogen assimilation is the uptake and metabolic use of N by plants and soil microbes (Figure 1). Assimilation by the terrestrial ecosystem controls the form of N eventually released into surface waters, as well as affecting the acid-base status of soil and surface waters. 

Nitrification. Nitrification, the oxidation of NH4+ to N03 , is mediated by bacteria and fungi in both the terrestrial and aquatic portions of watersheds. It is an important process in controlling the form of N released to surface waters by watersheds, as well as in controlling the acid-base status of surface waters (Figure 1). Nitrification is a strongly acidifying process, producing 2 moles of H for each mole of N (NH4+) nitrified. 

Sodium, potassium and chloride are the primary dietary ions that influence the electrolytic balance and acid-base status, and the proper dietary balance of sodium, potassium and chloride is necessary for growth, bone development, eggshell quality and AA utilization. Potassium is the third most abundant mineral in the body after calcium and phosphorus, and is the most abundant mineral in muscle tissue. It is involved in electrolyte balance and neuromuscular function. The content of potassium in poultry diets is usually adequate. Chloride is present in gastric juice and chlorine is part of the HC1 molecule which assists in the breakdown of feed in the proventriculus. Sodium is essential for nerve membrane stimulation and ionic transport across cell membranes. Signs of sodium, potassium or chloride deficiency include reduced appetite, poor growth, dehydration and increased mortality. 

Recognize the various acidotic and alkalotic conditions from the acid-base status of an individual. 

A patient with slow and shallow breathing had a pC02 of 58 mm Hg and a total C02 of 33.8 meq/L. What is the acid-base status ... 

Aldosterone secretion is also stimulated by increased plasma potassium concentration. Potassium is secreted into the urine in exchange for reabsorption of sodium in the distal nephron. Aldosterone also promotes secretion of hydrogen ions from the distal tubule according to the acid-base status of the... 

Q4 Potassium concentration is mainly controlled by the steroid hormone aldosterone. Aldosterone release from the adrenal cortex can be stimulated by either decreased plasma sodium or by increased plasma potassium concentration. An increase in aldosterone secretion causes retention (reabsorption) of sodium in the distal nephron in exchange for secretion of potassium into the urine. The amount of potassium excreted by the kidney is influenced by the acid-base status of the body. In alkalosis, potassium excretion increases, whereas in acidosis it is decreased. In the distal nephron H+ and K+ compete for excretion in exchange for the reabsorption of sodium. Insulin also affects plasma potassium concentration because it promotes the movement of potassium from the plasma into cells. 

Eshleman K. N. and Hemond H. F. (1985) The role of organic acids in the acid-base status of surface waters at Bickford watershed, Massachusetts. Water Resour. Res. 21, 1503-1510. 

Hemond H. F. (1990) Acid neutralizing capacity, alkalinity, and acid-base status of natural waters containing organic acids. Environ. Set Technol. 24, 1486-1489. 

Variations in climate may change the concentration and fluxes of solutes and compounds, thereby altering the acid-base status of runoff. 

The increase of atmospheric CO2 may have decreased the pH of precipitation very slightly, but PcOj in soils is far more important for the acid-base status of surface waters. Variation in forest soil Pco is related to the temperature and moisture content of soils as well as the release of excess soil CO2 to the atmosphere. Warmer conditions increase the rate of microbial and root respiration in the soil, thereby increasing soil Pco above the long-term average value and producing short-term increases in runoff ANC, and vice versa. Norton et al. (2001) found that intra-seasonal variations in Pco caused by variable snowpack thickness could induce variation in ANC in runoff of 10-15 peqL Such variability is comparable to variability in ANC caused by a 15-20 p.eqL change in SO4 in runoff. Decline in soil Pco, despite increased temperature and possibly increased soil respiration could result from a lower soil moisture content and a greater efflux of soil CO2. 

The importance of these secondary effects on acid-base status, metal concentration, and toxicity are still being studied. The recovery from acidification has been simulated by MAGIC for many watersheds, but sufficient time has not elapsed since acid inputs declined to assess the accuracy of the model predictions (Majer et aL, in review). 

The determination of ammonia in blood is carried out enzymatically, which is considered to be specific, precise and simple. (48) Serious mistakes can easily occur during the preanalytical phase of ammonia determination, making it imperative to comply with the standardized method of taking a blood sample, (s. p. 91) EDTA blood should be taken with the addition of sodium borate and L-serine. Furthermore, elevated serum y-GT activity and increased thrombocytes cause the ammonia level to rise, as does cigarette smoking prior to blood collection. Even minor haemolysis (e. g. in the event of prolonged transport) will spoil the blood for ammonia determination, since the ammonia concentration of erythrocytes is three times that found in plasma. Besides these interfering factors, ammonia concentration is influenced by (7.) the metabolic performance of the urea cycle, (2.) the extrahepatic formation and elimination of ammonia, and (5.) the acid-base status. 

Acid-base status (at the outset possibly every... 

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