Sodium, electrolyte/acid-base

Sodium Water, electrolyte, acid-base balance extracellular... 

Sodium chloride [7647-14-5] is an essential dietary component. It is necessary for proper acid—base balance and for electrolyte transfer between the iatra-and extracellular spaces. The adult human requirement for NaCl probably ranges between 5—8 g/d. The normal diet provides something ia excess of 10 g/d NaCl, and adding salt duting cooking or at the table iacreases this iatake. 

This electrolyte plays a vital role in the acid-base balance of the body. Bicarbonate may be given IV as sodium bicarbonate (NaHC03) in the treatment of metabolic acidosis, a state of imbalance that may be seen in diseases or situations such as severe shock, diabetic acidosis, severe diarrhea, extracorporeal circulation of blood, severe renal disease, and cardiac arrest. Oral sodium bicarbonate is used as a gastric and urinary alkalinizer. It may be used as a single drug or may be found as one of the ingredients in some antacid preparations. It is also useful in treating severe diarrhea accompanied by bicarbonate loss. 

Mecftanism of Action Sodium Is a major cat ion of extracellular fluid that controls water distribution, fluid and electrolyte balance, and osmotic pressure of body fluids it also maintains acid-base balance. 

Different surfactants are usually characterised by the solubility behaviour of their hydrophilic and hydrophobic molecule fraction in polar solvents, expressed by the HLB-value (hydrophilic-lipophilic-balance) of the surfactant. The HLB-value of a specific surfactant is often listed by the producer or can be easily calculated from listed increments [67]. If the water in a microemulsion contains electrolytes, the solubility of the surfactant in the water changes. It can be increased or decreased, depending on the kind of electrolyte [68,69]. The effect of electrolytes is explained by the HSAB principle (hard-soft-acid-base). For example, salts of hard acids and hard bases reduce the solubility of the surfactant in water. The solubility is increased by salts of soft acids and hard bases or by salts of hard acids and soft bases. Correspondingly, the solubility of the surfactant in water is increased by sodium alkyl sulfonates and decreased by sodium chloride or sodium sulfate. In the meantime, the physical interactions of the surfactant molecules and other components in microemulsions is well understood and the HSAB-principle was verified. The salts in water mainly influence the curvature of the surfactant film in a microemulsion. The curvature of the surfactant film can be expressed, analogous to the HLB-value, by the packing parameter Sp. The packing parameter is the ratio between the hydrophilic and lipophilic surfactant molecule part [70] ... 

ELECTROLYTE IMBALANCE Improper proportions of acids, bases, salts, and fluids in the body. Electrolytes include the salts sodium, potassium, magnesium, chloride chlorine. They can conduct electricity, and therefore are essential in nerve, muscle, and heart function. 

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. 

Conductivity detection is excellent for ionic or dipolar systems. It is optimal only if the ions under study are contained in solution or suspension, since the sensitivity of detection decreases when other electrolytes or acid-base buffers are added (Bernasconi, 1976). However, Strehlow and Wendt (1963) obtained good precision even in systems where 98% of the conductance was ascribable to inert electrolytes. One way to minimize extra conductance is to add salts with ions of low mobility such as tetra-alkylammonium ions, rather than sodium or potassium ions. 

Many organic acids, bases, and salts can act as depolarizers when ions are discharged which react easily with them. For example, p-nitrobenzoic acid in alkaline solution is reduced smoothly to p-azobenzoic acid. The sodium ions which are discharged react so rapidly with the nitro-group that the nitrobenzoic acid does not behave as an electrolyte but essentially as a depolarizer, particularly since the ions of the sodium... 

One key property of a solution is its electrical conductivity or ability to conduct electricity. When a substance, a solute, is dissolved is water, a solvent, ions may or may not be formed. A strong electrolyte is formed when the solute completely ionizes (the substance completely separates into ions), such as sodium chloride (a soluble salt), hydrochloric acid (strong acid), or sodium hydroxide (strong base). A weak electrolyte is formed when the solute partially ionizes, such as acetic acid (weak acid) or ammonia (weak base). A nonelectrolyte is a substance that dissolves in water but does not ionize, such as sugar or alcohol. Most soluble, nonacid organic molecules are nonelectrolytes. 

The electrolytes and acid-base balance should be restored in careful coordination with the renal function. In hyponatraemia, either the fluid intake should be reduced to 700-1,000 ml/day, or a combination of a hypertonic salt solution (3%) and a loop diuretic should be administered intravenously, (s. p. 308) Likewise, an attempt can be made using a combination of diuretics and urea diuresis. Generally, sodium and water intake should be restricted. It is imperative to achieve an even volumetric balance, possibly supported by the cautious intake of fluid. 

There is no specific antidote. Supportive care should be instituted for all patients with history of serious boric acid exposure. Substantial recent ingestions may benefit from administration of activated charcoal. Fluid and electrolyte balance, correction of acid/base disturbance, and control of seizures are essential to therapy. Hemodialysis has been successfully used to treat acute boric acid poisoning. Sodium bicarbonate may be used for any metabolic acidosis. 

If ingested, the formic acid should be diluted with milk or water in alert patients. Careful gastric aspiration with a nasogastric tube may be attempted to limit systemic absorption. The goal of the clinical management is to correct the acidosis. Acidosis may be treated with sodium bicarbonate or by hemodialysis. Immediate hemodialysis may remove formic acid from systemic circulation. Acid-base balance, electrolytes, and kidney function should be monitored closely. 

If ingestion has occurred, emesis or gastric lavage may be useful if initiated within 30 min. If acidosis is present, it can be treated with intravenous sodium bicarbonate as needed. Hemodialysis may be indicated in cases of severe acid-base and/or fluid-electrolyte abnormalities or in cases of renal failure. Animal data suggest that ethanol therapy may inhibit the formation of toxic metabolites. 

Sodium is an electrolyte (cation) in extracellular fluid (tissue spaces and vessels) and regenerates and transmits nerve impulses. Sodium affects water distribution inside and outside cells. Sodium also combines readily in the body with chloride (CL) or bicarbonate (HC03) to promote acid-base balance (Ph). 

They occur not only when a precipitate is formed, but also when an insoluble gas or a weak electrolyte is formed. An acid-base neutralization reaction between sodium hydroxide and hydrochloric acid is an example. 

Many types of electrolytes have been used in fuel cells. Water solutions of acids, such as phosphoric, sulfuric, and trifluoroacetic acids (acidic electrolytes), and bases such as sodium hydroxide or potassium hydroxide (alkaline electrolytes), can be incorporated into efficient cells. Cells using water solutions as electrolytes have complex problems of water management and electrolyte retention under conditions of severe physical motion. These will probably not be suitable for automobile service. For stationary applications described in Chapter 6 the water based electrolytes may offer advantages. 

Maintenance of fluid volume, osmolarity, electrolyte balance, and acid-base status are aU regulated in large part by the kidney. Homeostasis of sodium, potassium, chloride, calcium, magnesium, and phosphorus is altered due to changes in urinary excretion that occur in patients with impaired kidney function. A comprehensive discussion... 

Arieff Al, DeFronzo RA. Disorders of sodium metabolism— hyponatremia. In Arieff Al, DeFronza RA, eds. Huid, Electrolyte, and Acid-Base Disorders, 2nd ed. New York, Churchill Livingstone, 1995 255-303. 

Fluid, Electrolyte, and Acid-Base Disorders The volume status of patients with ARF depends primarily on residual urine output and the type of dialysis received, if any. The patient with oliguric ARF will have impaired excretion of sodium and water. In nonoliguric ARF, considerable sodium may be lost in the urine, necessitating replacement to maintain sodium balance. This also applies to the patient who is losing considerable gastric fluids. Patients on CRRT will lose sodium via hemofiltration or dialysis and should be given sodium as part of their CRRT replacement fluid regimen. 

By far the most likely diagnosis in this case is diabetic ketoacidosis. This may be precipitated by a number of conditions, such as infection. This may have caused anorexia and, thus, the patient may have omitted to take her insulin. Trauma can increase a patient s requirement for insulin but there is nothing to suggest that in this case. The blood glucose can be checked at the bedside as can a specimen of urine for the presence or absence of ketones. The laboratory tests which may be requested are urea and electrolytes to assess renal function, the presence or absence of hyperkalaemia and the serum sodium concentration. The patient s acid-base status should be assessed to quantitate the severity of the acidosis present, and the blood glucose should be accurately measured. These will influence the patient s treatment. It is essential in cases such as this that samples of blood and urine and, if appropriate, sputum are sent to the microbiological laboratory to look for the presence of infection. 

Acute hepatic failure is a major medical emergency, since the f ailure of the complex metabolic functions of the liver cannot be compensated for by any other organ. In severe ca.ses, much of the biochemical picture is disnipied. Electrolyte imbalance occurs, sodium and calcium concentrations may both fall. There may be severe metabolic acid-base ilisuirbances and hypoglycaemia. 

Chloride is mostly described in relation to hydrogen, sodium, potassium, and calcium, except when deviations are well described specifically for Cl in biological systems as a result of deficiency or excess availability. In addition, dysfunctions of CD transport or CD channels are of clinical relevance and have indeed been the subject of intensive research. One principle of CD-mediated effects is a change in osmotic condition, cell volume, and excitability and in acid-base balance in biological systems. In this way, CD is essentially linked to water distribution and electrolyte turnover. 

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