Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43926939" target="_blank" >RIV/00064173:_____/24:43926939 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11120/24:43926939

Výsledek na webu

<a href="https://doi.org/10.1152/japplphysiol.00917.2023" target="_blank" >https://doi.org/10.1152/japplphysiol.00917.2023</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1152/japplphysiol.00917.2023" target="_blank" >10.1152/japplphysiol.00917.2023</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation

Popis výsledku v původním jazyce

It is commonly assumed that changes in plasma strong ion difference (SID) result in equal changes in whole blood base excess (BE). However, at varying pH, albumin ionic-binding and transerythrocyte shifts alter the SID of plasma without affecting that of whole blood (SIDwb), i.e., the BE. We hypothesize that, during acidosis, 1) an expected plasma SID (SIDexp) reflecting electrolytes redistribution can be predicted from albumin and hemoglobin&apos;s charges, and 2) only deviations in SID from SIDexp reflect changes in SIDwb, and therefore, BE. We equilibrated whole blood of 18 healthy subjects (albumin = 4.8 +/- 0.2 g/dL, hemoglobin = 14.2 +/- 0.9 g/dL), 18 septic patients with hypoalbuminemia and anemia (albumin = 3.1 +/- 0.5 g/dL, hemoglobin = 10.4 +/- 0.8 g/dL), and 10 healthy subjects after in vitro-induced isolated anemia (albumin = 5.0 +/- 0.2 g/dL, hemoglobin = 7.0 +/- 0.9 g/dL) with varying CO2 concentrations (2-20%). Plasma SID increased by 12.7 +/- 2.1, 9.3 +/- 1.7, and 7.8 +/- 1.6 mEq/L, respectively (P &lt; 0.01) and its agreement (bias[limits of agreement]) with SIDexp was strong: 0.5[-1.9; 2.8], 0.9[-0.9; 2.6], and 0.3[-1.4; 2.1] mEq/L, respectively. Separately, we added 7.5 or 15 mEq/L of lactic or hydrochloric acid to whole blood of 10 healthy subjects obtaining BE of -6.6 +/- 1.7, -13.4 +/- 2.2, -6.8 +/- 1.8, and -13.6 +/- 2.1 mEq/L, respectively. The agreement between Delta BE and Delta SID was weak (2.6[-1.1; 6.3] mEq/L), worsening with varying CO2 (2-20%): 6.3[-2.7; 15.2] mEq/L. Conversely, Delta SIDwb (the deviation of SID from SIDexp) agreed strongly with Delta BE at both constant and varying CO2: -0.1[-2.0; 1.7], and -0.5[-2.4; 1.5] mEq/L, respectively. We conclude that BE reflects only changes in plasma SID that are not expected from electrolytes redistribution, the latter being predictable from albumin and hemoglobin&apos;s charges.

Název v anglickém jazyce

Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation

Popis výsledku anglicky

It is commonly assumed that changes in plasma strong ion difference (SID) result in equal changes in whole blood base excess (BE). However, at varying pH, albumin ionic-binding and transerythrocyte shifts alter the SID of plasma without affecting that of whole blood (SIDwb), i.e., the BE. We hypothesize that, during acidosis, 1) an expected plasma SID (SIDexp) reflecting electrolytes redistribution can be predicted from albumin and hemoglobin&apos;s charges, and 2) only deviations in SID from SIDexp reflect changes in SIDwb, and therefore, BE. We equilibrated whole blood of 18 healthy subjects (albumin = 4.8 +/- 0.2 g/dL, hemoglobin = 14.2 +/- 0.9 g/dL), 18 septic patients with hypoalbuminemia and anemia (albumin = 3.1 +/- 0.5 g/dL, hemoglobin = 10.4 +/- 0.8 g/dL), and 10 healthy subjects after in vitro-induced isolated anemia (albumin = 5.0 +/- 0.2 g/dL, hemoglobin = 7.0 +/- 0.9 g/dL) with varying CO2 concentrations (2-20%). Plasma SID increased by 12.7 +/- 2.1, 9.3 +/- 1.7, and 7.8 +/- 1.6 mEq/L, respectively (P &lt; 0.01) and its agreement (bias[limits of agreement]) with SIDexp was strong: 0.5[-1.9; 2.8], 0.9[-0.9; 2.6], and 0.3[-1.4; 2.1] mEq/L, respectively. Separately, we added 7.5 or 15 mEq/L of lactic or hydrochloric acid to whole blood of 10 healthy subjects obtaining BE of -6.6 +/- 1.7, -13.4 +/- 2.2, -6.8 +/- 1.8, and -13.6 +/- 2.1 mEq/L, respectively. The agreement between Delta BE and Delta SID was weak (2.6[-1.1; 6.3] mEq/L), worsening with varying CO2 (2-20%): 6.3[-2.7; 15.2] mEq/L. Conversely, Delta SIDwb (the deviation of SID from SIDexp) agreed strongly with Delta BE at both constant and varying CO2: -0.1[-2.0; 1.7], and -0.5[-2.4; 1.5] mEq/L, respectively. We conclude that BE reflects only changes in plasma SID that are not expected from electrolytes redistribution, the latter being predictable from albumin and hemoglobin&apos;s charges.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30223 - Anaesthesiology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Applied Physiology

ISSN

8750-7587

e-ISSN

1522-1601

Svazek periodika

136

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

966-976

Kód UT WoS článku

001206316800005

EID výsledku v databázi Scopus

2-s2.0-85190900788