Causes of metabolic acidosis in canine hemorrhagic shock: role of unmeasured ions

Bruegger, Dirk; Kemming, Gregor; Jacob, Matthias; Meisner, Franz; Wojtczyk, Christoph J.; Packert, K.B.; Keipert, Peter E.; Faithfull, N. S.; Häbler, O.; Becker, Bernhard F.; Rehm, Markus

doi:10.1186/cc6200

Cited by 36 publications

(39 citation statements)

References 41 publications

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“…In the light of the results obtained, considering the above-mentioned Constabl's (2000) proposition and taking into consideration other researchers opinions (Bruegger et al 2007, Siegling-Vlitakis et al 2007, it can be assumed that a diagnostic procedure scheme should combine both methods, for example, through the calculation of AG m , especially as the values needed for its calculation are still normally determined in routine laboratory diagnostics. It ought to be remembered that the notion of anion gap describes an APPARENT lack of negative ions as the total positive and negative charges, according to the electrical neutrality principle, must be the same.…”

Section: Discussionmentioning

confidence: 94%

“…In dogs, the metabolic acidosis resulting from renal insufficiency and septic shock was diagnosed on the basis of the HH equation and, then, concentration of buffer and non-buffer ions was determined which enabled completion of the conducted treatment with their supplementation (Siegling--Vlitakis et al 2007). Being part of the Stewart model, SIG or strong ion gap, is considered by some researchers to be the most credible indicator of evaluation of chances of the dog survival in the course of hemorrhagic shock as one can determine how advanced the developing metabolic acidosis is on the basis of the analysis of the difference between concentrations of buffer and non-buffer ions (Bruegger et al 2007). Constabl (2000) suggested application of the classic method in such cases when concentration of total protein, albumins, and inorganic phosphorus in blood serum of an animal is within the norm.…”

Section: Discussionmentioning

confidence: 99%

“…In practice, the Stewart model is used to diversify the ABB disorders when their interpretation according to the classic method is doubtful Glińska-Suchocka 2012, 2013), allows evaluation of chances of the patient survival in the course of the severe metabolic acidosis (Bruegger et al 2007), and often enables conducting of a more effective treatment (Siegling-Vlitakis et al 2007).…”

Section: Introductionmentioning

confidence: 99%

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The use of elements of the Stewart model (Strong Ion Approach) for the diagnostics of respiratory acidosis on the basis of the calculation of a value of a modified anion gap (AGm) in brachycephalic dogs

Sławuta¹,

Glińska-Suchocka²,

Cekiera³

2015

Polish Journal of Veterinary Sciences

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Apart from the HH equation, the acid-base balance of an organism is also described by the Stewart model, which assumes that the proper insight into the ABB of the organism is given by an analysis of: pCO 2 , the difference of concentrations of strong cations and anions in the blood serum -SID, and the total concentration of nonvolatile weak acids -Acid total. The notion of an anion gap (AG), or the apparent lack of ions, is closely related to the acid-base balance described according to the HH equation. Its value mainly consists of negatively charged proteins, phosphates, and sulphates in blood. In the human medicine, a modified anion gap is used, which, including the concentration of the protein buffer of blood, is, in fact, the combination of the apparent lack of ions derived from the classic model and the Stewart model. In brachycephalic dogs, respiratory acidosis often occurs, which is caused by an overgrowth of the soft palate, making it impossible for a free air flow and causing an increase in pCO 2 -carbonic acid anhydride The aim of the present paper was an attempt to answer the question whether, in the case of systemic respiratory acidosis, changes in the concentration of buffering ions can also be seen. The study was carried out on 60 adult dogs of boxer breed in which, on the basis of the results of endoscopic examination, a strong overgrowth of the soft palate requiring a surgical correction was found. For each dog, the value of the anion gap before and after the palate . The values of AG calculated for the dogs before and after the procedure fell within the limits of the reference values and did not differ significantly whereas the values of AG m calculated for the dogs before and after the procedure differed from each other significantly. Conclusions: 1) On the basis of the values of AG m obtained it should be stated that in spite of finding respiratory acidosis in the examined dogs, changes in ion concentration can also be seen, which, according to the Stewart theory, compensate metabolic ABB disorders 2) In spite of the fact that all the values used for calculation of AG m were within the limits of reference values, the values of AG m in dogs before and after the soft palate correction procedure differed from each other significantly, which proves high sensitivity and usefulness of the AG m calculation as a diagnostic method.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The use of elements of the Stewart model (Strong Ion Approach) for the diagnostics of respiratory acidosis on the basis of the calculation of a value of a modified anion gap (AGm) in brachycephalic dogs

Sławuta¹,

Glińska-Suchocka²,

Cekiera³

2015

Polish Journal of Veterinary Sciences

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“…Hemorrhagic shock was induced according to a protocol by Bruegger and colleagues [14] . Briefly, animals were anesthetized with sodium pentobarbital (30 mg/kg, iv), and an endotracheal tube was inserted to maintain normocapnia.…”

Section: Hemorrhagic Shock Modelmentioning

confidence: 99%

Combined administration of anisodamine and neostigmine produces anti-shock effects: involvement of α7 nicotinic acetylcholine receptors

Sun

Zhang

et al. 2012

Acta Pharmacol Sin

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Aim: To evaluate the anti-effects of anisodamine and neostigmine in animal models of endotoxic and hemorrhagic shock. Methods: Kunming mice were injected with lipopolysaccharide (LPS 30 mg/kg, ip) to induce endotoxic shock. Anisodamine (12.5, 25, and 50 mg/kg, ip) and neostigmine (12.5, 25, and 50 μg/kg, ip) were administered immediately after LPS injection. Survival rate was monitored, and the serum levels of TNF-α and IL-1β were analyzed using ELISA assays. The effects of anisodamine and neostigmine were also examined in α7 nicotinic acetylcholine receptor (α7 nAChR) knockout mice with endotoxic shock and in Beagle dogs with hemorrhagic shock. Results: In mice with experimental endotoxemia, combined administration of anisodamine and neostigmine significantly increased the survival rate and decreased the serum levels of inflammatory cytokines, as compared to those produced by either drug alone. The antishock effect of combined anisodamine and neostigmine was abolished in α7 nAChR knockout mice. On the other hand, intravenous injection of the combined anisodamine and neostigmine, or the selective α7 nAChR agonist PNU282987 exerted similar anti-shock effects in dogs with hemorrhagic shock. Conclusion:The results demonstrate that combined administration of anisodamine and neostigmine produces significant anti-shock effects, which involves activation of α7 nAChRs.

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“…Lactate levels after volume resuscitation from hemorrhagic shock in group-Dextran[glucose] were significantly lower than those in group-Dextran[saline]. The significant correlation between base excess at T-4 and lactate levels at T-4 reflects the contribution of hyperlactatemia to acid/base-imbalance in groupDextran[saline], although the blood concentration of other anions (i.e., citrate and acetate), which have been reported to be responsible, to some extent, for metabolic acidosis after hemorrhagic shock, were not examined (8). Volume resuscitation, using a plasma substitute alone, from hemorrhagic shock is not practical in clinical settings; however, results in this study using fasted rats suggest the possible advantageous effect of glucose administration during volume resuscitation from hemorrhagic shock.…”

Section: Discussionmentioning

confidence: 99%

Glucose administration during volume resuscitation using dextran-40 from hemorrhagic shock ameliorates acid/base-imbalance in fasted rats under sevoflurane anesthesia

2013

Biosci Trends

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Causes of metabolic acidosis in canine hemorrhagic shock: role of unmeasured ions

Abstract: Introduction Metabolic acidosis during hemorrhagic shock is common and conventionally considered to be due to hyperlactatemia. There is increasing awareness, however, that other nonlactate, unmeasured anions contribute to this type of acidosis.

Cited by 36 publications

References 41 publications

The use of elements of the Stewart model (Strong Ion Approach) for the diagnostics of respiratory acidosis on the basis of the calculation of a value of a modified anion gap (AGm) in brachycephalic dogs

The use of elements of the Stewart model (Strong Ion Approach) for the diagnostics of respiratory acidosis on the basis of the calculation of a value of a modified anion gap (AGm) in brachycephalic dogs

Combined administration of anisodamine and neostigmine produces anti-shock effects: involvement of α7 nicotinic acetylcholine receptors

Glucose administration during volume resuscitation using dextran-40 from hemorrhagic shock ameliorates acid/base-imbalance in fasted rats under sevoflurane anesthesia

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