Clinical significance of acid–base balance in an emergency setting in patients with acute heart failure

Shirakabe, Akihiro; Hata, Noritake; Kobayashi, Nobuaki; Shinada, Tetsuro; Tomita, Kazunori; Tsurumi, Masafumi; Matsushita, M.; Okazaki, Hirotake; Yamamoto, Yoshiya; Yokoyama, Shinya; Asai, Kuniya; Mizuno, Kyoichi

doi:10.1016/j.jjcc.2012.06.004

Cited by 29 publications

(65 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If respiratory diseases, such as chronic obstructive pulmonary diseases, are excluded, the impact of respiratory acid-base balances to CO 2 CP can be minimized. On the other hand, reduced CO 2 CP suggests metabolic acidosis (1) or respiratory alkalosis (16), both of which are indicators of poor outcomes. Although ABG analysis has become an essential test to diagnose acid-base disturbances, only a small percentage of patients received this test for its invasive procedure and complications.…”

Section: Discussionmentioning

confidence: 99%

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Wang

Geng

et al. 2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Metabolic acidosis has been proved to be a risk factor for the progression of chronic kidney disease, but its relation to acute kidney injury (AKI) has not been investigated. In general, a diagnosis of metabolic acidosis is based on arterial blood gas (ABG) analysis, but the diagnostic role of carbon dioxide combining power (CO2CP) in the venous blood may also be valuable to non-respiratory patients. This retrospective study included all adult non-respiratory patients admitted consecutively to our hospital between October 01, 2014 and September 30, 2015. A total of 71,089 non-respiratory patients were included, and only 4,873 patients were evaluated by ABG analysis at admission. In patients with ABG, acidosis, metabolic acidosis, decreased HCO3− and hypocapnia at admission was associated with the development of AKI, while acidosis and hypocapnia were independent predictors of hospital mortality. Among non-respiratory patients, decreased CO2CP at admission was an independent risk factor for AKI and hospital mortality. ROC curves indicated that CO2CP was a reasonable biomarker to exclude metabolic acidosis, dual and triple acid-base disturbances. The effect sizes of decreased CO2CP on AKI and hospital mortality varied according to age and different underlying diseases. Metabolic acidosis is an independent risk factor for the development of AKI and hospital mortality. In non-respiratory patient, decreased CO2CP is also an independent contributor to AKI and mortality and can be used as an indicator of metabolic acidosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Wang

Geng

et al. 2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

show abstract

“…There might be an insufficient amount of time to compensate the acid-base balance in patients presenting with vascular failure because of its acute onset, therefore, the vascular failure (occurring more often in the nighttime) is thus considered to show more advanced acidosis. Shirakabe et al demonstrated that the AHF patients with acidosis tended to show a higher SBP, which is a characteristic of vascular failure, and they also more frequently demonstrated CS 1 [14]. The WBC counts increased upon the exacerbation of HF caused by inflammatory processes [15,16].…”

Section: Arterial Blood Gas Laboratory Data Chest X-rays and The Tmentioning

confidence: 99%

Association between the visiting time and the clinical findings on admission in patients with acute heart failure

Matsushita

Shirakabe

Hata

et al. 2013

Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…A significant fall in alveolar ventilation occurs in patients with concomitant chronic obstructive pulmonary disease (COPD) and in those with severe or advanced acute pulmonary oedema and respiratory fatigue, which usually will lead to hypercapnia. Mixed acidosis (respiratory and metabolic) is the predominant blood gas alteration in severe acute pulmonary oedema . Severe metabolic acidosis, seen in cardiogenic shock, triggers hyperventilation (Kussmaul breathing) and contributes to respiratory distress .…”

Section: Clinical and Biochemical Assessments Of Acute Heart Failure mentioning

confidence: 99%

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Harjola

Mullens

Banaszewski

et al. 2017

European J of Heart Fail

301

256

View full text Add to dashboard Cite

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.

show abstract

Clinical significance of acid–base balance in an emergency setting in patients with acute heart failure

Cited by 29 publications

References 33 publications

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Association between the visiting time and the clinical findings on admission in patients with acute heart failure

Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Contact Info

Product

Resources

About