Importance of the Effective Strong Ion Difference of an Intravenous Solution in the Treatment of Diarrheic Calves with Naturally Acquired Acidemia and Strong Ion (Metabolic) Acidosis

Abstract

Background: The effect of sodium bicarbonate on acid-base balance in metabolic acidosis is interpreted differently by Henderson-Hasselbalch and strong ion acid-base approaches. Application of the traditional bicarbonate-centric approach indicates that bicarbonate administration corrects the metabolic acidosis by buffering hydrogen ions, whereas strong ion difference theory indicates that the co-administration of the strong cation sodium with a volatile buffer (bicarbonate) corrects the strong ion acidosis by increasing the strong ion difference (SID) in plasma.Objective: To investigate the relative importance of the effective SID of IV solutions in correcting acidemia in calves with diarrhea.Animals: Twenty-two Holstein-Friesian calves (4-21 days old) with naturally acquired diarrhea and strong ion (metabolic) acidosis.Methods: Calves were randomly assigned to IV treatment with a solution of sodium bicarbonate (1.4%) or sodium gluconate (3.26%). Fluids were administered over 4 hours and the effect on acid-base balance was determined.Results: Calves suffered from acidemia owing to moderate to strong ion acidosis arising from hyponatremia and hyper-D-lactatemia. Sodium bicarbonate infusion was effective in correcting the strong ion acidosis. In contrast, sodium gluconate infusion did not change blood pH, presumably because the strong anion gluconate was minimally metabolized.Conclusions: A solution containing a high effective SID (sodium bicarbonate) is much more effective in alkalinizing diarrheic calves with strong ion acidosis than a solution with a low effective SID (sodium gluconate). Sodium gluconate is ineffective in correcting acidemia, which can be explained using traditional acid-base theory but requires a new parameter, effective SID, to be understood using the strong ion approach.

Contribution of Unmeasured Anions to Acid–Base Disorders and its Association with Altered Demeanor in 264 Calves with Neonatal Diarrhea

“…It has been suggested than metabolic acidosis without appreciable increase in [ d ‐lac − ] has only a minor influence on posture and behavior of calves with diarrhea; however, posture and especially demeanor normalized after correction of the acidemia with sodium bicarbonate despite a persistent increase in [ d ‐lac − ] concentration in calves with diarrhea and metabolic acidosis . Moreover, in 1 study of calves with naturally acquired diarrhea and strong ion acidosis that were treated with intravenous solution of sodium, behavior was normalized despite of the persistent increases in [ d ‐lac − ] above 3 mmol/L . In this retrospective study SID 3 and p CO 2 did not correlate with changes in attitude, suckle reflex and posture; additionally, A tot was not significantly correlated with attitude and suckle response although it did correlate with posture.…”

“…The definition of acid–base disorders by using the H–H and physicochemical approaches was presented in the Table …”

Effect of Intravenous Small‐Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea

“…The measured strong ion difference obtained from 7 strong ions34 (SID 7 , mEq/L) was calculated by the measured value for [Ca 2+ ] determined by ion‐selective potentiometry and assigning a charge of +1.38 to magnesium assuming 69% dissociation35 and −1 to D‐lactate and L‐lactate assuming 100% dissociation such that:…”

Physicochemical Approach to Determine the Mechanism for Acid–Base Disorders in 793 Hospitalized Foals

“…However, this speculation remains to be proven. Other possibilities include increased negatively charged acute phase proteins,36 or exogenous compounds in administered fluids (lactate, acetate, citrate, gluconate)39 or medications (anion‐containing β‐lactam antibiotics, parenteral nutrition)40 administered before hospital admission. However, because the retrospective design of this study we were unable to comment beyond this.…”