Standard Bicarbonate, its Clinical Significance, and a new Method for its Determination

Jørgensen, K.; Astrup, Poul

doi:10.3109/00365515709101210

Cited by 137 publications

(42 citation statements)

References 2 publications

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“…Titration of a buffer mixture over a narrow range of hydrogen ion concentrations could produce such a pattern; whole blood, for example, yields a straight line relationship over a hydrogen ion concentration as wide as that examined here (20)(21)(22)(23). The sittuation in vivo, however, is more complicated, since bicarbonate is generated not only by buffers in the extracellular fluid but also (and to an even larger extent) by sources outside this compartment (1).…”

Section: Resultsmentioning

confidence: 99%

The Nature of the Carbon Dioxide Titration Curve in the Normal Dog*

Cohen¹,

Brackett²,

Schwartz³

1964

J. Clin. Invest.

101

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Section: Resultsmentioning

confidence: 99%

The Nature of the Carbon Dioxide Titration Curve in the Normal Dog*

Cohen¹,

Brackett²,

Schwartz³

1964

J. Clin. Invest.

101

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“…WVhole-blood pH, and the pH of separated plasma equilibrated at 380 C with a known CO2 tension (40 mm Hg), were determined at once, using the 'Radiometer' pH meter and Astrup apparatus (Astrup & Schroder, 1956; from these two pH determinations the 'standard' bicarbonate in separated plasma, and the plasma CO2 tension, were calculated as described by Astrup (1956); in three studies arterial oxygen saturation was determined spectrophotometrically (Nahas, 1951). (J0rgensen & Astrup, 1957). Although small increases occurred at variable times during diffusion respiration, the 'standard' bicarbonate concentration did not exceed 24 m-mole/l.…”

Section: R a Millarmentioning

confidence: 99%

Plasma adrenaline and noradrenaline during diffusion respiration

Millar¹

1960

The Journal of Physiology

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Draper & Whitehead (1944) showed that dogs maintained in apnoea with large doses of thiopentone could survive for periods of half an hour or longer when exposed to 100% oxygen through a patent airway at atmospheric pressure. The critical factor limiting the duration of this condition, termed 'diffusion respiration', was a severe respiratory acidosis secondary to progressive elevation of alveolar carbon dioxide tension (Draper, Whitehead & Spencer, 1947).-Provided that alveolar and tissue nitrogen are at least partially eliminated beforehand, such states of oxygenated apnoea provide an opportunity to study the effects of progressive rises in arterial C02 tension, with a minimum of interference from anoxia, and without respiratory stimulation (Holmdahl, 1956). In this study direct measurement has been made of plasma adrenaline and noradrenaline concentrations during diffusion respiration in dogs maintained in apnoea by means of a continuous infusion of succinyl choline. METHODSSeven dogs (7-16 kg) were lightly anaesthetized with intravenous thiopentone. The trachea was intubated with a No. 9 Magill cuffed portex tube, this being connected through a T-piece to an expiratory valve and a 51. rubber bag, which was kept partly filled by a flow of 100% oxygen. The femoral artery on one side was cannulated after infiltration of the groin with 5-10 ml. of 1 % lignocaine solution; arterial blood pressure was measured continuously by means of a Statham strain gauge (Model p 23-A), Sanborn amplifier and recorder; a three-way tap allowed withdrawal of blood samples as required. Heparin 10,000 u. was injected intravenously.The dogs were allowed to breathe 100 % oxygen for 20-30 min, after which spontaneous respiration was abolished by means of a continuous intravenous infusion, containing 200 mg succinyl choline chloride in each 100 ml. of 0.9% (w/v) sodium chloride solution, which was given at a very slow rate throughout each study. Before the start of diffusion respiration the dogs were ventilated manually for 10 min with 100% oxygen, using high gas flows to obtain good oxygenation with adequate elimination of nitrogen and carbon dioxide. The first arterial blood sample for assay was withdrawn during this period of ventilation. Manual respiration was then stopped and the endotracheal tube left attached to the gas bag which was kept partly filled with 100% oxygen. The expiratory valve was loose to ensure that no positive pressure was applied to the airway.

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“…The form of in vivo titration curves in man and animal are significantly different from those obtained in vitro (Cunningham, et al, 1962;Cohen, et al, 1964;Brackett et al, 1965;Linden &Norman, 1966;Norman, 1969). Alsoit has been shown by in vitro measurements that, whereas the apparent first dissociation constant of carbonic acid (pK') varies inversely with pK (Severinghaus, Stupfel & Bradley, 1956) the in vivo measurements show pK' to vary directly with pH Linden &Norman, 1966;Linden & Norman, 1970). In addition a large significant variation in pK' at any one pH and temperature has been observed in studies on the whole animal (Norman, 1969;Linden & Norman, 1970).…”

Section: H + + B a -E H B Amentioning

confidence: 93%

“…Previous methods of assessing acid-base balance (Singer & Hastings, 1948 ;Davenport, 1958 ;Astrup, Jorgensen, Siggaard Andersen & Engel, 1960;Campbell, 1962;Owen, Dudley & Masterton, 1965) have depended upon the use of the Henderson-Hasselbalch equation linking pH to the molar concentrations of carbonic acid and bicarbonate ions in plasma. It is now appreciated that the constants in this equation cannot be predicted with sufficient accuracy to warrant its use (Linden & Norman, 1966;Trenchard, Noble & Guz, 1967;Norman, 1969;Linden & Norman, unpublished observations). Finally some of the existing concepts (buffer base, standard bicarbonate, base excess and base deficit) which have evolved from studies conducted on blood in vitro are at best misleading and at their worst frankly untenable when applied to changing states within the whole animal.…”

mentioning

confidence: 94%

“…Finally some of the existing concepts (buffer base, standard bicarbonate, base excess and base deficit) which have evolved from studies conducted on blood in vitro are at best misleading and at their worst frankly untenable when applied to changing states within the whole animal. It is known that titration of the whole animal with CO, produces titration curves significantly different from those obtained by the titration of blood in vitro (Cunningham, Lloyd & Michel, 1962;Cohen, Brackett & Schwartz, 1964;Brackett, Cohen & Schwartz, 1965;Linden & Norman, 1966).…”

mentioning

confidence: 98%

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An Approach to the Problems of Acid-Base Balance

Kappagoda

Snow

1970

Clinical Science

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1. The existing methods for assessing states of acidosis are discussed with particular reference to non-respiratory acidosis. Most of these methods are based either on the Henderson-Hasselbalch equation or on the direct extrapolation of in vitro studies on blood to the whole animal. The evidence available shows that these methods cannot be used to obtain an accurate assessment of disturbances of acid-base balance in the whole animal.2. The experiments were designed to investigate the acid-base parameters of an animal when a respiratory acidosis was superimposed on a non-respiratory acidosis caused by the infusion of N HC1; from these experiments it was possible to construct COz titration curves at various levels of non-respiratory acidosis. 3.A scheme which is based upon the C02 titration curves, has been proposed for assessing an acute acid-base disturbance in terms of its respiratory and non-respiratory components.4. The use of sodium bicarbonate to correct a non-respiratory acidosis was investigated, and it was shown that the amount of sodium bicarbonate required varied with the rate of infusion. No firm predictions could be made regarding the dose of bicarbonate required, but from the results of the present experiments an infusion rate of 0.1 mEq kgg' min-' is recommended in dogs. I N T R O D U C T I O NAcid-base balance is an aspect of physiology which has engaged the attention of biochemists, clinicians and physiologists. Unfortunately due to defects in communication between these disciplines there has been a considerable degree of confusion over both the terminology and the concepts involved.A basic difficulty is that it is not possible to measure either the hydrogen ion concentration or its activity in physiological fluids. The pH numbers provided by electrometric measurements Correspondence : Professor R. J. Linden,

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Standard Bicarbonate, its Clinical Significance, and a new Method for its Determination

Cited by 137 publications

References 2 publications

The Nature of the Carbon Dioxide Titration Curve in the Normal Dog*

The Nature of the Carbon Dioxide Titration Curve in the Normal Dog*

Plasma adrenaline and noradrenaline during diffusion respiration

An Approach to the Problems of Acid-Base Balance

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