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Diagnosis and Treatment of Inhalation Injury in Burn Patients
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Khan Z. Shirani, Joseph A. Moylan, Basil A. Pruitt
Conversely, Ogawa et al. (1972) found that 17 of 72 patients (24%) with severe carbon monoxide poisoning (unconscious on admission) expired within 1 week (7) or showed little or no change in level of consciousness (10) following a 1-hr treatment with oxygen at 2 ATA once a day for 3 days. Marked acidosis on admission was prognostic of a fatal outcome in those patients. In normal adults, it appears that up to 4 hr of exposure to oxygen at 2.5 ATA is well tolerated except for the occasional development of seizures due to the central nervous system toxicity of oxygen. High concentrations of oxygen in premature infants, on the other hand, are extremely toxic and should be avoided (Winter and Smith, 1972). From these reports, it appears that hyperbaric oxygen at 2.5-3 ATA may be used for short periods as an adjunctive therapy in severe carbon monoxide poisoning. In the absence of rigorously controlled clinical studies, the effectiveness of hyperbaric oxygen therapy remains uncertain.
Maple syrup urine disease (branched-chain oxoaciduria)
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
A number of variants of branched-chain oxoaciduria has been described in addition to the classic, severe, or neonatal form [41]. Each is milder in its clinical presentation than classic MSUD. The first of these to be described [42–45] and the second most common form has been referred to as intermittent branched-chain ketoaciduria. Involved individuals may have no problems except in the presence of some special stress, such as infection or surgery. On the other hand, this disorder too can be lethal. Patients with no symptoms at all for a period of years can suddenly develop coma, convulsions, and death following an apparently mild infection [45]. More commonly, these patients have intermittent bouts of acute ataxia. In one report, severe acidosis was a prominent clinical finding [44]. In previous editions of this book, we have cited our experience that the biochemical abnormality of the accumulation of amino acids and oxoacids in body fluids is not intermittent, even though the clinical manifestations may be. In all of these patients, the biochemical features were always demonstrable, except of course when successfully treated. We have now encountered patients who clearly fit the definition of intermittent even of the biochemistry.
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Since the urinary system eliminates such a variety of wastes, alterations in urinary function can quickly alter the composition of the blood. Along with the lungs, the kidneys perform a significant function in maintaining acid-base balance in the body, primarily by tubular reabsorption of filtered bicarbonate and excretion of hydrogen ions released by nonvolatile acids. Thus, the urinary system is involved in metabolic acidosis of several types. Renal tubularacidosis is hypokalemic (abnormally low serum potassium) in nature, while hypoaldosteronism can lead to metabolic acidosis, which is hyperkalemic. Starvation can lead to ketoacidosis, and kidney failure leads to lactic acidosis.
Preparation and exchange transfusion effect of a double polymerization human umbilical cord haemoglobin of red blood cell substitute
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2023
Wentao Zhou, Shen Li, Shasha Hao, Xintong Xie, Honghui Zhang, Jiaxin Liu, Hong Wang, Chengmin Yang
The results showed that the Beecf in the control group was higher than the GDA-HCHb group and the DBBF-GDA-HCHb group at end of ET (−13.78 ± 3.34 vs. −6.57 ± 2.50, −6.75 ± 2.42) (p < 0.05), and the Lac in the DBBF-GDA-HCHb group were significantly lower than the control group and the GDA-HCHb group at the end of ET (3.12 ± 0.63, 3.23 ± 0.48 vs. 1.70 ± 0.16) (p < 0.05). BE, Beecf and Lac are all important indicators to evaluate the body’s acidosis. The higher the Lac content in the body, the more obvious the state of acidosis. The important reason for acidosis is the lack of oxygen in the body. Hypoxic state, causing the body’s anaerobic respiration, results in excess lactic acid [30–32]. If the delivery of oxygenated blood is disrupted, hypoxia occurs and rat’s metabolism shifts to the anaerobic pathway with the production of lactic acid. With high lactic acid production, the buffer system becomes insufficient leading to rat’s acidosis, low pH. And the lower pH was positively correlated with BE increase and a trend towards higher pCO2 levels [30]. Therefore, compared with the control group, the HBOC group can better supply oxygen to the hypoxic tissues and organs. Due to the lower oxygen affinity of DBBF-GDA-HCHb, it can provide sufficient oxygen for the hypoxic body in a better and more timely manner, resulting in a significant decreasing in the lactic acid content of DBBF-GDA-HCHb group.
Arterial blood gas analysis: base excess and carbonate are predictive of noninvasive ventilation adaptation and survival in amyotrophic lateral sclerosis
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Umberto Manera, Maria Claudia Torrieri, Cristina Moglia, Antonio Canosa, Rosario Vasta, Fulvia Ribolla, Francesca Palumbo, Luca Solero, Gabriele Mora, Alessio Mattei, Adriano Chiò, Andrea Calvo
The correlation between ABG parameters and survival was found to be stronger before NIV starting (8): this could be due to the real efficacy of ventilatory therapy, that can normalize pCO2 and HCO3− blood levels if performed correctly, thus reducing the strength of correlation between ABG values and survival. The inverse correlation between pH and survival could be related to the chronic HCO3− increase in ALS patients with nocturnal hypoventilation (9); so a higher pH is a sign of chronic compensation during a respiratory failure of longer duration and thus a marker of worse prognosis in ALS. Indeed acidosis is not a common event in our patients, being usually associated with an acute respiratory failure concomitant to pneumonia or other precipitant causes (10).
Renal complications in COVID-19: a systematic review and meta-analysis
Published in Annals of Medicine, 2020
Setor K. Kunutsor, Jari A. Laukkanen
In hospitalized patients with renal manifestations of COVID-19, the prevalence of pre-existing CKD was 5.2% and that for end-stage kidney disease was 2.3%. Over hospital stays ranging from 2 to 28 days, AKI was the common outcome reported by studies; howeverelectrolyte disturbance (hyperkalaemia) was the most frequent renal complication with an incidence of 12.5% followed by AKI and RRT at 11.0% and 6.8%, respectively. Other reported complications included acidosis and alkalosis. Subgroup analyses suggested evidence of effect modification by location and pre-existing history of CKD on the incidence of AKI; the incidence of AKI was higher in the US population (than the Chinese population) and among groups with higher prevalence of pre-existing CKD (than those with lower prevalence). However, AKI incidence was comparable in younger (<60 years) and older (≥60 years) individuals.