• Title/Summary/Keyword: Acid-Base Balance

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Analysis of Researches on the Warming Therapy for Surgical Patients (수술 환자에게 적용한 가온요법 연구논문 분석)

  • Jun, Jum-Yi
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.260-270
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    • 2010
  • Purpose: The main question is systematic review of the published in Korea and foreign countries on warming therapy for surgical patients. Methods: The researchers searched at Medline, CINAHL, KERIS, Adult Nursing Association, Korean Society of Nursing Science, Korean Academy of fundamentals of Nursing, and National Assembly Library web site for the published on warming therapy for surgical patients from 1980 to 2008. Words for search were operation/surgery, warming, operation/surgery and warming. Studies were included randomized controlled trial, and there were no restrictions regarding operative phase and outcome measures. Results: 36 published researches that met the criteria were mostly published in foreign countries between 2000 and 2008 and focused on surgery with general anesthesia. Sample size ranged from 21 to 60 subjects, age range between 21 and 60 years of age. Thirty different warming therapies were reported, fifty-two different dependent variables. Outcome indicators included active external warming, intra-operative, and body temperature. 'Positive effects' and 'no effects' equaled. The most frequently reported 'positive effects' were body temperature, shivering, and acid-base balance. No effects were more likely to be heart rate, blood pressure, and hemodynamics. Conclusion: Many types of warming therapy, are reported in the literature with little information about the efficacy of each, many different dependant variables were studied. There were no consistent reports as to length of time used for warming procedures. Overall, the effects of warming therapy are inconsistent. And additional research must be down before any particular method of warming can be used with confidence as to its effectiveness. Attention must be made as to the research design, better measurement of the dependent variables. This review may serve as a base.

Diagnosis and Management of Acute Renal Failure in Surgical Patient (외과환자에 발생한 급성신부전의 진단과 치료)

  • Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.13-23
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    • 1984
  • Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

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Behaviors of Glucose Decomposition during Dilute-Acid Hydrolysis of Lignocellulosic Biomass (목질계 바이오매스의 묽은 산 가수분해 공정에서 포도당 분해물 거동)

  • Jeong, Tae-Su;Oh, Kyeong-Keun
    • KSBB Journal
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    • v.24 no.3
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    • pp.267-272
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    • 2009
  • During a dilute acid hydrolysis, degradation products are formed or liberated by pre-treatment of lignocelluloses depend on both the biomass and the pretreatment conditions such as temperature, time, pressure, pH, redox conditions, and addition of catalysts. In lignocellulosic biomass, sugars can be degraded to furfural which is formed from pentoses and 5-hydroxymethulfurfural (HMF) from hexoses. 5-HMF can be further degraded, forming levulinic acid and formic acid. Acetate is liberated from hemicellulose during hydrolysis. Some decomposed compounds hinder the subsequent bioconversion of the solubilized sugars into desired products, reducing conversion yields and rates during fermentation. In the present work, samples of rapeseed strawwere hydrolyzed to study the optimal pretreatment condition by assessing yields of sugars and decomposed products obtained under different reaction conditions ($H_2SO_4$ 0.5-1.25% (w/w), reaction time 0-20 min and temperature range 150-220 C). A careful analytical investigation of acid hydrolyzate of rapeseed straw has not yet been undertaken, and a well-closed mass balance for the hydrolyzate in general is necessary to verify the productivity and economic predictions for this process.

Comparative Analysis of $\alpha$-STAT and pH-STAT Strategies During Deep Hypothermic Circulatory Arrest in the Young Pig (초저체온 순환정지시 $\alpha$-STAT와 pH-STAT 조절법의 비교분석 -어린돼지를 이용한 실험모델에서-)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Won, Tae-Hee;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.553-559
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    • 1998
  • Introduction: The most dramatic application of hypothermia in cardiac surgery is in deep hypothermic circulatory arrest(DHCA). Because man in natural circumstances is never exposed to this extreme hypothermic condition, one of the controversial aspects of clinical hypothermia is appropriate acid-base management($\alpha$-stat versus pH-stat). This study aims to compare $\alpha$-stat with pH-stat for: (1) brain cooling and re-warming speed during hypothermia induction and re-warming by cardiopulmonary bypass (CPB); (2) cerebral perfusion, metabolism, and their coupling; and (3) the extent of development of cerebral edema after circulatory arrest, in young pigs. Materials & Methods: Fourteen young pigs were assigned to one of two strategies of gas manipulation. Cerebral blood flow was measured with a cerebral venous outflow technique. After a median sternotomy, CPB was established. Core cooling was initiated and continued until nasopHaryngeal temperature fell below $20^{\circ}C$. The flow rate was set at 2,500 ml/min. Once their temperatures were below $20^{\circ}C$, the animals were subjected to DHCA for 40 mins. During cooling, acid-base balance was maintained according to either $\alpha$-STAT or pH-STAT strategies. After DHCA, the body was re-warmed to normal body temperature. The animals were then sacrificed, and their brains measured for edema. Cerebral perfusion and metabolism were measured before the onset of CPB, before cooling, before DHCA, 15 mins after re-warming, and upon completion of re-warming. Results & Conclusion: Cooling time was significantly shorter with $\alpha$-stat than with pH-stat strategy, while there were no significant differences in rewarming time between the two groups. Nosignificant differences were found in cerebral blood flow, metabolic rate, or flow/ metabolic rate ratio between two groups. Temperature-related differences were significant in cerebral blood flow, metabolic rate, and flow/metabolic rate ratio within each group. Brain water content showed no significant differences between two groups.

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A Case Report of Complaining of Disturbed Liver Function in Hyperemesis Gravidarium (간기능장애를 동반한 임신악조(姙娠惡阻)환자의 치험 1례(例)에 대한 임상보고)

  • Yoo, Yung-Ki;Bea, Sang-Jin;Kim, Hyung-Jun;Lee, Dong-Nyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.4
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    • pp.279-286
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    • 2006
  • Purpose : The purpose of this study is to report the effect of oriental treatments to hyperemesis gravidarum in disturbed liver function. Methods : Hyperemesis gravidarum is a severe and intractable form of nausea and vomiting in pregnancy. It is a diagnosis of exclusion and may result in weight loss; nutritional deficiencies; and abnormalities in fluids, electrolyte levels, and acid-base balance. The peak incidence is at 4, 8-16 weeks of pregnancy. Interestingly, nausea and vomiting of pregnancy is generally associated with a lower rate of miscarriage. However disturbed diver dunction with Hyperemesis gravidarium is rare very and dangerous. Traditionally, oriental medical therapy has been used to patients with hyperemesis gravidarum and showed effective result. We treated 1 patient who had hyperemesis gravidarum in disturbed diver dunction at Se-Myung university Oriental Hospital in affiliation by Herbal medication, acupuncture and moxa therapy and got good result from them. Results : As a result, symptoms are remarkably alleviated and liver function test are improved. Conclusion : Therefore we would like to report that it is effective to cure the hyperemesis gravidarum in disturbed liver function through the herb-medication and acupuncture treatment.

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The histological structure and the pathological lesions of gill in teleosts (어류의 아기미의 조직학적 구조와 병변)

  • Huh, Min-Do;Jeong, Hyun-Do
    • Journal of fish pathology
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    • v.6 no.1
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    • pp.65-70
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    • 1993
  • The delicate histological structure of gill in teleosts can be easily affected by a variety of biological, chemical or physical detrimental agents because it is directly exposed to the surrounding water. The epithelium of secondary lamella is thin to allow efficient gaseous exchange and this also renders it particularly vulnerable to various pathogens. As well as the main respiratory role, the gill has other various important functions such as acid-base balance, osmoregulation or the excretion of nitrogenous waste products. Thus destruction of epithelial integrity such as epithelial necrosis or thickening can render a fish very vulnerable to respiratory, secretory and excretory difficulties. This article was tried to describe in detail the common processes of pathological responses correlated to the normal histological structures of the gill in teleosts.

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EFFECTS OF LYSINE AND SODIUM ON THE GROWTH PERFORMANCE, BONE PARAMETER, SERUM COMPOSITION AND LYSINE-ARGININE ANTAGONISM IN BROILER CHICKS

  • Yun, C.H.;Han, I.K.;Choi, Y.J.;Park, B.C.;Lee, H.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.4 no.4
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    • pp.353-360
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    • 1991
  • An experiment with completely randomized design was performed to investigate the effects of lysine and supplemented sodium on growth performance, nutrients utilization, acid-base balance and lysine arginine antagonism in broiler chicks. The experiment was carried out with 3 levels of dietary lysine (0.6, 1.2 and 1.8%) and 3 levels of sodium(0.4, 0.8 and 1.2%) for an experimental period of 7 weeks. Body weight gain of 1.2% lysine group was significantly (p<0.01) higher than that of low or high lysine group. The highest feed consumption was obtained at 1.2% lysine and 0.4% sodium supplemented level (ML-1.2) and the lowest at LL-1.2. The best feed efficiency was obtained at ML-0.8 level and the worst at LL-1.2 level. Mortalities of high (1.8%) and low (0.6%) lysine groups were significantly (p<0.05) higher than medium lysine (1.2%) group. Among the sodium levels, the mortality at 1.2% sodium supplemented level was significantly (p<0.01) different by the levels of dietary lysine. Lysine-arginine antagonism was observed in high lysine diet. Among the lysine levels, the lowest none weight and length were shown in low lysine group. Interactions between lysine and sodium were significantly (p<0.05) shown in femur weight. The levels of sodium and lysine affected significantly (p<0.01) the utilization of nitrogen, ether extract, total carbohydrate and energy.

Open Heart Surgery for Six Cases of the Conegnital Heart Disease (선천성(先天性) 심장병(心臟病)의 개심술(開心術) -6례(例) 수술경험(手術經驗) -)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Kihl Rho;Kim, Song Myung;Lee, Kwang Sook;Lee, Chong Kook
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.220-238
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    • 1976
  • Six cases of congenital heart disease were operated on by means of cardiopulmonary bypass between December, 1975 and April, 1976. Two cases of ventricular septal defects (VSD), two cases of VSD, associated with ruptured aneurysm of sinus Valsalva, two cases of atrial septal defects (ASD) and one case of pulmonic stenosis with patent ductus arteriosus were operated. Sarns roller pumps and Bentley Temptrol oxygenators were used for extracorporeal circulation. Pump oxygenator was primed with Ringer's lactate solution, 5% dextrose in water, mannitol, and ACD blood. Flow rate ranged from 2.0 to $2.4L/M^2/min$. Bicarbonate was added to the oxygenator with estimated amount as 15 mEq/L/hr. Venous catheters were introduced into superior and inferior vena cava, and oxygenated blood was returned to the body through aortic cannula inserted into ascending aorta. Moderate hypothermia ($30^{\circ}C$) was induced by core cooling. Aorta was cross clamped for 15 minutes and released for 3 minutes, and repeated clamping when necessary. Atrial and ventricular septal efects were closed by direct sutures. Aneurysms of sinus Valsalva ruptured into the right ventricle were repaired through right ventriculotomy by d:rect closure with Dacron patch reinforcement. Cardiopulmonary bypass time varied from 66 to 209 minutes, and aorta cross clamping time ranged from 13 to 56 minutes. Postoperative bleeding was minimal except one case who needed for evacuation of substernal hematoma. Intra- and postoperative urinary output was satisfactory. Acid-base balance, partial pressure of $O_2$, electrolytes, and hematological changes during intra- and post-perfusion period remained at the acceptable ranges. No mortality was experienced.

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Serum Mineral and Haematobiochemical Profile of Microfilariae Infected Cattle in India: Its Effects on Production and Therapy

  • Sharma, M.C.;Joshi, Chinmay
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.3
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    • pp.357-365
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    • 2002
  • A survey was under taken of six district of Northern India viz. Bareilly, Pilibhit, Udham Singh Nagar, Nainital, Almora and Rampur. The age, breed, sex and physiological status recorded. A total number of 854 cattle examined out of which lactating (274 cases), non lactating (302 cases) heifers (128 cases), calves (82 cases) and adult male (68 cases) were examined. An incidence of 4.92 percent (42) of microfilarisis was recorded. The highest prevalence was observed in Rudrapur District of Udham Singh Nagar (33.33%, 4/12), followed by Lalkaun in Nanital District (21.74%, 10/46), Rampur (12.50%, 2/16), Bareilly (8.16%, 8/98) and Pilibhit (1.22%, 1/82). No infection was observed in Almora region. Amongst 854 cattle of different group incidence was highest in adult male (12.20%, 10/82), followed by non lactating (3.82%, 12/314) and lactating (2.70%, 2/74), (7.64%, 12/157) was found in Heifers. For haemeto-biochemical, serum minerals estimations and therapeutic study 32 animals suffering from filariasis and 18 healthy animals were taken. 16 animals were treated with ivermectin $@200{\mu}g/kg $ body weight. Effect of this disease on production has also been estimated for which body weight and milk production was observed. The main clinical manifestations observed were anaemia, loss of appetite, debility, oedematous swelling especially in the abdominal region, increased heart rate, and respiration rate. Haematological changes indicated decrease in hemoglobin, total erythrocyte count, packed cell volume, erthrocyte fragility and neutrophil, whereas there was significant increase in erythrocytes sedimentation rate (ESR), total leukocyte count (TLC), lymphocyte and eosinophils. Biochemical changes showed significant reduction in the values of serum albumin, A : G ratio, where as there was significant increase in blood glucose, blood urea nitrogen (BUN), globulin, total lipid, total cholesterol, phospholipids, serum bilirubin. Serum mineral profile also altered markedly, which indicate a significant decrease in Ca, Cu, Fe, Zn, and Mn with increase value of Na and Cl. There was no significant change in P and K values. Enzyme pattern in micro filaria infected animal indicated increased level of AST, ALT, alkaline phosphatase, ornithine carbamyl transferase, sorbitol dehydrogenase, glutamate dehydrogenase, isocitric dehydrogenase and lactate dehydrogenase. In blood gas values and acid/base balance, there was an increase in $PVCo_2$ and $PVo_2$. It has been observed that microfilaria infected cattle showed decrease in body weight and milk production. Animal treated with ivermectin showed the return of these above values toward normalcy.

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs

  • Oliveira, Marilia Teresa de;Feranti, Joao Pedro Scussel;Coradini, Gabriela Pesamosca;Chaves, Rafael Oliveira;Correa, Luis Felipe Dutra;Linhares, Marcella Teixeira;Thiesen, Roberto;Silva, Marco Augusto Machado;Brun, Mauricio Veloso
    • Journal of Veterinary Science
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    • v.22 no.3
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    • pp.44.1-44.15
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    • 2021
  • Background: Intraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes. Objectives: The aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy. Methods: Twenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg-1·h-1 of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure. Results: All animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg-1·h-1), differing from the G20 group (2.17 ± 0.52 mL·kg-1·h-1) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61℃) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017). Conclusions: The use of lactated Ringer's solution at the rate of 10 mL·kg-1·h-1 seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg-1·h-1 rates of infusion.