Latest documents http://publikationen.ub.uni-frankfurt.de/index/index/ Wed, 17 Oct 2012 11:17:49 +0200 Wed, 17 Oct 2012 11:17:49 +0200 http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/26791 INTRODUCTION: Metabolic acidosis during hemorrhagic shock is common and conventionally considered to be due to hyperlactatemia. There is increasing awareness, however, that other nonlactate, unmeasured anions contribute to this type of acidosis. METHODS: Eleven anesthetized dogs were hemorrhaged to a mean arterial pressure of 45 mm Hg and were kept at this level until a metabolic oxygen debt of 120 mLO2/kg body weight had evolved. Blood pH, partial pressure of carbon dioxide, and concentrations of sodium, potassium, magnesium, calcium, chloride, lactate, albumin, and phosphate were measured at baseline, in shock, and during 3 hours post-therapy. Strong ion difference and the amount of weak plasma acid were calculated. To detect the presence of unmeasured anions, anion gap and strong ion gap were determined. Capillary electrophoresis was used to identify potential contributors to unmeasured anions. RESULTS: During induction of shock, pH decreased significantly from 7.41 to 7.19. The transient increase in lactate concentration from 1.5 to 5.5 mEq/L during shock was not sufficient to explain the transient increases in anion gap (+11.0 mEq/L) and strong ion gap (+7.1 mEq/L), suggesting that substantial amounts of unmeasured anions must have been generated. Capillary electrophoresis revealed increases in serum concentration of acetate (2.2 mEq/L), citrate (2.2 mEq/L), alpha-ketoglutarate (35.3 microEq/L), fumarate (6.2 microEq/L), sulfate (0.1 mEq/L), and urate (55.9 microEq/L) after shock induction. CONCLUSION: Large amounts of unmeasured anions were generated after hemorrhage in this highly standardized model of hemorrhagic shock. Capillary electrophoresis suggested that the hitherto unmeasured anions citrate and acetate, but not sulfate, contributed significantly to the changes in strong ion gap associated with induction of shock. Dirk Steffen Brügger; Gregor I. Kemming; Matthias Jacob; Franz Georg Meisner; Christoph J. Wojtczyk; Kristian Packert; Peter E. Keipert; N Simon Faithfull; Oliver Habler; Bernhard F. Becker; Markus Rehm article http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/26791 Wed, 17 Oct 2012 11:17:49 +0200 http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/13664 Matthias Jacob Schleiden book http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/13664 Thu, 21 Jan 2010 14:47:20 +0100 http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9232 Matthias Jacob Schleiden book http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9232 Tue, 22 Aug 2006 09:33:35 +0200 http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9233 Matthias Jacob Schleiden book http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9233 Tue, 22 Aug 2006 09:33:35 +0200 http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9234 Matthias Jacob Schleiden book http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/9234 Tue, 22 Aug 2006 09:33:35 +0200