Base excess and strong ion difference: clinical limitations related to inaccuracy.
نویسندگان
چکیده
the use of genotyping to stratify patients according to the risk of a disease, such as prolonged QT interval syndrome or myocardial infarction; the use of genotyping to increase our understanding of drug pharmacokinetics and pharmocodynamics; and the use of genetics for tissue engineering and the cloning of several different species. Recently, the National Human Genome Research Institute announced the formation of the International HapMap project, which will attempt to improve the ease and accuracy of human genetic risk profiling by creating a haplotype map consisting of approximately 500,000 tag single nucleotide polymorphisms from the more than 10 million that exist within the human genome. Even in diseases such as Huntington chorea, in which identification of the specific causative mutation has yet to lead to improved treatment, patients and their families have benefited from genetic counseling. All of these mind-boggling accomplishments have occurred within a single generation. Is perioperative functional genomics ready for prime time? Maybe not quite yet. But one thing is assured: If genetic advances continue to occur at the current rate and the discipline of anesthesiology remains on the sidelines, we may very well find ourselves in the scientific “reruns” instead of at the forefront of novel, cutting-edge research.
منابع مشابه
Hyperchloremic acidosis in the critically ill: one of the strong-ion acidoses?
Decreases in plasma bicarbonate are associated with hyperchloremic acidosis and lactic acidosis. According to the Stewart approach to acid-base physiology, the strong-ion difference regulates plasma bicarbonate, with chloride and lactate being the only strong anions routinely measured in clinical chemistry. We hypothesized that the plasma strong-ion difference, both with and without lactate, wo...
متن کاملAnalytic calculation of physiological acid-base parameters in plasma.
Analytic expressions for plasma total titratable base, base excess (DeltaCB), strong-ion difference, change in strong-ion difference (DeltaSID), change in Van Slyke standard bicarbonate (DeltaVSSB), anion gap, and change in anion gap are derived as a function of pH, total buffer ion concentration, and conditional molar equilibrium constants. The behavior of these various parameters under respir...
متن کاملQuantitative analysis of acid-base disorders in patients with chronic respiratory failure in stable or unstable respiratory condition.
BACKGROUND The Stewart approach theorizes that plasma pH depends on P(aCO₂), the strong ion difference, and the plasma total concentration of non-volatile weak acids (A(tot)). The conventional approach measures standardized base excess, bicarbonate (HCO₃⁻), and the anion gap. OBJECTIVE To describe acid-base disorders with the Stewart approach and the conventional approach in patients with chr...
متن کاملCalculation of physiological acid-base parameters in multicompartment systems with application to human blood.
A general formalism for calculating parameters describing physiological acid-base balance in single compartments is extended to multicompartment systems and demonstrated for the multicompartment example of human whole blood. Expressions for total titratable base, strong ion difference, change in total titratable base, change in strong ion difference, and change in Van Slyke standard bicarbonate...
متن کاملBase excess or buffer base (strong ion difference) as measure of a non-respiratory acid-base disturbance.
Stewart in 1983 (Can J Physiol Pharmacol 1983: 61: 1444) reintroduced plasma buffer base under the name "strong ion difference" (SID). Buffer base was originally introduced by Singer and Hastings in 1948 (Medicine (Baltimore) 1948: 27: 223). Plasma buffer base, which is practically equal to the sum of bicarbonate and albuminate anions, may be increased due to an excess of base or due to an incr...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Anesthesiology
دوره 100 2 شماره
صفحات -
تاریخ انتشار 2004