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[Studies on extracorporeal circulation with large volume hemodilution using lactate ringer's solution and low molecular weight dextran: alterations of acid-base balance associated with intentional hemodilution (author's transl)].

Twenty mongrel dogs, weighing between 7.5 and 13.0 kg were used to investigate the percentage limits permissible for hemodilution using a double-helical reservoir heart-lung machine which has a 1,100 ml of priming volume. In both 40 and 50 per cent groups of intentional hemodilution by 30 minute extracorporeal circulation, remarkable anemia was inevitable and recovery was extremely slow, especially in the 50 per cent dilution group. In both 40 and 50 per cent groups of intentional hemodilutions by 30 minute extracorporeal circulation, metabolic acidosis was observed. In 50 per cent group of intentional hemodilution, no improvement of metabolic acidosis was observed even after perfusion. When sodium bicarbonate was administered to 40 per cent hemodilution group, minimum alterations of acid-base balance and of serum electrolytes were observed during and after extracorporeal perfusion. When sodium bicarbonate was administered to 50 per cent hemodilution group, metabolic acidosis was more evident than in 40 per cent hemodilution group accompanied with an increase in serum sodium concentration and a decrease in serum chloride concentration. These data qualify the use of 40 per cent intentional hemodilution using Lactate Ringer's solution or low molecular weight dextran for 30 minute extracorporeal circulation when sodium bicarbonate is administered in adequate amounts.

Acid-Base Equilibrium↗

[Influence of low molecular dextran on the acid-base balance in mother and fetus].

9 normal pregnant women in the active phase of labor were treated with 500 ml low molecular dextrane with a pH of 4,5 under standardised external conditions. Before and after this infusion simultaneous estimations of the maternal and fetal acid-base status were made. There was neither a maternal nor a fetal acidosis.

Acid-Base Equilibrium↗

Use of protease inhibitor (trasylol) and heparin in cardiorespiratory resuscitation. II. Gasometric investigations of arterial blood.

The purpose of the present work was to assess the effect of trasylol--an inhibitor of proteases--and heparin on gasometric values in arterial blood during cardio-respiratory resuscitation. The investigations were carried out on rabbits in three experimental groups. In group I the simplest resuscitation procedures were applied: artificial respiration with AMBU self-expanding bag and heart massage. In group II oxygen was given for respiration, heart massage was applied, cardiac, vasoactive and alkalinizing drugs were given. Group III received the above drugs and procedures but trasylol and herparin were used additionally. Cardiac arrest was obtained by means of acute hypoxia following suxamethonium administration. The investigations showed that in groups I and II despite resuscitation management arterial hypoxaemia and metabolic acidosis persisted while in group III a certain return of normal gasometric values was observed and the animals in this group survived the experiment.

Acid-Base Equilibrium↗

[Conditions for the efficacy of nutritional therapy].

This is to discuss regulatory mechanisms which enable the organism to respond optimally to special nutritive conditions. Those regulatory mechanisms are often in disorder with patients who need nutritive therapy. However, normal functions of the body are required for nutrition. Disarrangements in microcirculation, oxygen supply, water and electrolyte metabolism and acid-base metabolism are described and the way they will influence nutrition therapy. Furthermore, we try to describe special conditions of metabolism in stress and its influence to efficiency of nutritive therapy.

Acid-Base Equilibrium↗

[Peculiarities of acid-base reserves in aging].

The age-dependent peculiarities of the acid-base balance at rest and with standard loads were studied in 466 rats. It was found that with age the pH value of blood decreases, the tension of the carbonic acid increases, but the values of BB, BE, SB, and AB do not undergo any significant changes. With loads, old animals showed more profound changes in the system and these changes were of decompensated character. The maximal changes in young animals were registered 1.5 hours after loading, in old rats--3 hours after. The normalization of the shifts in old rats occurred much more slowly than in young animals, and it does not reached the initial value by 24 hours after loading. The analysis of the data obtained shows that with aging the reserve potentialities of the organism's mechanisms of the acid-base balance regulation greatly decrease, which under certain conditions results in disturbance of the given system compensation, thus exerting a negative effect on the body vital processes.

Acid-Base Equilibrium↗

[Possibilities and limits of the intrauterine reanimation (author's transl)].

Intrauterine reanimation means the removal of acute maternal or fetal distress. Beside of maternal shock (traumatic, hoaemorrhagic, supine hypotension syndrome) all acute distress situation are seen during labour. The therapeutical possibilities and premises on the one side, the limits and dangers on the other are discussed. There are the change of position in bed, infusion of low molecular dextrane, O2- breathing, buffering of the mother, infusion of vasodilatators and beta-stimulators to the mother. The main therapeutical principle for intrauterine reanimation are change of side position and beta-stimulator therapy in case of disturbances in feto-maternal respiration because of an acute utero-placental insufficiency or a cord complication. As to an own patient group with intrauterine reanimation with the beta-stimulator "Partusisten" in 174 deliveries with cardiotocographic signs of fetal distress in the first stage of labour there is shown that threatened fetal distress because of uterine hyperactivity and cord complication is successfully treated by tocolysis. In case of chronic placental insufficiency there is no therapeutical success by intra partum tocolysis in 30%.

Acid-Base Equilibrium↗

Acid-base values of standardbred horses recovering from strenuous exercise.

Blood gases, lactic acid concentrations, and pH were measured in arterial and mixed venous blood in moderately conditioned Standardbred horses after a standardized exercise load of 1.6 km in 2 minutes, 40 seconds. Samples were obtained at rest, immediately after exercise, and at 3, 6, 15, 30, and 60 minutes after exercise. Arterial oxygen tension and mixed venous oxygen tension increased after exercise, reaching peak values at 6 minutes. Arterial oxygen tension returned to the resting (preexercise) value by 15 minutes, and mixed venous oxygen tension by 30 minutes. Arterial carbon dioxide tension decreased immediately after exercise, reaching its lowest value at 6 minutes, and returned to resting value by 30 minutes. Mixed venous carbon dioxide tension reached its highest value immediately after exercise, then decreased to less than the resting value, reaching its lowest value by 15 minutes, and returned to normal by 60 minutes. Lactic acid concentration increased immediately after exercise, reaching its highest value at 6 minutes, and returned toward normal by 60 minutes. Arterial pH decreased immediately after exercise, reaching its lowest value at 6 minutes, and returned to normal by 60 minutes. Mixed venous pH reached its lowest value immediately after exercise, then began to increase, and returned to normal by 60 minutes. The decrease in mixed venous pH was more pronounced than that in arterial blood since, in addition to the increase in lartic acid, there was a considerable increase in mixed venous carbon dioxide tension.

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[Blood sugar and hypoxic dynamics in metabolic acidosis and alkalosis (experimental data)].

The dynamics of the glucose concentration and arterovenous glucose gradient was examined during different metabolic deviations in the acid-base balance. The metabolitic acidosis increased the level of sugar in the blood. A definite influence on the latter had the gravity of the acidosis and to a certain degree its pathogenetic form. The arterio-venous glucose difference changed from negative to positive with the increase of proton activity. The type of the peripheral hypoxic structure, formed during the state of acidosis influenced both the glucose gradient and its quantitative relations to the acid-base and oxygen indices. The sugar content in the blood during metabolitic alcalosis was not changed significantly. There was an increase in the arterio-venous gradient and inverse correlation between the glucose level and the arterio-venous oxygen difference with the increase of the bicarbonate concentration.

Acid-Base Equilibrium↗

[Blood acid-base changes produced by variations of water oxygenation in the crab Carcinus maenas (author's transl)].

10 Blood acid-base changes were studied at 17 degrees C in immersed crabs (Carcinus maenas) exposed to hypoxic and hyperoxic conditions, by measuring the pH and the CO2 partial pressure, PbCO2, and by calculating the bicarbonate concentration. 20 Hyperoxia first induces a marked respiratory acidosis with a rise of PbCO2. This acidosis is compensated thereafter by a non-ventilatory increase of the blood buffer base concentration. These results are discussed in relation to the general problems concerning the control of the blood acid-base balance in aquatic animals.

Acid-Base Equilibrium↗

Thiopental anaesthesia and the acid-base balance in the blood of experimental dogs.

An analysis of basic parameters representative of the acid-base balance was made in arterial blood samples from 140 clinically healthy dogs, under a general intravenous Thiopental anaesthesia. The following mean values +/- S.E.M. were obtained: pH = 7.33 +/- 0.01; pCO2 = 47.16 +/- 0.95; base excess = -2.12 +/- 0.27; buffer base = 46.63 +/- 0.37. The results showed a prevalent trend of lower values of pH, base excess and buffer base and higher values of pCO2 than those found commonly in human clinical practice. Special attention was paid to the respiratory component of the acid-base balance (ABB) revealing certain undesirable side effect of Thiopental anaesthesia.

Acid-Base Equilibrium↗

[Accidental peroperative hypothermia during rapid transfusion].

Six cases of grave hypothermias are reported, having arisen during surgical interventions which necessitated a rapid and abundant transfusion of badly warmed blood. The role of favouring factors, surrounding cold due to the air-conditioning, anaesthesia, extent of the area of operation, seems important. The symptomatology permits the individualization of a hypothermic syndrom neighbouring the picture described in toxic accidental hypothermias. Accidents during the warming process associate collapse and disturbances in coagulation. It is therefore necessary to consider certain signs of alarm as important and generalize the conditions for prevention of thermolysis in the operating theatre.

Acid-Base Equilibrium↗

[Effect of peripheral counterpulsation on the body of an animal with intact heart].

The effect of lasting peripheral counterpulsation upon the haemodynamics and the main biochemical factors of the blood was studied in 14 dogs with intact hearts. In cases of significant tachycardia counterpulsation in a 1:2 regimen results in only a partial reduction of the resistance to the cardiac output. This does not always permit to prevent the formation of the phenomenon of an elevated myocardial contractility. The haemodynamic conditions are most optimal in a 1:1 regimen of counterpulsation. Slowing down of the cardiac rhythm was achieved by means of hypothermia.

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[Effects of acid-base changes upon the chronotropic response to norepinephrine (author's transl)].

The effect of changes in pH produced by changing NaHCO2 at constant pCO2 and by changing pCO2 at constant NaHCO2 concentration was studied in the spontaneous beating rat atrium. Alkalosis produced either by changes in pCO2 or in NaHCO2 concentration increased basal heart rate shifting dose-response curves to norepinephrine upwards. When these dose-response curves were analysed for a horizontal shift, it was found that the necessary dose to produce a given effect was lesser in alkalosis than in acidosis. This shift was significant at the ED10 and at ED30 when the pCO2 was lowered and at ED30, ED50 and ED70 when the NaHCO2 concentration was increased. Beta-adrenergic blockade did not prevent the rate increasing effect of alkalosis. Our results suggest that there is a sensitizing effect to norepinephrine in alkalosis superimposed to a direct effect of pH upon heart rate.

Acid-Base Equilibrium↗

[Computer experience and further developments in the respiratory function laboratory (author's transl)].

Reported is on satisfactory results obtained with a small-size computer consisting of punching and scanning device, as well as plain writing machine in the respiratory function laboratory. Developed in on- as well as off-line processing by an own technical staff, a diagnostic and teaching program was established for all respiratory function routine methods with the advantages of a large number of cases examined, elimination of sources of error, considerable supply of data and information, automatic documentation and filing, plain writing, interpretation and evaluation of findings. In continuation of such works also the blood gas analysis has been included. These values as the total of disturbances of the pathophysiological acid-base status are considered and interpreted. Clinical correction is forced in this man-machine dialogue by automatic stops of the whole machinery before going on. Subsequently and in addition are computer alveolar-arterial oxygen pressure gradient, venous shunt and oxygen saturation and expressed utilizing the capacity of the small-size computer. Further developments in the respiratory function diagnostic- and teaching program for small-size computers--not too expensive in the building block principle - are intended.

Acid-Base Equilibrium↗

Acid-base parameters in the dehydrated camel.

The effect of prolonged (10 days) dehydration on acid-base parameters of camel blood was examined. The pH and PCO2 levels rose significantly in the course of dehydration. This state was comparable with compensated non-respiratory alkalosis found in other animals. The plasma sodium, and magnesium levels rose significantly also. The plasma oxygen and calcium levels declined significantly. There were no significant changes in potassium and phosphate levels. It is concluded that the changes found in acid-base status following dehydration are further evidence of water preservation mechanisms in the dehydrated camel.

Acid-Base Equilibrium↗