在实验性酸化期间量化血强离子差异的pH诱导的变化:对过量解释的临床影响
Lorenzo Giosa1,2, Francesco Zadek3, Mattia Busana4
1Department of Critical Care Medicine, Guy's and St. Thomas' National Health Service Foundation Trust, London, United Kingdom.
Journal of applied physiology (Bethesda, Md. : 1985)
|February 29, 2024
概括
血强离子差异 (SID) 的变化并不总是等于全血基过量 (BE) 的变化. 专和血红蛋白负荷预测预期的SID转移,其中的偏差反映了在酸化过程中真正的BE变化.
科学领域:
- 身体生理学 身体生理学
- 生物化学 生物化学
- 酸平衡是指酸平衡的情况.
背景情况:
- 强离子差异 (SID) 是酸状态的一个关键决定因素.
- 血SID的变化通常被认为与全血基过量 (BE) 直接相关.
- 然而,像蛋白结合和跨细胞离子转移等因素使这种关系复杂化.
研究的目的:
- 在不同的生理条件下,研究血SID和全血BE之间的关系.
- 为了确定"预期"的血SID (SIDexp) 是否可以根据白蛋白和血红蛋白指数进行预测.
- 测试假设,只有SIDexp的偏差反映了BE的实际变化.
主要方法:
- 来自健康受试者和败血症患者的全血平衡,含有不同的二氧化碳度.
- 在体外诱导健康人群的贫血.
- 将乳酸或盐酸添加到全血中.
- 血SID的计算和比较,预期的SID (SIDexp) 和全血基过量 (BE).
主要成果:
- 观察到血SID变化,但它们与SIDexp的一致性很强,表明可预测的电解质再分配.
- 在BE (ΔBE) 的变化和总血SID (ΔSID) 的变化之间,一致性很弱,特别是在变化CO2的情况下.
- "非碳"SID (ΔSIDwb) 的变化,代表了SIDexp的偏差,显示了与ΔBE的强烈一致.
结论:
- 全血基过量 (BE) 仅反映了那些与可预测的电解质再分配无关的血强离子差异 (SID) 的变化.
- 专和血红蛋白电荷对于预测预期的SID转移至关重要.
- 这种理解使SID和BE在体外酸化过程中能够得到更准确的解释.
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