Meconium aspiration syndrome in term neonates with normal acid-base status at delivery: Is it different?

2001 ◽  
Vol 184 (7) ◽  
pp. 1422-1426 ◽  
Author(s):  
Sean C. Blackwell ◽  
Julie Moldenhauer ◽  
Sonia S. Hassan ◽  
Mark E. Redman ◽  
Jerrie S. Refuerzo ◽  
...  
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Acid Base ◽  
Term Neonates ◽  
Meconium Aspiration ◽  
Acid Base Status ◽  
Normal Acid

scholarly journals Acid-Base Status Disturbances in Patients on Chronic Hemodialysis at High Altitudes

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Javier Enrique Cely ◽  
Oscar G. Rocha ◽  
María J. Vargas ◽  
Rafael M. Sanabria ◽  
Leyder Corzo ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Metabolic Alkalosis ◽  
Base Excess ◽  
Chronic Hemodialysis ◽  
High Altitudes ◽  
Acid Base ◽  
Arterial Blood ◽  
Base Disorder ◽  
Acid Base Status ◽  
Normal Acid

Background. Acid-base disorders have been previously described in patients with chronic hemodialysis, with metabolic acidosis being the most important of them; however, little is known about the potential changes in acid-base status of patients on dialysis living at high altitudes. Methods. Cross-sectional study including 93 patients receiving chronic hemodialysis on alternate days and living in Bogotá, Colombia, at an elevation of 2,640 meters (8,661 feet) over sea level (m.o.s.l.). Measurements of pH, PaCO2, HCO3, PO2, and base excess were made on blood samples taken from the arteriovenous fistula (AVF) during the pre- and postdialysis periods in the midweek hemodialysis session. Normal values for the altitude of Bogotá were taken into consideration for the interpretation of the arterial blood gases. Results. 43% (n= 40) of patients showed predialysis normal acid-base status. The most common acid-base disorder in predialysis period was metabolic alkalosis with chronic hydrogen ion deficiency in 19,3% (n=18). Only 9,7% (n=9) had predialysis metabolic acidosis. When comparing pre- and postdialysis blood gas analysis, higher postdialysis levels of pH (7,41 versus 7,50, p<0,01), bicarbonate (21,7mmol/L versus 25,4mmol/L, p<0,01), and base excess (-2,8 versus 2,4, p<0,01) were reported, with lower levels of partial pressure of carbon dioxide (34,9 mmHg versus 32,5 mmHg, p<0,01). Conclusion. At an elevation of 2,640 m.o.s.l., a large percentage of patients are in normal acid-base status prior to the dialysis session (“predialysis period”). Metabolic alkalosis is more common than metabolic acidosis in the predialysis period when compared to previous studies. Paradoxically, despite postdialysis metabolic alkalosis, PaCO2 levels are lower than those found in the predialysis period.

The Effect of Acidosis on Lactate Removal by the Perfused Rat Kidney

1976 ◽  
Vol 50 (3) ◽  
pp. 185-194 ◽  
Author(s):  
J. Yudkin ◽  
R. D. Cohen
Keyword(s):  
Rat Kidney ◽  
Acid Base ◽  
Ph Values ◽  
Constant Rate ◽  
Perfused Rat Kidney ◽  
Lactate Removal ◽  
Acid Base Status ◽  
Glucose Output ◽  
Normal Acid

1. The isolated perfused kidneys of fed rats in normal acid-base status showed a constant rate of lactate removal from the perfusate between 5 and 90 min of perfusion at a perfusate pH of 7·4–7·5. 2. Lactate removal by kidneys of rats in normal acid-base status was stimulated within 30 min by a reduction in perfusate pH to 7·1–7·2, but depressed when perfusate pH was reduced further. 3. Kidneys taken from rats previously made acidotic and perfused with media of various pH values showed a progressive fall in the rate of lactate removal during the perfusion. 4. Glucose output by the kidneys of rats in normal acid—base status perfused with lactate as substrate was not affected by an alteration in perfusate pH. The kidneys of acidotic rats generally showed an increased rate of glucose output compared with those of control rats.

scholarly journals Factors Leading To Meconium Aspiration Syndrome in Term- and Post-term Neonates

Cureus ◽  
2019 ◽  
Author(s):  
Saroop Chand ◽  
Aamna Salman ◽  
Razia Mustafa Abbassi ◽  
Abdul Rehman Siyal ◽  
Fayaz M Ahmad ◽  
...  
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Term Neonates ◽  
Meconium Aspiration

scholarly journals Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7049 ◽  
Author(s):  
Kyoko Yokoi ◽  
Osuke Iwata ◽  
Satoru Kobayashi ◽  
Kanji Muramatsu ◽  
Haruo Goto
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Meconium Aspiration Syndrome ◽  
Univariate Logistic Regression Analysis ◽  
Term Neonates ◽  
Meconium Aspiration ◽  
Independent Variable ◽  
Male Sex ◽  
Meconium Stained Amniotic Fluid

Background Meconium-stained amniotic fluid is observed in approximately 10–15% of all deliveries; however, only 5% of neonates with meconium-stained amniotic fluid develop meconium aspiration syndrome (MAS). Although foetal distress and subsequent sympathetic stimulation have been considered as the primary upstream events of MAS, this clinical complication sometimes occurs due to other pathologies, such as intraamniotic inflammation. The aim of this study was to investigate whether the incidence of MAS is associated with the presence of funisitis and chorioamnionitis in term neonates with meconium-stained amniotic fluid. Methods Between April 2013 and March 2015, a total of 95 term neonates with meconium-stained amniotic fluid, who were hospitalized at a neonatal intensive care unit, were enrolled in the study. The placenta and umbilical cord were histopathologically examined. Clinical variables and histopathological findings associated with the incidence of MAS were studied. Results A total of 36 neonates developed MAS. Univariate logistic regression analysis revealed that a heavier birth weight, male sex, 1-min Apgar score ≤ 7, funisitis (but not chorioamnionitis), and elevated acute-phase inflammatory reaction score were associated with increased incidence of MAS (all p < 0.05). The multivariate model comprised funisitis (OR = 5.03, 95% CI [1.63–15.5], 1-min Apgar score ≤ 7 (OR = 2.74, 95% CI [1.06–7.09], and male sex (OR = 3.4, 95% CI [1.24–9.34]. Conclusion In neonates with meconium-stained amniotic fluid, funisitis, as well as low 1-min Apgar score and male sex, was identified as an independent variable for MAS development. Intraamniotic inflammation might be involved in the pathological mechanisms of MAS.

scholarly journals Acid-Base Effects of a Bicarbonate-Balanced Priming Fluid during Cardiopulmonary Bypass: Comparison with Plasma-Lyte 148. A Randomised Single-Blinded Study

2008 ◽  
Vol 36 (6) ◽  
pp. 822-829 ◽  
Author(s):  
T. J. Morgan ◽  
G Power ◽  
B. Venkatesh ◽  
M. A. Jones
Keyword(s):  
Metabolic Acidosis ◽  
Cardiopulmonary Bypass ◽  
Base Excess ◽  
Strong Ion Difference ◽  
Acid Base ◽  
Elective Cardiac Surgery ◽  
Standard Base Excess ◽  
Acid Base Status ◽  
Standard Base ◽  
Normal Acid

Fluid-induced metabolic acidosis can be harmful and can complicate cardiopulmonary bypass. In an attempt to prevent this disturbance, we designed a bicarbonate-based crystalloid circuit prime balanced on physico-chemical principles with a strong ion difference of 24 mEq/l and compared its acid-base effects with those of Plasma-Lyte 148, a multiple electrolyte replacement solution containing acetate plus gluconate totalling 50 mEq/l. Twenty patients with normal acid-base status undergoing elective cardiac surgery were randomised 1:1 to a 2 litre prime of either bicarbonate-balanced fluid or Plasma-Lyte 148. With the trial fluid, metabolic acid-base status was normal following bypass initiation (standard base excess 0.1 (1.3) mEq/l, mean, SD), whereas Plasma-Lyte 148 produced a slight metabolic acidosis (standard base excess -2.2 (2.1) mEq/l). Estimated group difference after baseline adjustment was 3.6 mEq/l (95% confidence interval 2.1 to 5.1 mEq/l, P=0.0001). By late bypass, mean standard base excess in both groups was normal (0.8 (2.2) mEq/l vs. -0.8 (1.3) mEq/l, P=0.5). Strong ion gap values were unaltered with the trial fluid, but with Plasma-Lyte 148 increased significantly on bypass initiation (15.2 (2.5) mEq/l vs. 2.5 (1.5) mEq/l, P <0.0001), remaining elevated in late bypass (8.4 (3.4) mEq/l vs. 5.8 (2.4) mEq/l, P <0.05). We conclude that a bicarbonate-based crystalloid with a strong ion difference of 24 mEq/l is balanced for cardiopulmonary bypass in patients with normal acid-base status, whereas Plasma-Lyte 148 triggers a surge of unmeasured anions, persisting throughout bypass. These are likely to be gluconate and/or acetate. Whether surges of exogenous anions during bypass can be harmful requires further study.

scholarly journals A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
C. Fischer ◽  
C. Rybakowski ◽  
C. Ferdynus ◽  
P. Sagot ◽  
J. B. Gouyon
Keyword(s):  
Amniotic Fluid ◽  
Low Frequency ◽  
Population Based ◽  
Meconium Aspiration Syndrome ◽  
Population Based Study ◽  
Term Neonates ◽  
Meconium Aspiration ◽  
High Prevalence ◽  
Term Newborns ◽  
Meconium Stained Amniotic Fluid

The epidemiology of meconium aspiration syndrome (MAS) in term neonates is described in a population-based retrospective study of data recorded for all births from 2000 to 2007 in a French region (Burgundy). Of the 132 884 eligible term newborns, the rate of meconium-stained amniotic fluid (MSAF) was 7.93%. The prevalence of severe MAS was 0.067% in the overall population. MAS rate was 0.11% at 37-38 weeks of gestation (WG), 0.20% at 39–41 WG, and 0.49% at 42-43 WG. Factors independently associated with severe MAS were identified by a case-control study, that is, thick meconium amniotic fluid, fetal tachycardia, Apgar score ≤3 at 1 minute, and birth in a level III facility. Our results confirm the high prevalence of MSAF after 37 WG but also show the low frequency of severe MAS in a period corresponding to the new international recommendations on the management of birth with MSAF.

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