Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation-Reference-Cited by-同舟云学术

Quantifying pH-induced changes in plasma strong ion difference during experimental acidosis: clinical implications for base excess interpretation

Published:2024-04-01 Issue:4 Volume:136 Page:966-976
ISSN:8750-7587
Container-title:Journal of Applied Physiology
language:en
Short-container-title:Journal of Applied Physiology

Author:

Giosa Lorenzo¹²^ORCID,Zadek Francesco³^ORCID,Busana Mattia⁴^ORCID,De Simone Giovanna⁵,Brusatori Serena⁶,Krbec Martin⁷^ORCID,Duska Frantisek⁷^ORCID,Brambilla Paolo³,Zanella Alberto⁶,Di Masi Alessandra⁵,Caironi Pietro⁸⁹,Perez Emanuele¹⁰,Gattinoni Luciano⁴^ORCID,Langer Thomas³¹¹^ORCID

Affiliation:

1. Department of Critical Care Medicine, Guy’s and St. Thomas’ National Health Service Foundation Trust, London, United Kingdom

2. Centre for Human and Applied Physiological Sciences, King’s College London, London, United Kingdom

3. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

4. Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany

5. Department of Sciences, Roma Tre University, Rome, Italy

6. Department of pathophysiology and Transplantation, University of Milan, Milan, Italy

7. Department of Anesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czechia

8. Department of Anesthesia and Critical Care, AOU S. Luigi Gonzaga, Turin, Italy

9. Department of Oncology, University of Turin, Turin, Italy

10. Department of biomedical and neuromotor sciences, Headquarter of Human physiology, University of Bologna, Bologna, Italy

11. Department of Anesthesia and Intensive Care Medicine, Niguarda Ca’ Granda, Milan, Italy

Abstract

This paper challenges the assumed equivalence between changes in plasma strong ion difference (SID) and whole blood base excess (BE) during in vitro acidosis. We highlight that redistribution of strong ions, in the form of albumin ionic-binding and transerythrocyte shifts, alters SID without affecting BE. We demonstrate that these expected SID alterations are predictable from albumin and hemoglobin’s charges, or from the noncarbonic whole blood buffer value, allowing a better interpretation of SID and BE during in vitro acidosis.

Publisher

American Physiological Society

Link

https://journals.physiology.org/doi/pdf/10.1152/japplphysiol.00917.2023

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