The Effect of Bicarbonate Administration via Continuous Venovenous Hemofiltration on Acid-Base Parameters in Ventilated Patients
Background. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods. Metabolic and ve...
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| Published in | BioMed research international Vol. 2015; no. 2015; pp. 1 - 8 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Cairo, Egypt
Hindawi Publishing Corporation
01.01.2015
John Wiley & Sons, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2314-6133 2314-6141 2314-6141 |
| DOI | 10.1155/2015/901590 |
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| Abstract | Background. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods. Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time. Results. During the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0 ± 14.6 versus end-study pCO2 43.8 ± 16.1 mmHg; P=0.13 for interaction with time), for those with initial pCO2 ≤40 mmHg (31.3 ± 5.7 versus 35.0 ± 4.8; P=0.06) and for those with initial pCO2 >40 mmHg (52.7 ± 12.8 versus 53.4 ± 19.2; P=0.57). pCO2 decreased during the immediate hours following CVVH initiation (42.0 ± 14.6 versus 37.3 ± 12.6 mmHg), though this change was nonsignificant (P=0.052). Conclusions. We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. |
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| AbstractList | Background. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods. Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time. Results. During the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0 ± 14.6 versus end-study pCO2 43.8 ± 16.1 mmHg; P = 0.13 for interaction with time), for those with initial pCO2 <=40 mmHg (31.3 ± 5.7 versus 35.0 ± 4.8; P = 0.06 ) and for those with initial pCO2 >40 mmHg (52.7 ± 12.8 versus 53.4 ± 19.2; P = 0.57 ). pCO2 decreased during the immediate hours following CVVH initiation (42.0 ± 14.6 versus 37.3 ± 12.6 mmHg), though this change was nonsignificant ( P = 0.052 ). Conclusions. We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Background . Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods . Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide ( p CO 2 ), serum bicarbonate, and base excess over time. Results . During the 96-hour study period, p CO 2 levels remained stable overall (initial p CO 2 42.0 ± 14.6 versus end-study p CO 2 43.8 ± 16.1 mmHg; P = 0.13 for interaction with time), for those with initial p CO 2 ≤40 mmHg (31.3 ± 5.7 versus 35.0 ± 4.8; P = 0.06) and for those with initial p CO 2 >40 mmHg (52.7 ± 12.8 versus 53.4 ± 19.2; P = 0.57). p CO 2 decreased during the immediate hours following CVVH initiation (42.0 ± 14.6 versus 37.3 ± 12.6 mmHg), though this change was nonsignificant ( P = 0.052). Conclusions . We did not detect a significant increase in p CO 2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Background . Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods . Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (p CO sub(2) ), serum bicarbonate, and base excess over time. Results . During the 96-hour study period, p CO sub(2) levels remained stable overall (initial p CO sub(2) 42.0 plus or minus 14.6 versus end-study p CO sub(2) 43.8 plus or minus 16.1 mmHg; P=0.13 for interaction with time), for those with initial p CO sub(2) < or =40 mmHg (31.3 plus or minus 5.7 versus 35.0 plus or minus 4.8; P=0.06 ) and for those with initial p CO sub(2) >40 mmHg (52.7 plus or minus 12.8 versus 53.4 plus or minus 19.2; P=0.57 ). p CO sub(2) decreased during the immediate hours following CVVH initiation (42.0 plus or minus 14.6 versus 37.3 plus or minus 12.6 mmHg), though this change was nonsignificant ( P=0.052 ). Conclusions . We did not detect a significant increase in p CO sub(2) in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Background . Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods . Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide ( p CO 2 ), serum bicarbonate, and base excess over time. Results . During the 96-hour study period, p CO 2 levels remained stable overall (initial p CO 2 42.0 ± 14.6 versus end-study p CO 2 43.8 ± 16.1 mmHg; P = 0.13 for interaction with time), for those with initial p CO 2 ≤40 mmHg (31.3 ± 5.7 versus 35.0 ± 4.8; P = 0.06 ) and for those with initial p CO 2 >40 mmHg (52.7 ± 12.8 versus 53.4 ± 19.2; P = 0.57 ). p CO 2 decreased during the immediate hours following CVVH initiation (42.0 ± 14.6 versus 37.3 ± 12.6 mmHg), though this change was nonsignificant ( P = 0.052 ). Conclusions . We did not detect a significant increase in p CO 2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Background. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Methods. Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time. Results. During the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0 ± 14.6 versus end-study pCO2 43.8 ± 16.1 mmHg; P=0.13 for interaction with time), for those with initial pCO2 ≤40 mmHg (31.3 ± 5.7 versus 35.0 ± 4.8; P=0.06) and for those with initial pCO2 >40 mmHg (52.7 ± 12.8 versus 53.4 ± 19.2; P=0.57). pCO2 decreased during the immediate hours following CVVH initiation (42.0 ± 14.6 versus 37.3 ± 12.6 mmHg), though this change was nonsignificant (P=0.052). Conclusions. We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support. Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time. During the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0±14.6 versus end-study pCO2 43.8±16.1 mmHg; P=0.13 for interaction with time), for those with initial pCO2≤40 mmHg (31.3±5.7 versus 35.0±4.8; P=0.06) and for those with initial pCO2>40 mmHg (52.7±12.8 versus 53.4±19.2; P=0.57). pCO2 decreased during the immediate hours following CVVH initiation (42.0±14.6 versus 37.3±12.6 mmHg), though this change was nonsignificant (P=0.052). We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support.BACKGROUNDAcute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is unclear in those receiving continuous venovenous hemofiltration (CVVH) and mechanical ventilatory support.Metabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time.METHODSMetabolic and ventilatory parameters were prospectively examined in 19 ventilated subjects for up to 96 hours following CVVH initiation for AKI at an academic tertiary care center. Mixed linear regression modeling was performed to measure changes in pH, partial pressure of carbon dioxide (pCO2), serum bicarbonate, and base excess over time.During the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0±14.6 versus end-study pCO2 43.8±16.1 mmHg; P=0.13 for interaction with time), for those with initial pCO2≤40 mmHg (31.3±5.7 versus 35.0±4.8; P=0.06) and for those with initial pCO2>40 mmHg (52.7±12.8 versus 53.4±19.2; P=0.57). pCO2 decreased during the immediate hours following CVVH initiation (42.0±14.6 versus 37.3±12.6 mmHg), though this change was nonsignificant (P=0.052).RESULTSDuring the 96-hour study period, pCO2 levels remained stable overall (initial pCO2 42.0±14.6 versus end-study pCO2 43.8±16.1 mmHg; P=0.13 for interaction with time), for those with initial pCO2≤40 mmHg (31.3±5.7 versus 35.0±4.8; P=0.06) and for those with initial pCO2>40 mmHg (52.7±12.8 versus 53.4±19.2; P=0.57). pCO2 decreased during the immediate hours following CVVH initiation (42.0±14.6 versus 37.3±12.6 mmHg), though this change was nonsignificant (P=0.052).We did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding.CONCLUSIONSWe did not detect a significant increase in pCO2 in response to the administration of bicarbonate via CVVH in a ventilated population. Additional studies of larger populations are needed to confirm this finding. |
| Audience | Academic |
| Author | Benda, Vinod Flythe, Jennifer E. Charytan, David M. Allegretti, Andrew S. Robinson, Emily S. |
| AuthorAffiliation | 3 Renal Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, MRB4, Boston, MA 02115, USA 1 Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, MA 02114, USA 2 Division of Nephrology and Hypertension, Department of Medicine and Genetics, UNC School of Medicine, UNC Kidney Center, 7024 Burnett-Womack, CB No. 7155, Chapel Hill, NC 27599-7155, USA |
| AuthorAffiliation_xml | – name: 3 Renal Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, MRB4, Boston, MA 02115, USA – name: 1 Division of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, MA 02114, USA – name: 2 Division of Nephrology and Hypertension, Department of Medicine and Genetics, UNC School of Medicine, UNC Kidney Center, 7024 Burnett-Womack, CB No. 7155, Chapel Hill, NC 27599-7155, USA |
| Author_xml | – sequence: 1 fullname: Robinson, Emily S. – sequence: 2 fullname: Benda, Vinod – sequence: 3 fullname: Flythe, Jennifer E. – sequence: 4 fullname: Allegretti, Andrew S. – sequence: 5 fullname: Charytan, David M. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25648653$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1007_s10157_024_02555_x crossref_primary_10_1007_s13546_017_1262_3 crossref_primary_10_1186_s40635_017_0141_6 crossref_primary_10_1007_s10877_020_00635_3 crossref_primary_10_1159_000507875 crossref_primary_10_1186_s13613_021_00850_4 |
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| Copyright | Copyright © 2015 Andrew S. Allegretti et al. COPYRIGHT 2015 John Wiley & Sons, Inc. Copyright © 2015 Andrew S. Allegretti et al. Andrew S. Allegretti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2015 Andrew S. Allegretti et al. 2015 |
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| Snippet | Background. Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base... Background . Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base... Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base parameters is... Background . Acute kidney injury (AKI) and metabolic acidosis are common in the intensive care unit. The effect of bicarbonate administration on acid-base... |
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| SubjectTerms | Acid-Base Equilibrium - drug effects Acids Adult Aged Arterial Pressure Artificial respiration Bicarbonates Bicarbonates - administration & dosage Bicarbonates - pharmacology Bicarbonates - therapeutic use Biomedical research Blood Carbon dioxide Carbon Dioxide - blood Electrolytes Female Filtration Fluids Health aspects Hemofiltration - methods Humans Hydrogen-Ion Concentration Laboratories Male Medicine Metabolism Middle Aged Mortality Nephrology Ostomy Prospective Studies Respiration, Artificial Sodium Studies Ventilators Womens health |
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| Title | The Effect of Bicarbonate Administration via Continuous Venovenous Hemofiltration on Acid-Base Parameters in Ventilated Patients |
| URI | https://search.emarefa.net/detail/BIM-1057166 https://dx.doi.org/10.1155/2015/901590 https://www.ncbi.nlm.nih.gov/pubmed/25648653 https://www.proquest.com/docview/1646349288 https://www.proquest.com/docview/1652442593 https://www.proquest.com/docview/1660409956 https://pubmed.ncbi.nlm.nih.gov/PMC4306401 |
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