Sławuta P, Glińska-Suchocka K
Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland.
Pol J Vet Sci. 2012;15(1):119-24. doi: 10.2478/v10181-011-0122-8.
Classically, the acid-base balance (ABB) is described by the Henderson-Hasselbach equation, where the blood pH is a result of a metabolic components--the HCO3(-) concentration and a respiratory component--pCO2. The Stewart model assumes that the proper understanding of the organisms ABB is based on an analysis of: pCO2, Strong Ion difference (SID)--the difference strong cation and anion concentrations in the blood serum, and the Acid total (Atot)--the total concentration of nonvolatile weak acids. Right sided heart failure in dogs causes serious haemodynamic disorders in the form of peripheral stasis leading to formation of transudates in body cavities, which in turn causes ABB respiratory and metabolic disorders. The study was aimed at analysing the ABB parameters with the use of the classic method and the Stewart model in dogs with the right sided heart failure and a comparison of both methods for the purpose of their diagnostic and therapeutic utility. The study was conducted on 10 dogs with diagnosed right sided heart failure. Arterial and venous blood was drawn from the animals. Analysis of pH, pCO2 and HCO3(-) was performed from samples of arterial blood. Concentrations of Na+, K+, Cl(-), P(inorganic), albumins and lactate were determined from venous blood samples and values of Strong Ion difference of Na+, K+ and Cl(-) (SID3), Strong Ion difference of Na+, K+, Cl(-) and lactate (SID4), Atot, Strong Ion difference effective (SIDe) and Strong Ion Gap (SIG4) were calculated. The conclusions are as follows: 1) diagnosis of ABB disorders on the basis of the Stewart model showed metabolic alkalosis in all dogs examined, 2) in cases of circulatory system diseases, methodology based on the Stewart model should be applied for ABB disorder diagnosis, 3) if a diagnosis of ABB disorders is necessary, determination of pH, pCO2 and HCO3(-) as well as concentrations of albumins and P(inorganic) should be determined on a routine basis, 4) for ABB disorder diagnosis, the classic model should be used only when the concentrations of albumins and P(inorganic) are normal.
传统上,酸碱平衡(ABB)由亨德森-哈塞尔巴赫方程描述,其中血液pH值是代谢成分(即HCO3(-)浓度)和呼吸成分(即pCO2)的结果。斯图尔特模型假定,对机体酸碱平衡的正确理解基于对以下因素的分析:pCO2、强离子差(SID)——血清中强阳离子与阴离子浓度之差,以及酸总量(Atot)——非挥发性弱酸的总浓度。犬右侧心力衰竭会导致严重的血流动力学紊乱,表现为外周淤血,进而导致体腔形成漏出液,这反过来又会引起酸碱平衡的呼吸和代谢紊乱。本研究旨在使用经典方法和斯图尔特模型分析右侧心力衰竭犬的酸碱平衡参数,并比较这两种方法在诊断和治疗方面的效用。该研究对10只确诊为右侧心力衰竭的犬进行。从动物身上采集动脉血和静脉血。从动脉血样本中分析pH、pCO2和HCO3(-)。从静脉血样本中测定Na+、K+、Cl(-)、无机磷(P)、白蛋白和乳酸的浓度,并计算Na+、K+和Cl(-)的强离子差(SID3)、Na+、K+、Cl(-)和乳酸的强离子差(SID4)、Atot、有效强离子差(SIDe)和强离子间隙(SIG4)。结论如下:1)基于斯图尔特模型诊断酸碱平衡紊乱显示,所有受试犬均存在代谢性碱中毒;2)在循环系统疾病病例中,应采用基于斯图尔特模型的方法诊断酸碱平衡紊乱;3)如果有必要诊断酸碱平衡紊乱,应常规测定pH、pCO2和HCO3(-)以及白蛋白和无机磷(P)的浓度;4)对于酸碱平衡紊乱的诊断,仅当白蛋白和无机磷(P)浓度正常时才应使用经典模型。