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口服给予水合正常的新生犊牛碳酸氢钠和葡萄糖时的碱化作用。

Alkalinizing effect of NaHCO₃ with and without glucose when administered orally to euhydrated neonatal dairy calves.

机构信息

Department of Farm Animal Health, Universiteit Utrecht, Utrecht, The Netherlands.

出版信息

J Dairy Sci. 2013 Jun;96(6):3895-906. doi: 10.3168/jds.2012-6202. Epub 2013 Mar 30.

Abstract

The use of oral rehydration solutions (ORS) is well established as an effective treatment to correct water-, electrolyte-, and acid-base balance in diarrheic calves. The main ingredients of a commercial ORS are Na, glucose, and alkalinizing agents, such as NaHCO3. Particular importance is attributed to the combination of glucose and Na at a specific ratio to optimize intestinal sodium, and thereby water uptake, through the sodium-glucose co-transport. Enhancing intestinal Na absorption by combining glucose and Na in an ORS has the potential to improve the alkalinizing effect of an ORS according the strong ion theory. The objective of this study was to investigate the effect of glucose on the alkalinizing effect of NaHCO3 when administered orally. Nine healthy neonatal Holstein-Friesian calves underwent 3 oral treatments with 2-L solutions of NaHCO3 (150 mmol/L), glucose (300 mmol/L), and glucose + NaHCO3 (300 mmol/L + 150 mmol/L, respectively) in randomized order. Arterial and venous blood was obtained before treatment and in 30-min intervals thereafter for blood gas analysis and determination of plasma protein and electrolyte concentrations. Urine was collected volumetrically to determine urine volume, osmolality, pH, net acid excretion, and renal Na excretion after treatment. Plasma volume changes were extrapolated from plasma protein concentration changes. Treatment and time effects were tested with repeated measures ANOVA. Only subtle differences between oral administration of NaHCO3, with and without glucose, were observed for the change of the standard HCO3 concentration relative to baseline. No differences in plasma Na, plasma volume expansion, renal Na, net base excretion, urine volume, or pH could be identified between animals treated orally with NaHCO3 with and without glucose. Similarly, no differences in blood glucose concentration, plasma volume expansion, urine volume, or renal glucose excretion were observed in the 8h after treatment when comparing oral glucose treatment with and without NaHCO3. Our results indicate that combination of NaHCO3 with glucose in a hypertonic ORS only had a minor effect on the alkalinizing effect of NaHCO3, which is unlikely to be of clinical relevance. The combination of NaHCO3 and glucose neither improved Na, glucose, nor water absorption in euhydrated neonatal dairy calves, questioning the relevance of a specific ratio between Na and glucose in ORS for calves.

摘要

口服补液盐(ORS)已被广泛用于纠正腹泻犊牛的水、电解质和酸碱平衡,是一种有效的治疗方法。商业 ORS 的主要成分是 Na、葡萄糖和碱化剂,如 NaHCO3。特别重要的是,葡萄糖和 Na 以特定比例组合,通过钠-葡萄糖共转运来优化肠道钠的吸收,从而增加水的吸收。通过 ORS 中葡萄糖和 Na 的组合来增强肠道 Na 吸收,根据强离子理论,有可能改善 ORS 的碱化作用。本研究旨在探讨葡萄糖对口服 NaHCO3 碱化作用的影响。9 头健康的新生荷斯坦-弗里森奶牛以随机顺序接受 3 种口服治疗,分别给予 2-L 的 NaHCO3(150mmol/L)、葡萄糖(300mmol/L)和葡萄糖+NaHCO3(300mmol/L+150mmol/L)溶液。在治疗前和此后 30 分钟内采集动脉和静脉血进行血气分析,并测定血浆蛋白和电解质浓度。收集尿液进行体积测定,以测定治疗后的尿量、渗透压、pH 值、净酸排泄和肾 Na 排泄。从血浆蛋白浓度变化推断血浆容量变化。用重复测量方差分析测试处理和时间的影响。相对于基线,仅观察到口服给予 NaHCO3 时添加葡萄糖与不添加葡萄糖之间标准 HCO3 浓度变化的细微差异。口服给予 NaHCO3 时添加或不添加葡萄糖的动物之间,在血浆 Na、血浆容量扩张、肾 Na、净碱排泄、尿量或 pH 值方面均未观察到差异。同样,在治疗后 8 小时比较口服葡萄糖治疗时添加或不添加 NaHCO3 时,在血糖浓度、血浆容量扩张、尿量或肾葡萄糖排泄方面也未观察到差异。我们的结果表明,在高渗 ORS 中,将 NaHCO3 与葡萄糖结合使用仅对 NaHCO3 的碱化作用产生较小影响,这不太可能具有临床意义。在水合良好的新生奶牛犊牛中,将 NaHCO3 和葡萄糖结合使用既不能改善 Na、葡萄糖和水的吸收,也不能质疑 ORS 中 Na 和葡萄糖之间特定比例对犊牛的相关性。

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