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患病山羊的酸碱平衡紊乱及其与死亡率的关系:简化的强离子差法。

Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach.

机构信息

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

J Vet Intern Med. 2020 Nov;34(6):2776-2786. doi: 10.1111/jvim.15956. Epub 2020 Nov 3.

Abstract

OBJECTIVES

To investigate the acid-base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution of sSID variables to changes in blood pH and HCO and to determine whether clinical, acid-base, and biochemical variables on admission are associated with the mortality of sick goats.

ANIMALS

One hundred forty-three sick goats.

METHODS

Retrospective study. Calculated sSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (A ). The relationship between measured blood pH and HCO , and the sSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization.

RESULTS

Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and A acidosis were acid-base disorders frequently encountered in sick goats. In sick goats, the sSID variables explained 97% and 100% of the changes in blood pH and HCO , respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats.

CONCLUSIONS AND CLINICAL IMPORTANCE

The sSID approach is a useful methodology to quantify acid-base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.

摘要

目的

使用简化强离子差(sSID)方法研究病羊的酸碱状态,确定 sSID 变量对血液 pH 和 HCO 变化的定量贡献,并确定入院时的临床、酸碱和生化变量是否与病羊的死亡率相关。

动物

143 只病羊。

方法

回顾性研究。计算的 sSID 变量包括使用 6 种电解质未测量强离子(USI)的 SID 和血浆中非挥发性缓冲离子总浓度(A)。使用逐步线性回归检查实测血液 pH 和 HCO 与 sSID 变量之间的关系。构建 Cox 比例风险模型以评估潜在预测变量与住院期间山羊死亡率之间的关联。

结果

低碳酸血症、低钾血症、高氯血症、高乳酸血症和高蛋白血症是病羊常见的异常表现。呼吸性碱中毒、强离子酸中毒和 A 酸中毒是病羊常见的酸碱紊乱。在病羊中,sSID 变量分别解释了血液 pH 和 HCO 变化的 97%和 100%。结果表明,入院时呼吸频率(<16 次/分钟)、USI 和 pH 的变化与病羊住院死亡率增加的风险相关。

结论和临床意义

sSID 方法是一种有用的方法,可以量化山羊的酸碱紊乱,并确定其发生机制。临床医生应考虑在病羊中计算 USI,作为确定预后所需信息的一部分。

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