Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Acid-Base Balance: Common Sense Approach

Acid-Base Balance: Common Sense Approach Abstract Currently, there is an unprecedented interest in acid-base problems and several new approaches have been recommended.1-4 However, the only serious challenge to the supremacy long enjoyed by the traditional methods is offered by the system of Astrup and his associates.2-5 For a complete review of this controversy the reader is referred to the recent symposium sponsored by the New York Academy of Science.6 It should be emphasized that either the Astrup system or the traditional approach can be used with excellent results if the clinician is experienced with the method in question and understands the pathophysiology of the disease state with which he is dealing. Equal emphasis should be placed on the truism that in order to evaluate an acid-base disorder by either approach, one must be familiar with the compensatory changes which occur as the result of a given primary disturbance. A common misconception is that References 1. Singer, R.B., and Hastings, A.B.: An Improved Method for the Estimation of Disturbances of the Acid-Base Balance of Human Blood , Medicine 27:223, 1948.Crossref 2. Astrup, P., et al: The Acid-Base Metabolism: A New Approach , Lancet 1:1035, 1960.Crossref 3. Peirce, E.C., II: Simplified Approach to Obtaining and Recording Acid-Base Information in Surgical Patients , Ann Surg 156:138, 1962.Crossref 4. Owne, J.A.; Dudley, H.A.F.; and Masterton, J.P.: Acid-Base Status Assessed from Measurements of Hydrogen-Ion Concentration and Pco2 , Lancet 2:660, 1965.Crossref 5. Siggaard-Anderson, O.: The Acid-Base Status of the Blood , ed 2, Baltimore: The Williams & Wilkins Company, 1964. 6. Nahas, G.G. (ed.): Current Concepts of Acid-Base Measurements , Ann NY Acad Sci 133:1, 1966. 7. Astrup, P.: Acid-Base Disorders , New Eng J Med 269:817, 1963. 8. Schwartz, W.B., and Relman, A.S.: A Critique of the Parameters Used in the Evaluation of Acid-Base Disorders , New Eng J Med 268:1382, 1963.Crossref 9. Austin, W.H.: Acid-Base Balance: A Review of Current Approaches and Techniques , Amer Heart J 69:691, 1965.Crossref 10. Gambino, S.R.: Choice of Blood for Acid-Base Studies , Lancet 1:726, 1964.Crossref 11. Campbell, E.J.M., and Howell, J.B.L.: " The Determination of Mixed Venous and Arterial CO2 Tension by Rebreathing Techniques ," in Woolmer, R.F. (ed): pH and Blood Gas Measurements , Boston: Little Brown & Company, 1959, p 102. 12. Bergofsky, E.H.; Jacobson, J.H.; and Fishman, A.P.: The Use of Lymph for the Measurement of Gas Tensions in Interstitial Fluid and Tissues , J Clin Invest 41:1971, 1962.Crossref 13. Blumentals, A.; Eichenholz, A.; and Mulhausen, R.O.: Acid-Base Equilibrium in Arterial Blood and Ascitic Fluid , Metabolism 15:414, 1966.Crossref 14. Stinebaugh, B.J., and Austin, W.H.: Acid-Base Balance: A Pattern-Analysis Diagram , New Eng J Med 275:375, 1966.Crossref 15. Poppell, J.W., et al: The Effect of Ventilatory Insufficiency on Respiratory Compensations in Metabolic Acidosis and Alkalosis , J Lab Clin Med 47:885, 1956. 16. Elkington, J.R.: Clinical Disorders of Acid-Base Regulation , Med Clin N Amer 50:1325, 1966. 17. Lennon, E.J., and Lemann, J., Jr.: Defense of Hydrogen Ion Concentration in Chronic Metabolic Acidosis , Ann Intern Med 65:265 ( (Aug) ) 1966.Crossref 18. Austin, W.H.: Letters to the Editor , Amer Heart J 70:435, 1965.Crossref 19. Moller, P.: The Hydrogen Ion Concentration in Arterial Blood: A Clinical Study of Patients with Diabetes Mellitus and Diseases of the Kidneys, Lungs and Heart , Acta Med Scand 165 ( (suppl 348) ):1, 1959. 20. Refsun, H.E.: Acid-Base Status in Patients With Chronic Hypercapnia and Hypoxemia , Clin Sci 27:407, 1964. 21. Robin, E.D.: Abnormalities of Acid-Base Regulation in Chronic Pulmonary Disease with Special Reference to Hypercapnia and Extracellular Alkalosis , New Eng J Med 268:917, 1963.Crossref 22. Dulfano, M.T., and Ishikawa, S.: Quantitative Acid-Base Relationships in Chronic Pulmonary Patients During the Stable State , Amer Rev Resp Dis 93:251, 1966. 23. van Ypersele de Strihou, C.; Brasseur, L.; and De Coninck, J.: The Carbon Dioxide Response Curve for Chronic Hypercapnia in Man , New Eng J Med 275:117, 1966.Crossref 24. Rodriguez, B., et al: In Vivo Titration of Acute Alkali Infusions in Man , Clin Res 14:369, 1966. 25. Brackett, N.C., Jr.; Cohen, J.J.; and Schwartz, W.S.: Carbon Dioxide Titration Curve of Normal Man , New Eng J Med 268:917, 1963.Crossref 26. Schwartz, W.B.; Brackett, N.C., Jr.; and Cohen, J.J.: The Response of Extracellular Hydrogen Ion Concentration to Graded Degree of Chronic Hypercapnia: The Physiologic Limits of Defense of pH , J Clin Invest 144:291, 1965.Crossref 27. Schwartz, W.B., et al: Effects of Chronic Hypercapnia on Electrolyte and Acid-Base Equilibrium: II. Recovery With Special Reference to Influence of Chloride Intake , J Clin Invest 40:1238, 1961.Crossref 28. Murray, J.F.: Carbon Dioxide Retention without Acidosis: A Common Occurrence Due to Coexisting Potassium Deficiency, abstracted , Amer Rev Resp Dis 86:126, 1962. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Acid-Base Balance: Common Sense Approach

Loading next page...
 
/lp/american-medical-association/acid-base-balance-common-sense-approach-8Gjd0Z7kz7
Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00290200106009
Publisher site
See Article on Publisher Site

Abstract

Abstract Currently, there is an unprecedented interest in acid-base problems and several new approaches have been recommended.1-4 However, the only serious challenge to the supremacy long enjoyed by the traditional methods is offered by the system of Astrup and his associates.2-5 For a complete review of this controversy the reader is referred to the recent symposium sponsored by the New York Academy of Science.6 It should be emphasized that either the Astrup system or the traditional approach can be used with excellent results if the clinician is experienced with the method in question and understands the pathophysiology of the disease state with which he is dealing. Equal emphasis should be placed on the truism that in order to evaluate an acid-base disorder by either approach, one must be familiar with the compensatory changes which occur as the result of a given primary disturbance. A common misconception is that References 1. Singer, R.B., and Hastings, A.B.: An Improved Method for the Estimation of Disturbances of the Acid-Base Balance of Human Blood , Medicine 27:223, 1948.Crossref 2. Astrup, P., et al: The Acid-Base Metabolism: A New Approach , Lancet 1:1035, 1960.Crossref 3. Peirce, E.C., II: Simplified Approach to Obtaining and Recording Acid-Base Information in Surgical Patients , Ann Surg 156:138, 1962.Crossref 4. Owne, J.A.; Dudley, H.A.F.; and Masterton, J.P.: Acid-Base Status Assessed from Measurements of Hydrogen-Ion Concentration and Pco2 , Lancet 2:660, 1965.Crossref 5. Siggaard-Anderson, O.: The Acid-Base Status of the Blood , ed 2, Baltimore: The Williams & Wilkins Company, 1964. 6. Nahas, G.G. (ed.): Current Concepts of Acid-Base Measurements , Ann NY Acad Sci 133:1, 1966. 7. Astrup, P.: Acid-Base Disorders , New Eng J Med 269:817, 1963. 8. Schwartz, W.B., and Relman, A.S.: A Critique of the Parameters Used in the Evaluation of Acid-Base Disorders , New Eng J Med 268:1382, 1963.Crossref 9. Austin, W.H.: Acid-Base Balance: A Review of Current Approaches and Techniques , Amer Heart J 69:691, 1965.Crossref 10. Gambino, S.R.: Choice of Blood for Acid-Base Studies , Lancet 1:726, 1964.Crossref 11. Campbell, E.J.M., and Howell, J.B.L.: " The Determination of Mixed Venous and Arterial CO2 Tension by Rebreathing Techniques ," in Woolmer, R.F. (ed): pH and Blood Gas Measurements , Boston: Little Brown & Company, 1959, p 102. 12. Bergofsky, E.H.; Jacobson, J.H.; and Fishman, A.P.: The Use of Lymph for the Measurement of Gas Tensions in Interstitial Fluid and Tissues , J Clin Invest 41:1971, 1962.Crossref 13. Blumentals, A.; Eichenholz, A.; and Mulhausen, R.O.: Acid-Base Equilibrium in Arterial Blood and Ascitic Fluid , Metabolism 15:414, 1966.Crossref 14. Stinebaugh, B.J., and Austin, W.H.: Acid-Base Balance: A Pattern-Analysis Diagram , New Eng J Med 275:375, 1966.Crossref 15. Poppell, J.W., et al: The Effect of Ventilatory Insufficiency on Respiratory Compensations in Metabolic Acidosis and Alkalosis , J Lab Clin Med 47:885, 1956. 16. Elkington, J.R.: Clinical Disorders of Acid-Base Regulation , Med Clin N Amer 50:1325, 1966. 17. Lennon, E.J., and Lemann, J., Jr.: Defense of Hydrogen Ion Concentration in Chronic Metabolic Acidosis , Ann Intern Med 65:265 ( (Aug) ) 1966.Crossref 18. Austin, W.H.: Letters to the Editor , Amer Heart J 70:435, 1965.Crossref 19. Moller, P.: The Hydrogen Ion Concentration in Arterial Blood: A Clinical Study of Patients with Diabetes Mellitus and Diseases of the Kidneys, Lungs and Heart , Acta Med Scand 165 ( (suppl 348) ):1, 1959. 20. Refsun, H.E.: Acid-Base Status in Patients With Chronic Hypercapnia and Hypoxemia , Clin Sci 27:407, 1964. 21. Robin, E.D.: Abnormalities of Acid-Base Regulation in Chronic Pulmonary Disease with Special Reference to Hypercapnia and Extracellular Alkalosis , New Eng J Med 268:917, 1963.Crossref 22. Dulfano, M.T., and Ishikawa, S.: Quantitative Acid-Base Relationships in Chronic Pulmonary Patients During the Stable State , Amer Rev Resp Dis 93:251, 1966. 23. van Ypersele de Strihou, C.; Brasseur, L.; and De Coninck, J.: The Carbon Dioxide Response Curve for Chronic Hypercapnia in Man , New Eng J Med 275:117, 1966.Crossref 24. Rodriguez, B., et al: In Vivo Titration of Acute Alkali Infusions in Man , Clin Res 14:369, 1966. 25. Brackett, N.C., Jr.; Cohen, J.J.; and Schwartz, W.S.: Carbon Dioxide Titration Curve of Normal Man , New Eng J Med 268:917, 1963.Crossref 26. Schwartz, W.B.; Brackett, N.C., Jr.; and Cohen, J.J.: The Response of Extracellular Hydrogen Ion Concentration to Graded Degree of Chronic Hypercapnia: The Physiologic Limits of Defense of pH , J Clin Invest 144:291, 1965.Crossref 27. Schwartz, W.B., et al: Effects of Chronic Hypercapnia on Electrolyte and Acid-Base Equilibrium: II. Recovery With Special Reference to Influence of Chloride Intake , J Clin Invest 40:1238, 1961.Crossref 28. Murray, J.F.: Carbon Dioxide Retention without Acidosis: A Common Occurrence Due to Coexisting Potassium Deficiency, abstracted , Amer Rev Resp Dis 86:126, 1962.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1967

References