Arterial blood gases and electrolytes were determined in 159 cases of adult respirato-ry distress syndrome(ARDS).It was found that disordered acid-base balance was a commonfinding in various kinds of ARDS.In mild ARDS...Arterial blood gases and electrolytes were determined in 159 cases of adult respirato-ry distress syndrome(ARDS).It was found that disordered acid-base balance was a commonfinding in various kinds of ARDS.In mild ARDS,respiratory alkalosis and the combination ofrespiratory alkalosis plus metabolic alkalosis or metabolic acidosis were usually encounted,whilein moderate and severe cases of ARDS,triple acid-base disorders,respiratory acidosis,and thecombination of respiratory acidosis plus metabolic acidosis were commonly seen.Severe alkalosiswas one of the factors to result in death.展开更多
BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution th...BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis techniques.In a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital stay.AIM To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor outcomes.METHODS This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography scan.Laboratory and clinical data were obtained from electronic records.Categorical variables were compared using Fisher’s exact test.Continuous data were presented as median and interquartile range.The Mann-Whitney U test was used for comparisons.RESULTS In total,211 patients were analyzed.The mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus hydrogenii.Of those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory origin.The non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score 3.We did not find severe acid-base imbalance in this population.The analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not different between the groups.CONCLUSION Alkalemia is prevalent in COVID-19 patients.Although we did not find an association between acid-base variables and mortality,the use of Stewart’s methodology may provide insights into this severe disease.展开更多
目的探讨呼吸道合胞病毒(RSV)感染时肺T-bet(T-box expressed in T cells)表达对Th1/Th2类细胞因子分泌的调控作用。方法随机将20只SD大鼠分为对照组、RSV感染组,每组10只。在第6周时测定气道反应性;取肺组织苏木素伊红(HE)染色观察病...目的探讨呼吸道合胞病毒(RSV)感染时肺T-bet(T-box expressed in T cells)表达对Th1/Th2类细胞因子分泌的调控作用。方法随机将20只SD大鼠分为对照组、RSV感染组,每组10只。在第6周时测定气道反应性;取肺组织苏木素伊红(HE)染色观察病理改变;通过蛋白质印迹法检测T-bet在肺组织中的表达;酶联免疫吸附法检测肺组织匀浆白细胞介素4(IL-4)和干扰素Ⅱ型(IFN-γ)水平。结果 RSV感染组大鼠肺部病理学切片呈现典型的间质性肺炎表现,而且RSV感染组大鼠气道阻力程度明显高于对照组。肺组织中T-bet表达RSV感染组相对灰度值0.61±0.23较对照组0.81±0.35显著减低(t=16.345,P<0.01)。RSV感染组的IL-4蛋白水平较对照组明显增高(P<0.01),而IFN-γ蛋白水平明显减低(P<0.01)。肺T-bet蛋白水平与IFN-γ蛋白水平呈正相关(r=0.725,P<0.01),与IL-4蛋白水平及IL-4/IFN-γ比值均呈负相关(r=-0.837、-0.864,P均<0.01)。结论 RSV感染可以下调T-bet在肺组织中表达,并与Th1/Th2免疫失衡相关。展开更多
文摘Arterial blood gases and electrolytes were determined in 159 cases of adult respirato-ry distress syndrome(ARDS).It was found that disordered acid-base balance was a commonfinding in various kinds of ARDS.In mild ARDS,respiratory alkalosis and the combination ofrespiratory alkalosis plus metabolic alkalosis or metabolic acidosis were usually encounted,whilein moderate and severe cases of ARDS,triple acid-base disorders,respiratory acidosis,and thecombination of respiratory acidosis plus metabolic acidosis were commonly seen.Severe alkalosiswas one of the factors to result in death.
文摘BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis techniques.In a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital stay.AIM To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor outcomes.METHODS This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography scan.Laboratory and clinical data were obtained from electronic records.Categorical variables were compared using Fisher’s exact test.Continuous data were presented as median and interquartile range.The Mann-Whitney U test was used for comparisons.RESULTS In total,211 patients were analyzed.The mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus hydrogenii.Of those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory origin.The non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score 3.We did not find severe acid-base imbalance in this population.The analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not different between the groups.CONCLUSION Alkalemia is prevalent in COVID-19 patients.Although we did not find an association between acid-base variables and mortality,the use of Stewart’s methodology may provide insights into this severe disease.
文摘目的探讨呼吸道合胞病毒(RSV)感染时肺T-bet(T-box expressed in T cells)表达对Th1/Th2类细胞因子分泌的调控作用。方法随机将20只SD大鼠分为对照组、RSV感染组,每组10只。在第6周时测定气道反应性;取肺组织苏木素伊红(HE)染色观察病理改变;通过蛋白质印迹法检测T-bet在肺组织中的表达;酶联免疫吸附法检测肺组织匀浆白细胞介素4(IL-4)和干扰素Ⅱ型(IFN-γ)水平。结果 RSV感染组大鼠肺部病理学切片呈现典型的间质性肺炎表现,而且RSV感染组大鼠气道阻力程度明显高于对照组。肺组织中T-bet表达RSV感染组相对灰度值0.61±0.23较对照组0.81±0.35显著减低(t=16.345,P<0.01)。RSV感染组的IL-4蛋白水平较对照组明显增高(P<0.01),而IFN-γ蛋白水平明显减低(P<0.01)。肺T-bet蛋白水平与IFN-γ蛋白水平呈正相关(r=0.725,P<0.01),与IL-4蛋白水平及IL-4/IFN-γ比值均呈负相关(r=-0.837、-0.864,P均<0.01)。结论 RSV感染可以下调T-bet在肺组织中表达,并与Th1/Th2免疫失衡相关。
