caa a22 4500 605510113 CHVBK 20210128100644.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10877-014-9625-z doi (NATIONALLICENCE)springer-10.1007/s10877-014-9625-z Wolf Matthew Department of Pharmacology, Physiology and Neuroscience, School of Medicine, University of South Carolina, 29209, Columbia, SC, USA aut Comprehensive diagnosis of whole-body acid-base and fluid-electrolyte disorders using a mathematical model and whole-body base excess [Elektronische Daten] [Matthew Wolf] A mathematical model of whole-body acid-base and fluid-electrolyte balance was used to provide information leading to the diagnosis and fluid-therapy treatment in patients with complex acid-base disorders. Given a set of measured laboratory-chemistry values for a patient, a model of their unique, whole-body chemistry was created. This model predicted deficits or excesses in the masses of Na+, K+, Cl− and H2O as well as the plasma concentration of unknown or unmeasured species, such as ketoacids, in diabetes mellitus. The model further characterized the acid-base disorder by determining the patient's whole-body base excess and quantitatively partitioning it into ten components, each contributing to the overall disorder. The results of this study showed the importance of a complete set of laboratory measurements to obtain sufficient accuracy of the quantitative diagnosis; having only a minimal set, just pH and PCO2, led to a large scatter in the predicted results. A computer module was created that would allow a clinician to achieve this diagnosis at the bedside. This new diagnostic approach should prove to be valuable in the treatment of the critically ill. Springer Science+Business Media New York, 2014 Acid-base balance nationallicence Fluid-electrolyte balance nationallicence Whole-body base excess nationallicence Metabolic acidosis nationallicence Bicarbonate space nationallicence Mathematical model nationallicence Atot : Electrical charge of plasma "weak” ions (mEq/lP) nationallicence ABS : Apparent bicarbonate space (lP/kg) nationallicence AG : Anion gap (mEq/lP) nationallicence AGadj : AG adjusted for albumin effect nationallicence AGc : AG corrected for albumin and Pi effects nationallicence Alb : Serum albumin nationallicence B : Blood nationallicence BE : Base excess (mEq/l) nationallicence BS : Bicarbonate space (lP/kg) nationallicence CIPE : Refers to cell-interstitial-plasma-erythrocyte model compartments nationallicence E : Erythrocyte nationallicence ECF : Extracellular fluid nationallicence Ht : Height (cm) nationallicence IPE : Refers to interstitial-plasma-erythrocyte model compartments nationallicence Hb : Hemoglobin nationallicence I : Interstitial nationallicence LBM : Lean body mass (kg) nationallicence M : Mass (mmol) nationallicence MZ : Mass times electrical valence (mEq) nationallicence P : Plasma nationallicence Pi− : Phosphate ions nationallicence SBE : Standard base excess (mEq/lB+ECF) nationallicence SID : Strong ion difference (mEq/lP) nationallicence SIG : Strong ion gap (mEq/lP) nationallicence QDV : Quantitative diagnostic variable nationallicence Wt : Weight (kg) nationallicence WBBE : Whole-body base excess (mEq/kg) nationallicence XA− : Net charge of undetermined or unmeasured ions in plasma (mEq/lP) nationallicence a : Arterial nationallicence v : Venous nationallicence [i] : Concentration of species i nationallicence Δ : Change nationallicence Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 475-490 1387-1307 29:4<475 2015 29 10877 https://doi.org/10.1007/s10877-014-9625-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9625-z text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Wolf Matthew Department of Pharmacology, Physiology and Neuroscience, School of Medicine, University of South Carolina, 29209, Columbia, SC, USA aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 475-490 1387-1307 29:4<475 2015 29 10877