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

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 HCO₃ ^- 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_tot ). The relationship between measured blood pH and HCO₃ ^- , 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_tot 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 HCO₃ ^- , 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.

SUBMITTER: Gomez DE

PROVIDER: S-EPMC7694813 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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

Gomez Diego E DE Bedford Sofia S Darby Shannon S Palmisano Megan M MacKay Robert J RJ Renaud David L DL

Journal of veterinary internal medicine 20201103 6

<h4>Objectives</h4>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<sub>3</sub> <sup>-</sup> and to determine whether clinical, acid-base, and biochemical variables on admission are associated with the mortality of sick goats.<h4>Animals</h4>One hundred forty-three sick goats.<h4>Methods</h4>Retrospective study. Calculated sSID variables include ...[more]

PMID: 33140905

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Project description:ObjectivesDerangements of chloride ion concentration ([Cl-]) have been shown to be associated with acute kidney injury and other adverse outcomes. For a physicochemical approach, however, chloride ion concentration should be considered with sodium ion concentration. This study aimed to examine the association of chloride ion concentration and the main strong ion difference (difference between sodium ion concentration and chloride ion concentration) during the first 24 hours after admission into ICU with the development of acute kidney injury and mortality.DesignRetrospective analyses using the eICU Collaborative Research Database.SettingICUs in 208 hospitals across the United States between 2014 and 2015.PatientsCritically ill patients who were admitted into the ICU.InterventionsNone.Measurements and main resultsA total of 34,801 patients records were analyzed. A multivariable logistic regression analysis for the development of acute kidney injury within 7 days of ICU admission shows that, compared with main strong iron difference 32-34 mEq/as a reference, there were significantly high odds for the development of acute kidney injury in nearly all groups with main strong iron difference more than 34 mEq/L (main strong iron difference = 34-36 mEq/L, odds ratio = 1.17, p = 0.02; main strong iron difference = 38-40 mEq/L, odds ratio = 1.40, p < 0.001; main strong iron difference = 40-42 mEq/L, odds ratio = 1.46, p = 0.001; main strong iron difference > 42 mEq/L, odds ratio = 1.56, p < 0.001). With chloride ion concentration 104-106 mEq/L as a reference, the odds for acute kidney injury were significantly higher only in chloride ion concentration less than or equal to 94 mEq/L and chloride ion concentration 98-100 mEq/L groups. Analyses conducted using inverse probability weighting showed significantly greater odds for ICU mortality in all groups with main strong iron difference greater than 34mEq/L other than the 36-38mEq/L group, as well as in the less than 26-mEq/L group.ConclusionsMain strong iron difference measured on ICU presentation to the ICU predicts acute kidney injury within 7 days, with low and, in particular, high values representing increased risk. The association between the chloride levels and acute kidney injury is statistically insignificant in models incorporating main strong iron difference, suggesting main strong iron difference is a better predictive marker than chloride on ICU admission.

Dataset Information

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

Publications

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

Similar Datasets

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