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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Acetazolamide-mediated decrease in strong ion difference accounts for the correction of metabolic alkalosis in critically ill patients. | Available online http ccforum.eom content 10 1 R14 Research Acetazolamide-mediated decrease in strong ion difference accounts for the correction of metabolic alkalosis in critically ill patients Miriam Moviat1 Peter Pickkers1 Peter HJ van der Voort2 and Johannes G van der Hoeven1 Open Access Department of Intensive Care Medicine Radboud University Nijmegen Medical Centre Nijmegen The Netherlands 2Department of Intensive Care Medicine Medical Centre Leeuwarden Corresponding author Peter Pickkers p.pickkers@ic.umcn.nl Received 22 Aug 2005 Accepted 14 Dec 2005 Published 9 Jan 2006 Critical Care 2006 10 R14 doi 10.1186 cc3970 This article is online at http ccforum.com content 10 1 R1 4 2006 Moviat et al. licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License http creativecommons.org licenses by 2.0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Introduction Metabolic alkalosis is a commonly encountered acid-base derangement in the intensive care unit. Treatment with the carbonic anhydrase inhibitor acetazolamide is indicated in selected cases. According to the quantitative approach described by Stewart correction of serum pH due to carbonic anhydrase inhibition in the proximal tubule cannot be explained by excretion of bicarbonate. Using the Stewart approach we studied the mechanism of action of acetazolamide in critically ill patients with a metabolic alkalosis. Methods Fifteen consecutive intensive care unit patients with metabolic alkalosis pH 7.48 and HCO3- 28 mmol l were treated with a single administration of 500 mg acetazolamide intravenously. Serum levels of strong ions creatinine lactate weak acids pH and partial carbon dioxide tension were measured at 0 12 24 48 and 72 hours. The main strong ions in urine and pH were measured at 0 3 6 12 24 48 and 72 hours. Strong ion difference SID strong ion gap .
