Blood Gas Profile Research Articles

Simple method to make a supersaturated oxygen fluid.

Intravenous oxygenation has demonstrated significant increase in partial pressure of oxygen (PO2) in animal models. A highly dissolved oxygen solution might be able to provide a sufficient level of oxygen delivery to the tissues and organs in patients with hypoxia. However, conventional fluid oxygenation methods have required the use of original devices. If simpler oxygenation of a solution is possible, it will be a useful strategy for application in clinical practice. We simply developed its administration by injection of either air or oxygen gas into conventional saline. We determined the PO2 values in the solutions in comparison with conventional saline in vitro. To examine the effects of the administration of the new solutions on the blood gas profile, we diluted bovine blood with either conventional or the new solutions and analyzed PO2, oxygen saturation (SO2) and total oxygen content. PO2 levels in the blood and new solution mixture significantly increased with each additional injected gas volume. Significant increases in the PO2 and SO2 of the bovine blood were found in those blood samples with the new solution, as compared with those with the control solution. These results suggest that this solution promotes oxygen delivery to the hypoxic tissue and recovery from hypoxia. This method is simpler and easier than previous methods.

Patterns of Microvascular Response to Refractory Shock and Their Modulation by Vasoactive Resuscitations

Objective: Progressive hemorrhagic shock (HS) causes splanchnic vasoconstriction and hypo-perfusion together with profound depletions of cellular cytosolic energy phosphates (ATP). Cellular energy failure and the splanchnic hypo-perfusion are critical to the pathogenesis of shock decompensation and the subsequent death from cardiocirculatory arrest. We recently demonstrated post-resuscitation survival benefit for cellular cytosolic ATP replenishment but not for vasopressors use in a rat model of refractory HS. The aim of this study was to determine the effects of progressive HS on the splanchnic microvasculature, and to compare the effects of adjuvant resuscitations with either norepinephrine, vasopressin or lipid vesicles encapsulating ATP (ATPv) on this microvasculature. Methods: 40-male Sprague-Dawley rats were randomized into 4 groups of 10 each: HS/conventionalresuscitation (CR), HS/CR+Norepinephrine, HS/CR+Vasopressin, and HS/CR+ATPv. HS=initial removal of 30% of the calculated blood volume plus subsequent transection of the spleen for uncontrolled haemorrhage until a predefined intervention set-point was achieved; CR=shed blood returned+double the shed blood volume as lactated Ringer’s solution. Four-level intestinal microvascular A1 through A4 arterioles (100–8 μm diameter) in the terminalileum were continuously monitored with intravital-microscopy, and their diameters were measured at baseline, during shock, after completion of resuscitation, and during a 2 h post-resuscitation observation period. In addition, we recorded measurements of the mean arterial pressure, shock index, blood-gas profiles, and complete metabolic panels. Results: Progressive HS caused bimodal arteriole responses with progressive vasoconstriction from baseline of first-order A1 and second-order A2 (-22.1 ± 1.9%), a progressive vasodilation of the third-order A3 and fourth-order A4 arterioles (+22.2 ± 2.8%). Resuscitation initially restored A1 and A2 diameters to near baseline. This was followed by post-resuscitation A1 and A2 vasoconstriction in all groups, except the ATPv group (-8.1 ± 3.4%). The hemorrhage-induced vasodilation of the A3 and A4 arterioles was maintained during the post-resuscitation observation period in the CR (+55.3 ± 6.4%) and the ATPv groups (+39.5 ± 5.2%), but remarkably attenuated in the norepinephrine (+9.6 ± 5.8%) and vasopressin (+9.4 ± 8.8) groups. Conclusions: Severe hemorrhagic shock causes specific splanchnic microvascular bimodal response that is dependent on arteriolar level. First-order A1 and second-order A2 arterioles exhibit progressive vasoconstriction, whereas, third-order A3 and fourth-order A4 arterioles show progressive vasodilation. Temporary administration of either norepinephrine or vasopressin along with conventional resuscitation exerted deleterious effects at all splanchnic microvascular levels by virtue of their peripheral vascular actions. The cellular cytosolic ATP replenishment maintained a better microvascular profile when compared with the two vasopressors.

Acute and Chronic Management in an Atypical Case of Ethylmalonic Encephalopathy.

Ethylmalonic encephalopathy (EE) is caused by mutations in the ETHE1 gene. ETHE1 is vital for the catabolism of hydrogen sulfide (H2S). Patients with pathogenic mutations in ETHE1 have markedly increased thiosulfate, which is a reliable index of H2S levels. Accumulation of H2S is thought to cause the characteristic metabolic derangement found in EE. Recently introduced treatment strategies in EE, such as combined use of metronidazole (MNZ) and N-acetylcysteine (NAC), are aimed at lowering chronic H2S load. Experience with treatment strategies directed against acute episodes of metabolic decompensation (e.g., hemodialysis) is limited. Here we present an unusually mild, molecularly confirmed, case of EE in a 19-year-old male on chronic treatment with MNZ and NAC. During an acute episode of metabolic decompensation, we employed continuous renal replacement therapy (CRRT) to regain metabolic control. On continuous treatment with NAC and MNZ during the months preceding the acute event, plasma thiosulfate levels ranged from 1.6 to 4μg/mL (reference range up to 2μg/mL) and had a mean value of 2.5μg/mL. During the acute decompensation, thiosulfate levels were 6.7μg/mL, with hyperlactatemia and perturbed organic acid, acylglycine, and acylcarnitine profiles. CRRT decreased thiosulfate within 24h to 1.4μg/mL. Following discontinuation of CRRT, mean thiosulfate levels were 3.2μg/mL (range, 2.4-3.7μg/mL) accompanied by clinical improvement with metabolic stabilization of blood gas, acylcarnitine, organic acid, and acylglycine profiles. In conclusion, CRRT may help to regain metabolic control in patients with EE who have an acute metabolic decompensation on chronic treatment with NAC and MNZ.

Single Ventilation during Cardiopulmonary Resuscitation Results in Better Neurological Outcomes in a Porcine Model of Cardiac Arrest.

PurposeRecent basic life support (BLS) guidelines recommend a 30:2 compression-to-ventilation ratio (CV2) or chest compression-only cardiopulmonary resuscitation (CC); however, there are inevitable risks of interruption of high-quality cardiopulmonary resuscitation (CPR) in CV2 and hypoxemia in CC. In this study, we compared the short-term outcomes among CC, CV2, and 30:1 CV ratio (CV1).Materials and MethodsIn total, 42 pigs were randomly assigned to CC, CV1, or CV2 groups. After induction of ventricular fibrillation (VF), we observed pigs for 2 minutes without any intervention. Thereafter, BLS was started according to the assigned method and performed for 8 minutes. Defibrillation was performed after BLS and repeated every 2 minutes, followed by rhythm analysis. Advanced cardiac life support, including continuous chest compression with ventilation every 6 seconds and intravenous injection of 1 mg epinephrine every 4 minutes, was performed until the return of spontaneous circulation (ROSC) or 22 minutes after VF induction. Hemodynamic parameters and arterial blood gas profiles were compared among groups. ROSC, 24-hour survival, and neurologic outcomes were evaluated at 24 hours.ResultsThe hemodynamic parameters during CPR did not differ among the study groups. Partial pressure of oxygen in arterial blood and arterial oxygen saturation were lowest in the CC group, compared to those in the other groups, during the BLS period (p=0.002 and p<0.001, respectively). The CV1 groups showed a significantly higher rate of favorable neurologic outcome (swine CPC 1 or 2) than the other groups (p=0.044).ConclusionCPR with CV1 could promote better neurologic outcome than CV2 and CC.

Prediction of Post Operative Complication in Patients with Valvular Heart Surgery Based on O2 Challenge Test and A-A Gradient.

Patients with valvular heart diseases may have more physiological lung derangements and therefore at current study we studied correlation of O2 challenge, A-AG tests and spirometry values of patients who underwent valve surgery on post op respiratory complications. Method: 180 adult patients undergoing non-emergency cardiac valvular surgery were studied. On operating room all patients had arterial blood gas profile (ABG) at room air, 20 minutes after putting on ventilator with 100% O2, and pump oxygenator. Pulmonary function tests, alveolar Oxygen Pressure, mean Arterial pressure of carbon dioxide and alveolar -arterial gradients measured. Results: FEV1, FVC and FEV1/FVC%, pressure of arterial Blood Gasses (O2 and CO2) with fraction of inspired oxygen of 100% and air (PO2-100 and PO2-air), were significantly different between patients with POPC and patients without POPC (p-value <0.05). Indeed PO2-100 and PO2-air were significantly lower in patients with POPC. A-AG100 (p-value: 0.02) and A -AG21 (p-value: 0.02) were significantly higher in patients with POPC in comparison with patients without POPC. The AUC of A-AG100 for predicting POPC was 0.59 (95% confidence interval (CI) 0.51-0.67). The optimal cut point of A-AG100 was 311 and showed evidence of high relatively sensitivity of 80% and a negative predictive value of 61%. Conclusion: Valvular heart surgery still has significant post op complication and mortality. There is significant correlation between A-AG100, A-AG21 percent, PaO2100, and FEV1/FVC with post op complications in these patients. We recommend measurement of these values in pre op evaluation of patient who need cardiac surgery.

Chloride:Sodium Ratio May Accurately Predict Corrected Chloride Disorders and the Presence of Unmeasured Anions in Dogs and Cats.

Disorders of chloride and mixed acid–base disturbances are common in veterinary emergency medicine. Rapid identification of these alterations and the presence of unmeasured anions aid prompt patient assessment and management. This study aimed to determine in dogs and cats if site-specific reference values for [Cl−]:[Na+] ratio and [Na+] − [Cl−] difference accurately identify corrected chloride abnormalities and to evaluate the predictive ability of the [Cl−]:[Na+] ratio for the identification of unmeasured anions. A database containing 33,117 canine, and 7,604 feline blood gas and electrolyte profiles was generated. Institution reference intervals were used to calculate site-specific reference values for the [Cl−]:[Na+] ratio and the [Na+] − [Cl−] difference. Contingency tables were used to assess the ability of these values to correctly identify corrected chloride disorders. Unmeasured anions were estimated by calculating strong ion gap (SIG). Continuous variables were compared using the Mann–Whitney U test. Correlations between continuous variables were assessed using Spearman’s rho (rs). In dogs, site-specific reference values for the [Cl−]:[Na+] ratio correctly identified 94.6% of profiles as hyper-, normo-, or hypochloremic. For dogs with normal sodium concentrations, site-specific reference values for the [Na+] − [Cl−] difference correctly identified 97.0% of profiles. In dogs with metabolic acidosis (base deficit > 4.0), [Cl−]:[Na+] ratio and SIG were moderately but significantly negatively correlated (rs −0.592, P < 0.0001). SIG was significantly greater in dogs with metabolic acidosis and hypochloremia compared to those without hypochloremia (P < 0.0001). In cats, site-specific reference values for the [Cl−]:[Na+] ratio correctly identified 93.3% of profiles as hyper-, normo-, or hypochloremic, while site-specific reference values for [Na+] − [Cl−] difference correctly identified 95.1% of profiles. In cats with metabolic acidosis [Cl−]:[Na+] ratio and SIG were moderately significantly negatively correlated (rs −0.730, P < 0.0001). SIG was significantly greater in cats with metabolic acidosis and hypochloremia compared to those without hypochloremia (P < 0.0001). Site-specific values for [Cl−]:[Na+] ratio and [Na+] − [Cl−] difference accurately identify corrected chloride disorders in both dogs and cats and may aid identification of the presence of unmeasured anions.

Clinical, blood gas and biochemical profile of diarrheic dairy calves fed starter concentrate containing citrus pulp as a replacement for corn

ABSTRACT: The objective of this study was to evaluate clinical signs, gas analysis, and metabolic effects of diarrhea in milk-fed calves consuming starter feed containing citrus pulp (CP) as a replacement for corn. Twenty-four newborn Holstein male calves were distributed into treatments according to starter composition: (1) 0% CP, (2) 32% CP, (3) 64% CP, on dry matter basis. The calves were housed in individual hutches, with free access to water and concentrate, and received 4 L/d of milk replacer. After diarrhea diagnosis, evaluations of fecal score, score of clinical signs and measurement of physiological parameters were performed three times a day during 3-d. Blood samples were collected for electrolytes, blood gases, and plasma biochemical analysis. Starter feed composition had no negative effect (P&gt;0.05) on fecal score, characteristics of diarrheic stools and on the aggravation of diarrhea clinical signs. Biochemical, blood gases and electrolytes changes, as a function of starter composition, did not resulted (P&gt;0.05) in dehydration, acidosis, or other metabolic disturbance animals. Total lactate and D-lactate plasma concentrations were higher for calves on control and 64% CP, and L-lactate was highest for the 64% CP; however, calves showed no signs of metabolic acidosis. Thermal comfort indexes influenced clinical and physiological parameters (P&lt;0.05). Citrus pulp may replace corn in starter composition without prejudice to intestinal health or metabolism of young diarrheic calves.

Effects of restricted vs. step up dietary adaptation for 6 or 9days on feedlot performance, feeding behaviour, ruminal and blood variables of Nellore cattle.

This study was designed to determine effects of quantitatively restricted intake of the final finishing diet as a means of dietary adaptation compared with diets increasing in concentrate (step up) over periods of 6 and 9 days on feedlot performance, carcass characteristics, feeding behaviour, blood gas profile and rumen morphometrics of Nellore cattle. One hundred twenty 22-month-old Nellore bulls (352±20kg) were randomly allocated in 24 pens and fed for 84 days. The experimental design was a completely randomized block with 2×2 factorial arrangement of treatments: adaptation using either step up protocol for 6 days or 9 days or restriction protocol for 6 days or 9 days, where the pen (five bullocks/pen; six pens/treatment) was considered the experimental unit. Cattle adapted by step up protocol had significantly greater average daily gain throughout the study when compared to those adapted by restriction protocol, regardless of adaptation length. During the adaptation period, a greater dry matter intake fluctuation was observed for animals maintained on restriction programme when compared to those adapted to the finishing diets using step up protocol. In addition, a protocol×length interaction for rumenitis scores was observed, where the level of injuries to the ruminal wall was significantly higher for the cattle adapted by restriction protocol for 9 days and lower for animals submitted for 9 days to the step up programme. Likewise, a protocol×length interaction for mitotic index was observed, in which cattle adapted by step up protocol for 9 days had lower numbers of cells in mitosis. Thus, the step up protocol led to better feedlot performance, and based on this fact, the length of 9days promoted better rumen epithelium adaptation of Nellore cattle to high-concentrate diets.

Effects of feeding time with betaine diet on growth performance, blood markers, and short chain fatty acids in meat ducks exposed to heat stress

The objective of this study was to determine effect of the diet containing 1200 betaine diet on blood biomarkers, electrolytes, gas and cecum short-chain fatty acid profile in meat ducks exposed to very hot environment (high relative humidity) conditions from d 21–42 (11:00 to 17:00h; 33–43°C; 70% relative humidity). On the day of hatching, a total of 320 meat ducks(average, 48.6g body weight) were randomly assigned to 4 treatments with 4 pens per treatment and 20 ducks per pen for 42 d. Dietary treatments consisted of: 1) the control diet fed ad libitum, 2) the betaine diet fed ad libitum, 3) the betaine diet fed from 05:00 to 10:00 and 17:00 to 20:00h, and 4) the betaine diet fed from 17:00 to 20:00h. Ducks fed the betaine diets had greater body weight at d 42 than those fed the control diet (P<0.05). The total red blood cell counts, hematocrit, hemoglobin, mean corpuscular volume, red cell distribution width, platelet count, plateletcrit and mean platelet volume concentration in ducks fed the control diet were lower than those fed the betaine diets (P<0.05). Blood electrolyte concentrations in ducks fed the betaine diet at different feeding times had greater values than those fed the control diet (P<0.05). Partial pressure of carbon dioxide, partial pressure of oxygen, base excess of extracellular fluid, bicarbonate and total carbon dioxide concentrations in ducks fed the control diets were lower than those on the betaine treatments (P<0.05). Respective to ducks fed the betaine diets had greater concentrations of total SCFA, acetic acid, propionic acid in the cecum than those fed the control diet (P<0.05). However, ducks fed the betaine diets had lower levels of butyric acid, isobutyric acid, valeric acid, isovaleric acid than those fed the control diet (P<0.05). The body weight, feed intake, sodium, hematocrit, hemoglobin, base excess of extracelluar fluid, mean corpuscular volume in ducks fed the betaine diet from fed 05:00 to 10:00 and 17:00 to 20:00h were greater (P<0.05) than those fed the betaine diet ad libitum and from 17:00 to 20:00h. The results of this study indicated that restricted feeding of the diet with 1200ppm betaine in morning and afternoon can have beneficial effects on meat ducks exposed to the very hot environment (high relative humidity) condition.

The reference values for hepatic oxygen consumption and net lactate production, blood gasses, hemogram, major electrolytes, and kidney and liver profiles in anesthetized large white swine model

Aim: Pigs are extensively used as experimental models to study the human physiology and pathophysiological conditions. Knowledge of the normal values of the commonly used parameters is indispensable to the correct interpretation of the test results. This study reports on the normal hemogram, blood gas, major electrolytes, kidney and liver profiles, hepatic oxygen consumption, and net lactate production in a large white pig model. Methods: Twenty-five female large white pigs were included in this study. Blood gas samples were collected from the portal and hepatic veins as well as the carotid artery. Results: The mean hemoglobin level was 97.7 ± 15.8 g/L. white blood cells were 13.5 ± 3.3 10 [3] /mm [3] , and platelet count was 279 ± 104.6 10 [3] /mm [3] . The mean aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, total bilirubin, and direct bilirubin were 83.8 ± 73.9 IU/L, 43.7 ± 5.9 IU/L, 33.6 ± 8.6 IU/L, 296.5 ± 39.7 IU/L, 5.6 ± 3.2 mmol/L, and 1.6 ± 0.73 mmol/L. The mean albumin level was 29 ± 3.9 g/L. The mean ammonia and arterial lactate levels were 49.1 ± 45.67 mmol/L and 1.5 ± 0.46 mmol/L. Kidney profile parameters were comparable to human values. Hepatic oxygen consumption was 17.3 ± 9.7 mL/100 g liver tissue/min and net hepatic lactate production was 0.017 ± 0.03 mmol/L. Conclusion: Knowledge of the normal parameters is mandatory for accurate interpretation of the experimental results that involves large white animals.

A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting

Context:Metabolic acidosis is frequently found in patients with severe sepsis. An understanding of types of acidosis in sepsis and their evolution over the course of treatment may give us insight into the behavior of acid–base balance in these patients.Aims:To describe at Intensive Care Unit (ICU) admission and over the first 5 days the composition of metabolic acidosis in patients with sepsis and to evaluate and compare acidosis patterns in survivors and nonsurvivors.Settings and Design:A prospective study conducted at Amrita Institute of Medical Sciences, Kochi, Kerala, in the Department of Internal Medicine.Subjects and Methods:Seventy-five consecutive patients admitted in the medical ICU with sepsis and metabolic acidosis were assessed. Arterial blood gas and serum electrolytes were measured during the first five days of admission or until death, renal replacement or discharge supervened.Statistical Analysis:To test the statistical significance of the difference in mean values of different study variables at day 1 and last day between survivors and non survivors, Mann–Whitney U-test was applied. To test the statistical significance of the difference in mean changes in different study parameters from day 1 to last day, paired t-test was done in the survivor group and Mann–Whitney U-test in the non survivor group.Results:Regardless of survival status, on day 1 of admission, 37 had High Anion Gap metabolic acidosis (HAGMA), 21 had predominant lactic acidosis (LA), 8 had Normal anion gap metabolic acidosis (NAGMA), and 9 had both HAGMA and LA [Figure 1]. When we compared this to the last day, 25 had HAGMA, 3 had LA, 3 had both HAGMA and LA, and 22 patients had resolution of acidosis. Sixty–four patients survived for up to 5 days of admission. Fifteen of these patients underwent hemodialysis on the day of admission itself in view of HAGMA. The remaining 49 comprised of HAGMA (31), Lactic acidosis (12), and a combination (6) on day 1. On the last day in this group, 25 had HAGMA, 2 had LA, and 22 patients had resolution of acidosis. In survivors, over the observation period, changes seen were: mean pH: 7.25–7.34 (P < 0.001), mean serum bicarbonate: 13.9 mEq to 17.2 mEq (P < 0.001), and mean serum lactate: 3.18–1.9 (P = 0.002). The changes in serum albumin and pCO2 were not significant. Eleven patients in the study population succumbed. Seven patients underwent hemodialysis on day 1 and the remaining four were followed up for more than 1 day. On day 1, 7 had lactic acidosis and 5 had HAGMA. Over the observation period, changes seen were mean pH: 7.15–7.14, mean serum lactate: 6.3–7.3 mEq.Conclusions:In patients with sepsis and septic shock, high anion gap metabolic acidosis is the dominant blood gas anomaly. Fall in lactate levels over the first 5 days of admission is a good prognostic marker of survival. Evolution of the blood gas profile over time suggests that a fall in lactate levels and a rise in bicarbonate levels correlate with a better outcome. The role of the anion gap as a prognostic marker holds promise and further studies are needed in this regard.

Hematological and blood gas profiles of triploid Siberian sturgeon (Acipenser baerii Brandt)

Abstract The aim of the study was to determine the impact of triploidization on hematological and blood gas parameters in Siberian sturgeon, Acipenser baerii Brandt. The study material was comprised of juvenile Siberian sturgeon specimens with total body lengths of 22.3 ± 2.9 cm and mean body weights of 75.3 ± 40.7 g. Triploidization was confirmed to result in significant changes in the hematological profile of Siberian sturgeon. In comparison to the diploid group, the fish with higher levels of ploidy exhibited lower erythrocyte counts, increased hemoglobin concentration, and increased values of mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. A significant decrease in the percentage share of lymphocytes and an increase in the percentage share of granulocytes in the peripheral blood were also observed, which indicate disturbances in the immune response (particularly in the adaptive immune system) and greater susceptibility to stress. Triploidization did not, however, cause significant differences in the blood gas profile.

Comparison of Umbilical Cord Blood Gas Profiles Between Preeclamptic and Healthy Mothers

Comparison of Umbilical Cord Blood Gas Profiles Between Preeclamptic and Healthy Mothers

Comparison Between 30:1 and 30:2 Compression-to-ventilation Ratios for Cardiopulmonary Resuscitation: Are Two Ventilations Necessary?

Controversy is continuing over the need for ventilation and the optimal compression-ventilation (CV) ratio during cardiopulmonary resuscitation (CPR). The aim of this study was to comparatively elucidate the effect on hemodynamics and arterial oxygen saturation of a single ventilation relative to two consecutive ventilations during CPR in a dog model of cardiac arrest. Twenty mongrel dogs were divided into two groups. After 3 minutes of ventricular fibrillation (VF), the single-ventilation group received CPR with a 30:1 CV ratio, and the two-ventilation group received CPR with a 30:2 CV ratio, all with room air for 7 minutes. Thereafter, continuous chest compressions and intermittent ventilation at rate of 10 per minute were followed for both groups for 10 minutes. Hemodynamic parameters, arterial blood gas profiles, and variables from CPR were compared at baseline and at 5, 10, 15, and 20 minutes after induction of VF. Hemodynamic parameters including aortic systolic and diastolic pressures, right atrial systolic and diastolic pressures, coronary perfusion pressure, end-tidal carbon dioxide tension, and arterial blood gas profiles including arterial oxygen tension, arterial oxygen saturation, and arterial carbon dioxide tension were not different between two groups during CPR. In the 30:1 group, the period of compression interruption was shorter and chest compression fraction was higher than that in the 30:2 group (6 sec/min vs. 10.9 sec/min, p < 0.001; 90.0% vs. 81.8%, p < 0.001). CPR with a 30:1 CV ratio, compared to CPR with a 30:2 CV ratio, results in comparable arterial oxygenation saturation and hemodynamics.

Effects of feeding a spray-dried multivalent polyclonal antibody preparation on feedlot performance, feeding behavior, carcass characteristics, rumenitis, and blood gas profile of Brangus and Nellore yearling bulls.

The objective of this study was to evaluate the effects of replacing monensin (MON) with a spray-dried multivalent polyclonal antibody preparation (PAP) against several ruminal microorganisms on feedlot performance, carcass characteristics, feeding behavior, blood gas profile, and the rumenitis incidence of Brangus and Nellore yearling bulls. The study was designed as a completely randomized design with a 2 × 2 factorial arrangement, replicated 6 times (4 bulls per pen and a total of 24 pens), in which bulls ( = 48) of each biotype were fed diets containing either MON fed at 300 mg/d or PAP fed at 3 g/d. No significant feed additive main effects were observed for ADG ( = 0.27), G:F ( = 0.28), HCW ( = 0.99), or dressing percentage ( = 0.80). However, bulls receiving PAP had greater DMI ( = 0.02) and larger ( = 0.02) final LM area as well as greater ( < 0.01) blood concentrations of bicarbonate and base excess in the extracellular fluid than bulls receiving MON. Brangus bulls had greater ( < 0.01) ADG and DMI expressed in kilograms, final BW, heavier HCW, and larger initial and final LM area than Nellore bulls. However, Nellore bulls had greater daily DMI fluctuation ( < 0.01), expressed as a percentage, and greater incidence of rumenitis ( = 0.05) than Brangus bulls. In addition, Brangus bulls had greater ( < 0.01) DMI per meal and also presented lower ( < 0.01) DM and NDF rumination rates when compared with Nellore bulls. Significant interactions ( < 0.05) between biotype and feed additive were observed for SFA, unsaturated fatty acids (UFA), MUFA, and PUFA concentrations in adipose tissues. When Nellore bulls were fed PAP, fat had greater ( < 0.05) SFA and PUFA contents but less ( < 0.01) UFA and MUFA than Nellore bulls receiving MON. For Brangus bulls, MON led to greater ( < 0.05) SFA and PUFA and less ( < 0.05) UFA and MUFA than Brangus bulls fed PAP. Feeding a spray-dried PAP led to similar feedlot performance compared with that when feeding MON. Spray-dried PAP might provide a new technology alternative to ionophores.

Umbilical venous blood gas analysis for neonatal assessment.

Umbilical venous pH is claimed to mirror fetal acid-base status. Importantly, it is easier to perform. The aim of this study is to : 1. Evaluate the umbilical venous blood gas (UVBG) profile of normal newborns and to compare UVBG in the following situations: presence or absence of asphyxia presence or absence of meconium-stained amniotic fluid presence or absence of respiratory distress: and in newborns that did and did not survive and 2. To study the peripheral venous blood gas (PVBG) profile of newborns that develop cardio-respiratory insufficiency (CRI). Venous blood gas (VBG) was performed in 961 newborns consecutively admitted to the neonatal nursery over one year and in 100 controls. PVBG was also performed in 370 admissions to the nursery that developed signs of CRI. Demographic, clinical and outcome data were collected. Mean UVBG parameters (pH, pCO2, HCO3, base deficit, pO2 and SO2%) were compared between different groups of newborns using t test. This study had ethical approval. Of the 3349 live births over one year, 961 (28.7%) needed intensive care. Of these, 123 (12.8%) died. All the mean cord gas parameters differed significantly between who died and who survived. Metabolic acidosis and hypoxemia were conspicuous on PVBG among babies with CRI. Except for PO2 all the mean parameters of UVBG differed significantly with asphyxia and meconium-stained amniotic fluid. When similar comparison was made among newborns that did or that did not develop respiratory distress, the difference was significant for all the parameters except SO2%. UVBG gives useful information about common neonatal morbidities and appears to be a useful tool for neonatal assessment. PVBG gives objective information about babies with CRI that may need special interventions.

Take with a Grain of Salt

A 5-day-old girl, born at term after an uncomplicated pregnancy, was admitted to the hospital after a routine midwife check showed that she had lost 15% of her original birth weight [6.2 lb (2.83 kg)]. She was being fed normal-term formula milk, and an initial assessment revealed only mild dehydration. The working diagnosis was a feeding problem, and her management plan was to be fed 150 mL/kg formula milk per day with regular monitoring of weight. The patient's serum concentrations of selected analytes were as follows: sodium, 135 mEq/L (135 mmol/L; reference interval, 135–145 mmol/L); potassium, 5.3 mEq/L (5.3 mmol/L; reference interval, 3.5–5.3 mmol/L); and urea, 11.7 mg/dL (4.2 mmol/L; reference interval, 3.5–6.5 mmol/L). Five days after admission, the patient's weight was unchanged. Her serum analyte concentrations were now as follows: sodium, 128 mEq/L (128 mmol/L); potassium, 6.7 mEq/L (6.7 mmol/L); urea, 5.8 mg/dL (2.1 mmol/L); creatinine, 0.3 mg/dL (28 μmol/L; reference interval, 60–100 μmol/L); and blood glucose, 77.4 mg/dL (4.3 mmol/L; reference interval, 4–7 mmol/L). These findings prompted more-detailed biochemical and endocrine tests. Her bicarbonate concentration was 30 mEq/L (30 mmol/L; reference interval, 24–32 mmol/L), and her chloride concentration was 94 mEq/L (94 mmol/L; reference interval, 95–105 mmol/L). These results yielded an anion gap of 10.7 mmol/L. The urine sodium concentration was 10 mEq/L (10 mmol/L). Further blood results were available 2 days later: plasma renin, 854 mIU/L (reference interval, 4–190 mIU/L in >7 days to 1 year); serum aldosterone, >5786 ng/L (reference interval, 300–2000 ng/L in neonates). The results of blood gas, serum cortisol, ammonia, lactate, urine culture, and urine steroid profile tests were all normal. ### QUESTIONS TO CONSIDER 1. What are common causes for excess weight loss in a neonate who presents in the first few days of life? 2. What are the possible explanations for hyponatremia with hyperkalemia in a neonate …

Transient tachypnea of the newborn: Is empiric antimicrobial therapy needed?

Transient tachypnea of the newborn (TTN) is a self- limited increase in the work of breathing in near- and full-term infants; it is attributed to a delay in the clearance of alveolar fluids. Prophylactic antibiotics are usually administered until blood cultures are reported negative for 48 hours. To prospectively compare outcomes of infants presented with classic TTN who were treated with or denied from intravenous antibiotics. A prospective cohort study was conducted on all infants admitted with classic TTN. Pre-set diagnostic criteria for classic TTN were applied in order to exclude other cases presenting with respiratory distress. Infants with classic TTN were stratified into two groups based on whether they received or did not receive antibiotics. The decision to administer antibiotics solely depended upon the style of the covering physician at the time of admission to the NICU. The following investigations were obtained from infants of both groups: blood culture, C-reactive protein, complete blood count, blood gas profile and chest X-ray. A total of 15146 full-term infants were delivered during the study period; of them 923 were admitted to the NICU. Classic TTN was diagnosed in 168 infants; of them 106 (63%) received and 62 (37%) did not receive antibiotics. Two infants in the treated group and an infant in the non-treated group had microbiologically confirmed bacteremia. Infants in the treatment group stayed longer in the hospital (72 ± 6 vs. 48 ± 3 hrs). No recorded cases required readmission in either group. With the application of strict criteria for classic TTN and the close observation in the NICU, the empiric use of antibiotics may be avoidable. Randomized controlled trials are needed to confirm the feasibility and safety of such approach.

Blood gas profile of copper-poisoned in sheep treated with ammonium tetrathiomolybdate

O objetivo desse estudo foi avaliar o perfil de gases sanguineos em ovinos experimentalmente intoxicados com cobre (fases: pré-hemoltica, hemolitica e pós-hemolitica) tratados ou não com tetratiomolibidato de amônio (ATTM). Dez cordeiros da raça Santa Inês foram divididos em dois grupos:controle (tratados com solução fisiologica a 0,9%) e ATTM (tratados com 3,4 mg/kg de tetratiomolibidato de amonio). Os animais foram submetidos a doses crescentes de sulfato de cobre até a observação de hemoglobinúria macroscópica. Todos os animais do grupo controle morreram dentro de quatro dias após observação da hemoglobinúria, e um cordeiro do grupo ATTM morreu durante o tratamento. Não houve diferença nas varíaveis hemogasometricas entre os grupos durante o período experimental. Maiores valores da pCO2 foram observados nos dois grupos experimentais dutante a crise hemolitica (HC). O grupo controle exibiu valores mais elevados do hCO3 na HC e dois dias após a crise hemolitica em relação ao tempo 15 dias após a crise hemolitica. Os animais do grupo tratado com ATTM apresentaram, respectivamente, amenores e maiores valores do hCO3 sete dias antes da crise hemolitica e durante a crise hemolitica. Os dois grupos exibiram maiores valores da BE na crise hemolitica. A intoxicação por cobre gerou desordem no equilibrio ácido-base, caracterizada por alcalose metabolica e acidose respiratória. O tratamento com ATTM foi capaz de reverter as alterações hemogasometricas em ovinos intoxicados por cobre.

Effects of feeding a multivalent polyclonal antibody preparation on feedlot performance, carcass characteristics, rumenitis, and blood gas profile in Bos indicus biotype yearling bulls1

The objective of this study was to evaluate effects of feeding monensin (MON) or a multivalent polyclonal antibody preparation (PAP) against several rumen microorganisms on feedlot performance, carcass characteristics, blood gas profile, and rumenitis of Bos indicus biotype (BT) yearling bulls. The study was designed as a completely randomized design with a 3 × 2 factorial arrangement, replicated 4 times, in which 32 yearling bulls of each of 3 BT evaluated (3-way-cross, TC; Canchim, CC; and Nellore, NE) were fed diets containing either MON at 300 mg·d(-1) or PAP at 10 mL·d(-1) across 3 different periods. No significant (P > 0.10) feed additive (FA) main effects were observed for any of the feedlot performance variables and carcass characteristics with the exception of dressing percentage. Yearling bulls receiving PAP had a decreased (P = 0.047) dressing percentage when compared with yearling bulls receiving MON. Significant (P < 0.05) BT main effects were observed for all feedlot performance variables and carcass characteristics with the exception of kidney-pelvic fat expressed in kilograms (P = 0.49) and LM lipids content (P = 0.45). Crossbred yearling bulls (TC and CC) had greater (P < 0.001) ADG, DMI in kilograms, DMI as % of BW, and improved (P = 0.001) G:F when compared with NE yearling bulls. A tendency (P = 0.072) for a FA main effect was observed for rumenitis scores, in which yearling bulls receiving PAP had lesser rumenitis scores than those receiving MON. When the data were disposed as frequency percentage, 55.6% and 45.7% of the rumens from yearling bulls fed PAP and MON were scored between 0 and 1, respectively (0 = no lesions, 10 = severe lesions). Likewise, a significant BT main effect was observed (P = 0.008), where NE yearling bulls had greater rumenitis scores than those of crossbred yearling bulls (TC and CC). No significant FA main effects were observed (P > 0.10) for any of the fatty acids measured in the subcutaneous adipose tissue, with the exception that yearling bulls receiving MON had greater (P < 0.05) concentrations of palmitic acid (16:0), margaric acid (17:0), docosapentaenoic acid (22:5), and docosahexaenoic acid (22:6) than those yearling bulls receiving PAP. Feeding PAP tended to decrease incidence of rumen lesions and led to similar feedlot performance compared with feeding MON. Thus, PAP is a new technology that presents a possible alternative for ionophores.