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Acid-base balance in acute gastrointestinal bleeding.
- Source :
-
British medical journal [Br Med J] 1971 May 01; Vol. 2 (5756), pp. 242-4. - Publication Year :
- 1971
-
Abstract
- Acid-base balance has been studied in 21 patients with acute upper gastrointestinal bleeding. A low plasma bicarbonate concentration was found in nine patients, accompanied in each case by a base deficit of more than 3 mEq/litre, indicating a metabolic acidosis. Three patients had a low blood pH. Hyperlactataemia appeared to be a major cause of the acidosis. This was not accompanied by a raised blood pyruvate concentration. The hyperlactataemia could not be accounted for on the basis of hyperventilation, intravenous infusion of dextrose, or arterial hypoxaemia. Before blood transfusion it was most pronounced in patients who were clinically shocked, suggesting that it may have resulted from poor tissue perfusion and anaerobic glycolysis. Blood transfusion resulted in a rise in lactate concentration in seven patients who were not clinically shocked, and failed to reverse a severe uncompensated acidosis in a patient who was clinically shocked. These effects of blood transfusion are probably due to the fact that red blood cells in stored bank blood, with added acid-citrate-dextrose solution, metabolize the dextrose anaerobically to lactic acid. Monitoring of acid-base balance is recommended in patients with acute gastrointestinal bleeding who are clinically shocked. A metabolic acidosis can then be corrected with intravenous sodium bicarbonate.
- Subjects :
- Acidosis drug therapy
Acute Disease
Adult
Aged
Bicarbonates blood
Bicarbonates therapeutic use
Blood Transfusion
Carbon Dioxide metabolism
Female
Humans
Hydrogen-Ion Concentration
Lactates blood
Male
Middle Aged
Oxygen Consumption
Pyruvates blood
Shock, Hemorrhagic metabolism
Acid-Base Equilibrium
Gastrointestinal Hemorrhage metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0007-1447
- Volume :
- 2
- Issue :
- 5756
- Database :
- MEDLINE
- Journal :
- British medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 5313902
- Full Text :
- https://doi.org/10.1136/bmj.2.5756.242