Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metabolic acidosis immediately after surgical operation is followed by metabolic alkalosis. Hormonal change by surgical stress and anaerobic glucolysis due to tissue ischemia cause initial lactic acidosis. Later alkalosis may be caused by secondary aldosteronism and bicarbonate production from lactate and citrate supplied by massive infusion and transfusion. Postoperative complications, such as respiratory insufficiency, renal failure and hypovolemic or septic shock, cause acidosis. In the gastrointestinal surgery, acidosis can be caused by starvation and loss of bicarbonate contained in bile, pancreatic juice or intestinal fluid, and alkalosis can be caused by loss of HCl in gastric juice. Severe acidosis can be caused by extracorporeal circulation, hypothermia, low output syndrome or declamping shock in cardioaortic surgery.
 ...
PMID:[Acid-base disturbances in surgical operation]. 143 18

Liver transplant is the first therapeutic choice in most of the advanced liver diseases. Nevertheless, its performance originates a number of complications derived from: a) conservation techniques of the organ (in our study a prolonged time of hot ischemia was significantly associated with); b) surgery (all patients who required massive blood transfusions developed metabolic alkalosis); c) the graft itself (all the F 1. degrees were significantly infected), and d) extrahepatic causes (cyclosporin was responsible for high blood pressure and nephrotoxicity which appeared as oliguria with good response to furosemide, as well as hyperglycemia). Some other relevant results in our series were: right pleural effusion and thrombopenia which appeared with a high incidence. Infections were usually originated the staphylococcus which grows in half of the cultures. We also want to highlight the short mean stay and the low mortality incidence in the ICU.
 ...
PMID:[Complications of liver transplant in intensive care. Experience in 130 cases]. 176 10

On the basis of chronic weight loss, bilateral asymmetric abdominal distention, ballottement of a large abomasum, hypochloremic metabolic alkalosis, and high rumen chloride concentration, an adult Suffolk ewe was diagnosed as having an abomasal emptying defect. In this ewe, and in 4 of 7 other sheep diagnosed as having abomasal emptying defects, aspartate transaminase and sorbitol dehydrogenase activities were high, and histopathologic evidence of hepatic congestion and ischemia was found. It was theorized that increased intra-abdominal pressure from abomasal distention may be the cause of the hepatic abnormalities. These changes have not been previously associated with ovine abomasal emptying defect, the pathogenic mechanism of which remains unclear.
 ...
PMID:Abomasal dilatation and emptying defect in a ewe. 335 94

The acid-base disorders after hepatic vascular exclusion (HVE) were studied in 30 major liver resections. HVE included portal triad clamping and occlusion of the inferior vena cava below and above the liver, without venous shunt nor cooling. Clamping of the supra-coeliac abdominal aorta (AoC) was associated with HVE in 12 patients. HVE lasted 18 to 65 min (mean 37 min). Liver ischemia and splanchnic blood pooling resulted in metabolic acidosis and hyperlactatemia. In order to prevent his acidosis, prophylactic administration of NaHCO23 was used during the first 19 cases. This induced significant metabolic alkalosis during HVE and the early postoperative period; increasing experience made us reduce the amount of NaHCO3. After the release of the clamps, Paco2 increased 25% following HVE without AoC (p less than 0.001) and 53% following HVE with AoC (p less than 0.001). In an attempt to distinguish between the effects of the metabolic acidosis and the rise of Paco2 in the fall of pH which occurred after removal of the clamps, NAaHCO3 was deliberately not given in the last 11 patients. Acidosis appeared to be greater with AoC than without and mainly related to the rise of Paco2. A fall of Paco2 to its initial value was always followed by the return of pH to the normal range. This study demonstrated the human ability to correct spontaneously the acidosis which followed HVE. The need for NaHCO3 after HVE reflected a poor hemodynamic state after major liver resection rather than a metabolic consequence of hepatic ischaemia.
 ...
PMID:[Acid-base equilibrium and vascular exclusion of the liver: study of 30 extensive hepatectomies]. 662 49

6-Fluoropyridoxol (6-FPOL) was evaluated as a simultaneous indicator of intracellular and extracellular pH and, hence, pH gradient in perfused rat hearts. After infusion, 19F NMR spectra rapidly showed two well-resolved peaks assigned to the intracellular and extracellular compartments, and pH was calculated on the basis of chemical shift with respect to a sodium trifluoroacetate standard. To demonstrate use of this molecule, dynamic changes in myocardial pH were assessed with a time resolution of 2 min during respiratory and metabolic alkalosis or acidosis and ischemia. For a typical heart, intracellular pH (pHi) = 7.14+/-0.01 and extracellular pH (pHe) = 7.52+/-0.02. In response to metabolic alkalosis, pHi remained relatively constant and the pH gradient increased. In contrast, respiratory challenge caused a significant increase in pHi. Independent measurements using pH electrodes and 31P NMR confirmed validity of the 19F NMR results.
 ...
PMID:Simultaneous intracellular and extracellular pH measurement in the heart by 19F NMR of 6-fluoropyridoxol. 954 16

Hypokalemia (serum K+ < 3.5 mEq/1) is a potentially serious adverse effect of diuretic ingestion. We report a 27 year-old woman admitted with muscle weakness, a serum potassium of 2.0 mEq/1, metabolic alkalosis and EKG abnormalities simulating cardiac ischemia, that reverted with potassium chloride administration. She admitted high dose furosemide self-medication for edema. Glomerular filtration rate, tubular sodium reabsorption, potassium secretion, the renin-aldosterone system, total body water distribution and capillary permeability, were studied sequentially until 90 days after her admission. There was hyperactivity of the renin-aldosterone axis, reduction in extracellular and intracellular volumes, normal capillary permeability and high sodium tubular reabsorption, probably explained by a "rebound" salt retention associated with her decreased extracellular volume.
 ...
PMID:[Hypokalemia, hypovolemia and electrocardiographic changes due to furosemide abuse. Report of one case]. 1825 58

Patients with intestinal ischemia associated with acute aortic dissection often require emergent bowel resection, which results in serious complications. We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent emergent subtotal resection of the small intestine, right colectomy, tube gastrostomy, and transverse colostomy; however, intestinal continuity was not restored. He developed two major postoperative complications: unconsciousness due to metabolic alkalosis caused by massive discharge from the gastrostomy and jaundice due to bile salt depletion caused by disruption of the enterohepatic circulation. His serum bilirubin levels decreased after the infusion of gastric discharge through gastrostomy into the transverse colon through the colostomy; thereafter, a second operation was performed to restore gastrointestinal continuity. Overall, patients undergoing massive bowel resection without intestinal continuity require careful management of electrolytes and bile salt.
 ...
PMID:Successful management of extensive bowel resection without intestinal continuity: a case report. 3184 90