Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study
Non-carbonic buffer power (βNC) of blood is a pivotal concept in acid-base physiology as it is employed in several acid-base evaluation techniques, including the Davenport nomogram and the Van Slyke equation used for Base excess estimation in blood. So far, βNC has been assumed to be independent of...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2022.1009378/full |
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| author | Martin Krbec Martin Krbec Petr Waldauf Francesco Zadek Serena Brusatori Alberto Zanella Alberto Zanella František Duška Thomas Langer Thomas Langer |
| author_facet | Martin Krbec Martin Krbec Petr Waldauf Francesco Zadek Serena Brusatori Alberto Zanella Alberto Zanella František Duška Thomas Langer Thomas Langer |
| author_sort | Martin Krbec |
| collection | DOAJ |
| description | Non-carbonic buffer power (βNC) of blood is a pivotal concept in acid-base physiology as it is employed in several acid-base evaluation techniques, including the Davenport nomogram and the Van Slyke equation used for Base excess estimation in blood. So far, βNC has been assumed to be independent of metabolic acid-base status of blood, despite theoretical rationale for the contrary. In the current study, we used CO2 tonometry to assess βNC in blood samples from 10 healthy volunteers, simultaneously analyzing the electrolyte shifts across the red blood cell membrane as these shifts translate the action of intracellular non-carbonic buffers to plasma. The βNC of the blood was re-evaluated after experimental induction of metabolic acidosis obtained by adding a moderate or high amount of either hydrochloric or lactic acid to the samples. Moreover, the impact of βNC and pCO2 on the Base excess of blood was examined. In the control samples, βNC was 28.0 ± 2.5 mmol/L. In contrast to the traditional assumptions, our data showed that βNC rose by 0.36 mmol/L for each 1 mEq/l reduction in plasma strong ion difference (p < 0.0001) and was independent of the acid used. This could serve as a protective mechanism that increases the resilience of blood to the combination of metabolic and respiratory acidosis. Sodium and chloride were the only electrolytes whose plasma concentration changed relevantly during CO2 titration. Although no significant difference was found between the electrolyte shifts in the two types of acidosis, we observed a slightly higher rate of chloride change in hyperchloremic acidosis, while the variation of sodium was more pronounced in lactic acidosis. Lastly, we found that the rise of βNC in metabolic acidosis did not induce a clinically relevant bias in the calculation of Base excess of blood and confirmed that the Base excess of blood was little affected by a wide range of pCO2. |
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| format | Article |
| id | doaj.art-cbdada0bc9b14d468db8028d33048773 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-04-13T19:48:35Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-cbdada0bc9b14d468db8028d330487732022-12-22T02:32:38ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2022-10-011310.3389/fphys.2022.10093781009378Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro studyMartin Krbec0Martin Krbec1Petr Waldauf2Francesco Zadek3Serena Brusatori4Alberto Zanella5Alberto Zanella6František Duška7Thomas Langer8Thomas Langer9Department of Anaesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, CzechiaDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Anaesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, CzechiaDepartment of Medicine and Surgery, University of Milan-Bicocca, Monza, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, Milan, ItalyDepartment of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Anaesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, CzechiaDepartment of Medicine and Surgery, University of Milan-Bicocca, Monza, ItalyDepartment of Anesthesia and Intensive Care Medicine, Niguarda Ca’ Granda, Milan, ItalyNon-carbonic buffer power (βNC) of blood is a pivotal concept in acid-base physiology as it is employed in several acid-base evaluation techniques, including the Davenport nomogram and the Van Slyke equation used for Base excess estimation in blood. So far, βNC has been assumed to be independent of metabolic acid-base status of blood, despite theoretical rationale for the contrary. In the current study, we used CO2 tonometry to assess βNC in blood samples from 10 healthy volunteers, simultaneously analyzing the electrolyte shifts across the red blood cell membrane as these shifts translate the action of intracellular non-carbonic buffers to plasma. The βNC of the blood was re-evaluated after experimental induction of metabolic acidosis obtained by adding a moderate or high amount of either hydrochloric or lactic acid to the samples. Moreover, the impact of βNC and pCO2 on the Base excess of blood was examined. In the control samples, βNC was 28.0 ± 2.5 mmol/L. In contrast to the traditional assumptions, our data showed that βNC rose by 0.36 mmol/L for each 1 mEq/l reduction in plasma strong ion difference (p < 0.0001) and was independent of the acid used. This could serve as a protective mechanism that increases the resilience of blood to the combination of metabolic and respiratory acidosis. Sodium and chloride were the only electrolytes whose plasma concentration changed relevantly during CO2 titration. Although no significant difference was found between the electrolyte shifts in the two types of acidosis, we observed a slightly higher rate of chloride change in hyperchloremic acidosis, while the variation of sodium was more pronounced in lactic acidosis. Lastly, we found that the rise of βNC in metabolic acidosis did not induce a clinically relevant bias in the calculation of Base excess of blood and confirmed that the Base excess of blood was little affected by a wide range of pCO2.https://www.frontiersin.org/articles/10.3389/fphys.2022.1009378/fullacid-base equilibriumbuffersbloodmetabolic acidosisblood-gas analysisbase excess |
| spellingShingle | Martin Krbec Martin Krbec Petr Waldauf Francesco Zadek Serena Brusatori Alberto Zanella Alberto Zanella František Duška Thomas Langer Thomas Langer Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study Frontiers in Physiology acid-base equilibrium buffers blood metabolic acidosis blood-gas analysis base excess |
| title | Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study |
| title_full | Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study |
| title_fullStr | Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study |
| title_full_unstemmed | Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study |
| title_short | Non-carbonic buffer power of whole blood is increased in experimental metabolic acidosis: An in-vitro study |
| title_sort | non carbonic buffer power of whole blood is increased in experimental metabolic acidosis an in vitro study |
| topic | acid-base equilibrium buffers blood metabolic acidosis blood-gas analysis base excess |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2022.1009378/full |
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