The effects of severe hemoconcentration on acid-base equilibrium in critically ill patients: the forgotten role of buffers in whole blood

摘要: Abstract Purpose Idiopathic Systemic Capillary Leak Syndrome (ISCLS) is a paroxysmal permeability disorder characterized by abrupt onset of shock and hemoconcentration due to massive shift fluids proteins from the intravascular interstitial compartment. We hypothesize that increased hemoglobin concentration has pivotal role in acid-base imbalance during life-threatening crises. Materials methods Analysis balance fluctuations six severe ISCLS flares admitted ICU referral center for ISCLS. Results Acid-base equilibrium was assessed plasma whole blood single multicompartmental models. The acute phase shock, hypoalbuminemia, hemoconcentration, acidosis. physical-chemical approach found remarkable component unmeasured anions (SIG) phase. After correction model blood, SIG variations disappeared because buffer relevant. Conclusion Hemoglobin buffering metabolic acidosis In these circumstances, assessment alone may overestimate anions. On contrary, corrected better explains when marked occurs.