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Dai Y, Nolan J, Madsen E, Fratus M, Lee J, Zhang J, Lim J, Hong S, Alam MA, Linnes JC, Lee H, Lee CH. Wearable Sensor Patch with Hydrogel Microneedles for In Situ Analysis of Interstitial Fluid. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 38041570 DOI: 10.1021/acsami.3c12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Continuous real-time monitoring of biomarkers in interstitial fluid is essential for tracking metabolic changes and facilitating the early detection and management of chronic diseases such as diabetes. However, developing minimally invasive sensors for the in situ analysis of interstitial fluid and addressing signal delays remain a challenge. Here, we introduce a wearable sensor patch incorporating hydrogel microneedles for rapid, minimally invasive collection of interstitial fluid from the skin while simultaneously measuring biomarker levels in situ. The sensor patch is stretchable to accommodate the swelling of the hydrogel microneedles upon extracting interstitial fluid and adapts to skin deformation during measurements, ensuring consistent sensing performance in detecting model biomarker concentrations, such as glucose and lactate, in a mouse model. The sensor patch exhibits in vitro sensitivities of 0.024 ± 0.002 μA mM-1 for glucose and 0.0030 ± 0.0004 μA mM-1 for lactate, with corresponding linear ranges of 0.1-3 and 0.1-12 mM, respectively. For in vivo glucose sensing, the sensor patch demonstrates a sensitivity of 0.020 ± 0.001 μA mM-1 and a detection range of 1-8 mM. By integrating a predictive model, the sensor patch can analyze and compensate for signal delays, improving calibration reliability and providing guidance for potential optimization in sensing performance. The sensor patch is expected to serve as a minimally invasive platform for the in situ analysis of multiple biomarkers in interstitial fluid, offering a promising solution for continuous health monitoring and disease management.
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Affiliation(s)
- Yumin Dai
- School of Materials Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - James Nolan
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Emilee Madsen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Marco Fratus
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Junsang Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Jinyuan Zhang
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Jongcheon Lim
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Seokkyoon Hong
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Muhammad A Alam
- Elmore Family School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47907, United States
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Department of Public Health, Purdue University, West Lafayette, Indiana 47907, United States
| | - Hyowon Lee
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Center for Implantable Devices, Purdue University, West Lafayette, Indiana 47907, United States
| | - Chi Hwan Lee
- School of Materials Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47907, United States
- Center for Implantable Devices, Purdue University, West Lafayette, Indiana 47907, United States
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Villasana K, Quintero W, Montero Y, Pino C, Uzcategui O, Torres G, Prada M, Pozo L, Bauta W, Jimenez W. Effect of an ionic antineoplastic agent Cytoreg on blood chemistry in a Wistar rat model. Med Gas Res 2021; 12:18-23. [PMID: 34472498 PMCID: PMC8447950 DOI: 10.4103/2045-9912.324592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cytoreg is an ionic therapeutic agent comprising a mixture of hydrochloric, sulfuric, phosphoric, hydrofluoric, oxalic, and citric acids. In diluted form, it has demonstrated efficacy against human cancers in vitro and in vivo. Although Cytoreg is well tolerated in mice, rats, rabbits, and dogs by oral and intravenous administration, its mechanism of action is not documented. The acidic nature of Cytoreg could potentially disrupt the pH and levels of ions and dissolved gases in the blood. Here, we report the effects of the intravenous administration of Cytoreg on the arterial pH, oxygen and carbon dioxide pressures, and bicarbonate, sodium, potassium, and chloride concentrations. Our results demonstrate that Cytoreg does not disturb the normal blood pH, ion levels, or carbon dioxide content, but increases oxygen levels in rats. These data are consistent with the excellent tolerability of intravenous Cytoreg observed in rabbits, and dogs. The study was approved by the Bioethics Committee of the University of the Andes, Venezuela (CEBIOULA) (approval No. 125) on November 3, 2019.
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Affiliation(s)
- Katiusca Villasana
- Biochemistry Laboratories, Department of Pathology, University of the Andes, Mérida, Venezuela
| | - William Quintero
- Department of Biology, Faculty of Science, University of the Andes, Mérida, Venezuela
| | | | - Cristian Pino
- Department of Technical and Experimental Surgery, Faculty of Medicine, University of the Andes, Mérida, Venezuela
| | - Oscar Uzcategui
- Department of Technical and Experimental Surgery, Faculty of Medicine, University of the Andes, Mérida, Venezuela
| | - Geizon Torres
- Vitalis, Clinical Laboratory, Smart Health Laboratory, Merida, Venezuela
| | - Mariangel Prada
- Vitalis, Clinical Laboratory, Smart Health Laboratory, Merida, Venezuela
| | - Lewis Pozo
- Cytorex de Venezuela SA, Maracaibo, Venezuela
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Monitoring of Lactate in Interstitial Fluid, Saliva and Sweat by Electrochemical Biosensor: The Uncertainties of Biological Interpretation. CHEMOSENSORS 2021. [DOI: 10.3390/chemosensors9080195] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Lactate electrochemical biosensors were fabricated using Pediococcus sp lactate oxidase (E.C. 1.1.3.2), an external polyurethane membrane laminate diffusion barrier and an internal ionomeric polymer barrier (sulphonated polyether ether sulphone polyether sulphone, SPEES PES). In a needle embodiment, a Pt wire working electrode was retained within stainless steel tubing serving as pseudoreference. The construct gave linearity to at least 25 mM lactate with 0.17 nA/mM lactate sensitivity. A low permeability inner membrane was also unexpectedly able to increase linearity. Responses were oxygen dependent at pO2 < 70 mmHg, irrespective of the inclusion of an external diffusion barrier membrane. Subcutaneous tissue was monitored in Sprague Dawley rats, and saliva and sweat during exercise in human subjects. The tissue sensors registered no response to intravenous Na lactate, indicating a blood-tissue lactate barrier. Salivary lactate allowed tracking of blood lactate during exercise, but lactate levels were substantially lower than those in blood (0–3.5 mM vs. 1.6–12.1 mM), with variable degrees of lactate partitioning from blood, evident both between subjects and at different exercise time points. Sweat lactate during exercise measured up to 23 mM but showed highly inconsistent change as exercise progressed. We conclude that neither tissue interstitial fluid nor sweat are usable as surrogates for blood lactate, and that major reappraisal of lactate sensor use is indicated for any extravascular monitoring strategy for lactate.
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Coppola S, Caccioppola A, Froio S, Chiumello D. Sodium Bicarbonate in Different Critically Ill Conditions: From Physiology to Clinical Practice. Anesthesiology 2021; 134:774-783. [PMID: 33721887 DOI: 10.1097/aln.0000000000003733] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Intravenous sodium bicarbonate is commonly used in several critically ill conditions for the management of acute acidemia independently of the etiology, and for the prevention of acute kidney injury, although this is still controversial from a physiologic point of view.
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Svorc P, Petrasova D, Svorc Jr P. Chronobiological study of sex differences in the internal environment in zoletil-anaesthetized rats. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2018.1564577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Pavol Svorc
- Department of Physiology, Medical Faculty Safarik’s University, Kosice, Slovak Republic
- Department of Physiology and Pathophysiology, Medical Faculty, Ostrava University, Ostrava, Czech Republic
| | - Darina Petrasova
- Laboratory of Research Bio-models, Medical Faculty Safarik’s University, Kosice, Slovak Republic
| | - Pavol Svorc Jr
- Department of Physiology and Pathophysiology, Medical Faculty, Ostrava University, Ostrava, Czech Republic
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SVORC P, PETRÁŠOVÁ D, SVORC P. Arterial pH and Blood Gas Values in Rats Under Three Types of General Anesthesia: a Chronobiological Study. Physiol Res 2018; 67:721-728. [DOI: 10.33549/physiolres.933692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The aim of study was to review the status of arterial pH, pO2 and pCO2 under general anesthesias in dependence on the light-dark (LD) cycle in spontaneously breathing rats. The experiments were performed using three- to four-month-old pentobarbital(P)-, ketamine/xylazine(K/X)- and zoletil(Z)-anesthetized female Wistar rats after a four-week adaptation to an LD cycle (12 h light:12 h dark). The animals were divided into three experimental groups according to the anesthetic agent used: P (light n=11; dark n=8); K/X (light n=13; dark n=11); and Z (light n=18; dark n=26). pH and blood gases from arterial blood were analyzed. In P anesthesia, LD differences in pH, pO2, and pCO2 were eliminated. In K/X anesthesia, parameters showed significant LD differences. In Z anesthesia, LD differences were detected for pH and pO2 only. Acidosis, hypoxia, and hypercapnia have been reported for all types of anesthesia during the light period. In the dark period, except for P anesthesia, the environment was more stable and values fluctuated within normal ranges. From a chronobiological perspective, P anesthesia was not the most appropriate type of anesthesia in these rat experiments. It eliminated LD differences, and also produced a more acidic environment and more pronounced hypercapnia than K/X and Z anesthesias.
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Affiliation(s)
- P. SVORC
- Department of Physiology, Medical Faculty Safarik’s University, Kosice, Slovak Republic
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Mise au point sur les conséquences hémodynamiques de l’acidose lactique dans les états de choc. MEDECINE INTENSIVE REANIMATION 2017. [DOI: 10.1007/s13546-017-1262-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Abstract
Despite concerns about the negative effects of metabolic acidosis, there is minimal evidence that sodium bicarbonate administration is an effective treatment. In addition, sodium bicarbonate therapy is associated with many adverse effects, including paradoxic intracellular acidosis, hypokalemia, hypocalcemia, hypernatremia, and hyperosmolality. Definitive recommendations regarding bicarbonate therapy are challenging as there is little high-quality evidence available. In most clinical scenarios of metabolic acidosis, treatment efforts should focus on resolution of the underlying cause, and sodium bicarbonate therapy should be used with caution, if at all. An exception to this is kidney disease, wherein sodium bicarbonate therapy may have a valuable role.
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Affiliation(s)
- Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, Room 2112, Tupper Hall, Davis, CA 95616, USA.
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Lee SM, Kim SE, Kim EB, Jeong HJ, Son YK, An WS. Lactate Clearance and Vasopressor Seem to Be Predictors for Mortality in Severe Sepsis Patients with Lactic Acidosis Supplementing Sodium Bicarbonate: A Retrospective Analysis. PLoS One 2015; 10:e0145181. [PMID: 26692209 PMCID: PMC4686961 DOI: 10.1371/journal.pone.0145181] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/30/2015] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Initial lactate level, lactate clearance, C-reactive protein, and procalcitonin in critically ill patients with sepsis are associated with hospital mortality. However, no study has yet discovered which factor is most important for mortality in severe sepsis patients with lactic acidosis. We sought to clarify this issue in patients with lactic acidosis who were supplementing with sodium bicarbonate. MATERIALS AND METHODS Data were collected from a single center between May 2011 and April 2014. One hundred nine patients with severe sepsis and lactic acidosis who were supplementing with sodium bicarbonate were included. RESULTS The 7-day mortality rate was 71.6%. The survivors had higher albumin levels and lower SOFA, APACHE II scores, vasopressor use, and follow-up lactate levels at an elapsed time after their initial lactate levels were checked. In particular, a decrement in lactate clearance of at least 10% for the first 6 hours, 24 hours, and 48 hours of treatment was more dominant among survivors than non-survivors. Although the patients who were treated with broad-spectrum antibiotics showed higher illness severity than those who received conventional antibiotics, there was no significant mortality difference. 6-hour, 24-hour, and 48-hour lactate clearance (HR: 4.000, 95% CI: 1.309-12.219, P = 0.015) and vasopressor use (HR: 4.156, 95% CI: 1.461-11.824, P = 0.008) were significantly associated with mortality after adjusting for confounding variables. CONCLUSIONS Lactate clearance at a discrete time point seems to be a more reliable prognostic index than initial lactate value in severe sepsis patients with lactic acidosis who were supplementing with sodium bicarbonate. Careful consideration of vasopressor use and the initial application of broad-spectrum antibiotics within the first 48 hours may be helpful for improving survival, and further study is warranted.
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Affiliation(s)
- Su Mi Lee
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Eun Bin Kim
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Hyo Jin Jeong
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Young Ki Son
- Department of Internal Medicine, Dong-A University, Busan, Korea
| | - Won Suk An
- Department of Internal Medicine, Dong-A University, Busan, Korea
- Institute of Medical Science, Dong-A University College of Medicine, Busan, Korea
- * E-mail:
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The Use of Sodium Bicarbonate in the Treatment of Acidosis in Sepsis: A Literature Update on a Long Term Debate. Crit Care Res Pract 2015; 2015:605830. [PMID: 26294968 PMCID: PMC4534594 DOI: 10.1155/2015/605830] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 06/29/2015] [Accepted: 07/01/2015] [Indexed: 12/29/2022] Open
Abstract
Introduction. Sepsis and its consequences such as metabolic acidosis are resulting in increased mortality. Although correction of metabolic acidosis with sodium bicarbonate seems a reasonable approach, there is ongoing debate regarding the role of bicarbonates as a therapeutic option. Methods. We conducted a PubMed literature search in order to identify published literature related to the effects of sodium bicarbonate treatment on metabolic acidosis due to sepsis. The search included all articles published in English in the last 35 years. Results. There is ongoing debate regarding the use of bicarbonates for the treatment of acidosis in sepsis, but there is a trend towards not using bicarbonate in sepsis patients with arterial blood gas pH > 7.15. Conclusions. Routine use of bicarbonate for treatment of severe acidemia and lactic acidosis due to sepsis is subject of controversy, and current opinion does not favor routine use of bicarbonates. However, available evidence is inconclusive, and more studies are required to determine the potential benefit, if any, of bicarbonate therapy in the sepsis patient with acidosis.
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Kimmoun A, Novy E, Auchet T, Ducrocq N, Levy B. Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:175. [PMID: 25887061 PMCID: PMC4391479 DOI: 10.1186/s13054-015-0896-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Lactic acidosis is a very common biological issue for shock patients. Experimental data clearly demonstrate that metabolic acidosis, including lactic acidosis, participates in the reduction of cardiac contractility and in the vascular hyporesponsiveness to vasopressors through various mechanisms. However, the contributions of each mechanism responsible for these deleterious effects have not been fully determined and their respective consequences on organ failure are still poorly defined, particularly in humans. Despite some convincing experimental data, no clinical trial has established the level at which pH becomes deleterious for hemodynamics. Consequently, the essential treatment for lactic acidosis in shock patients is to correct the cause. It is unknown, however, whether symptomatic pH correction is beneficial in shock patients. The latest Surviving Sepsis Campaign guidelines recommend against the use of buffer therapy with pH ≥7.15 and issue no recommendation for pH levels <7.15. Furthermore, based on strong experimental and clinical evidence, sodium bicarbonate infusion alone is not recommended for restoring pH. Indeed, bicarbonate induces carbon dioxide generation and hypocalcemia, both cardiovascular depressant factors. This review addresses the principal hemodynamic consequences of shock-associated lactic acidosis. Despite the lack of formal evidence, this review also highlights the various adapted supportive therapy options that could be putatively added to causal treatment in attempting to reverse the hemodynamic consequences of shock-associated lactic acidosis.
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Affiliation(s)
- Antoine Kimmoun
- CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital de Brabois, Vandoeuvre-les-Nancy, 54511, France. .,Université de Lorraine, Nancy, 54000, France. .,INSERM U1116, Groupe Choc, Faculté de Médecine, Vandoeuvre-les-Nancy, 54511, France.
| | - Emmanuel Novy
- CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital de Brabois, Vandoeuvre-les-Nancy, 54511, France. .,Université de Lorraine, Nancy, 54000, France.
| | - Thomas Auchet
- CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital de Brabois, Vandoeuvre-les-Nancy, 54511, France.
| | - Nicolas Ducrocq
- CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital de Brabois, Vandoeuvre-les-Nancy, 54511, France.
| | - Bruno Levy
- CHU Nancy, Service de Réanimation Médicale Brabois, Pole Cardiovasculaire et Réanimation Médicale, Hôpital de Brabois, Vandoeuvre-les-Nancy, 54511, France. .,Université de Lorraine, Nancy, 54000, France. .,INSERM U1116, Groupe Choc, Faculté de Médecine, Vandoeuvre-les-Nancy, 54511, France.
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Kim HJ, Son YK, An WS. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis. PLoS One 2013; 8:e65283. [PMID: 23755210 PMCID: PMC3673920 DOI: 10.1371/journal.pone.0065283] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 04/23/2013] [Indexed: 01/12/2023] Open
Abstract
Background Lactic acidosis is a common cause of high anion gap metabolic acidosis. Sodium bicarbonate may be considered for an arterial pH <7.15 but paradoxically depresses cardiac performance and exacerbates acidosis by enhancing lactate production. This study aimed to evaluate the cause and mortality rate of lactic acidosis and to investigate the effect of factors, including sodium bicarbonate use, on death. Methods We conducted a single center analysis from May 2011 through April 2012. We retrospectively analyzed 103 patients with lactic acidosis among 207 patients with metabolic acidosis. We used SOFA and APACHE II as severity scores to estimate illness severity. Multivariate logistic regression analysis and Cox regression analysis models were used to identify factors that affect mortality. Results Of the 103 patients with a mean age of 66.1±11.4 years, eighty-three patients (80.6%) died from sepsis (61.4%), hepatic failure, cardiogenic shock and other causes. The percentage of sodium bicarbonate administration (p = 0.006), catecholamine use, ventilator care and male gender were higher in the non-survival group than the survival group. The non-survival group had significantly higher initial and follow-up lactic acid levels, lower initial albumin, higher SOFA scores and APACHE II scores than the survival group. The mortality rate was significantly higher in patients who received sodium bicarbonate. Sodium bicarbonate administration (p = 0.016) was associated with higher mortality. Independent factors that affected mortality were SOFA score (Exp (B) = 1.72, 95% CI = 1.12–2.63, p = 0.013) and sodium bicarbonate administration (Exp (B) = 6.27, 95% CI = 1.10–35.78, p = 0.039). Conclusions Lactic acidosis, which has a high mortality rate, should be evaluated in patients with metabolic acidosis. In addition, sodium bicarbonate should be prescribed with caution in the case of lactic acidosis because sodium bicarbonate administration may affect mortality.
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Affiliation(s)
- Hyun Jeong Kim
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Young Ki Son
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Won Suk An
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
- Institute of Medical Science, Dong-A University College of Medicine, Busan, Korea
- * E-mail:
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