DOCSLIB.ORG

Original Article Effects of Sodium Bicarbonate on Hepatic Injury After Left Lateral Hepatectomy with Inflow Occlusion: a Retrospective Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Original Article Effects of Sodium Bicarbonate on Hepatic Injury After Left Lateral Hepatectomy with Inflow Occlusion: a Retrospective Study Int J Clin Exp Med 2018;11(8):8196-8204 www.ijcem.com /ISSN:1940-5901/IJCEM0065538 Original Article Effects of sodium bicarbonate on hepatic injury after left lateral hepatectomy with inflow occlusion: a retrospective study Li Gong1, Chao Dong2, Yongzhong Tang1, Wen Ouyang1 1Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha 410013, Hunan, China; 2Xiangya International Medical Center-Surgical Ward, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China Received September 13, 2017; Accepted April 2, 2018; Epub August 15, 2018; Published August 30, 2018 Abstract: Ischemia-reperfusion injury induced by blocking the portal triad is a common clinical pathophysiological event during the hepatic lobectomy. We retrospectively investigated whether perioperative administration of sodium bicarbonate decreases occurrence of postoperative hepatic injury. 158 patients diagnosed with intrahepatic stone received left lateral lobectomy with inflow occlusion from Jan 2011 to Mar 2017. Control (n=124) and the sodium bicarbonate (n=34) groups were assigned depending on whether they intraoperatively received sodium bicarbonate or not. The data of alanine aminotransferase (ALT), aspartate transaminase (AST) and total Bilirubin, reflecting liver functions, on the pre-operative day, the first day and the third day after operation were collected and compared. Patients of two groups were well balanced for baseline characteristics. The AST level significantly decreased in the sodium bicarbonate group on the first day after operation compared with Control group (p=0.0058). 150 ml of intra- venous sodium bicarbonate showed a significant attenuate in increased plasma AST, ALT and total Bilirubin levels at one day after operation compared with 50 and 100 ml (all p < 0.05), but not on the third day after operation (p > 0.05). Significant differences were found in BE, sodium, bicarbonate levels both one hour after occlusion and after surgery in the sodium bicarbonate group compared with Control group. And the number of patients treated with hepatic protective drugs on the second day after surgery declined significantly in the sodium bicarbonate group compared with Control group (p=0.0194). A particular volume of sodium bicarbonate can reduce hepatic injury after left lateral lobectomy of liver with inflow occlusion on the first day after operation and alleviate the burden of postoperative liver protective drugs usage. Keywords: Sodium bicarbonate, hepatic ischemia-reperfusion injury, left lateral lobectomy Introduction on, play critical roles in hepatic IR injury [6-8]. And a variety of promising protective approach- Temporary portal triad clamping is one com- es have been explored to reduce the injury. mon methodology of reducing bleeding and Ischemic preconditioning, surgical strategies transfusion during hepatic lobectomy since the and pharmacological therapies with different early 20th century [1, 2]. Unfortunately, isch- targets play a predominant role in minimizing emia/reperfusion (IR)-induced ischemic injury the hepatic IR injury in experimental animals in the remnant liver remains a frequent and and clinical [9, 10]. However, effective ways to major complication after portal triad clamping. prevent hepatic IR injury are not available so far It compromises liver function and increases [11]. postoperative morbidity, mortality, progress, recovery, and overall outcomes [3-5]. A great Sodium bicarbonate was used to attenuate number of in-depth studies focused on the free radical formation and inhibit oxidase st- complicated mechanism underlying hepatic IR ress [12]. It has high accessibility and is a low- injury. It is now becoming clear that oxidative cost, easy-to-use drug in clinical. It’s also sug- stress, inflammatory response, the impairment gested that sodium bicarbonate serves as a of mitochondria and vascular integrity and so possible strategy for prevention of nephropathy Sodium bicarbonate and hepatic injury Material and methods Patients The de-identified data was retrospectively obtained from Jan 2011 to Mar 2017 from the structured hospital infor- mation system (HIS) and An- esthesia system of our insti- tute, in accordance with local ethical committee approval. Figure 1. Protocol of surgical procedure and outcome measures. 364 ASA physical status I/II/ III adult patients, who were diagnosed as intrahepatic bile duct stone and under- went left lateral lobectomy of liver + cholecystectomy + T- tube drainage + common bile duct exploration with or with- out inflow occlusion. The ex- clusion criteria were (1) diabe- tes mellitus; (2) preoperative hepatic dysfunctions; (3) hem- angioma; (4) hepatic occupi- ed lesion; (5) hepatitis; (6) scheduled resection not re- quiring hepatic portal occlu- sion; (7) reoperation; (8) peri- operative transfusion; (9) ad- ministration of hepatic pro- tective drugs on the first day after operation; (10) blood loss in operation > 700 ml; (11) occlusion time > 30 min. And in the patients with in- flow occlusion during surgery, Figure 2. Study Flow and Distribution of participants through each stage of the control and sodium bicar- the retrospective study. bonate groups were assign- ed depending on whether they in patients undergoing coronary angiography preoperatively received sodium bicarbonate or patients with systemic inflammatory res- or not. And in the sodium bicarbonate group, ponse syndrome or sepsis and oliguria [13, 50 ml up to 150 ml of sodium bicarbonate was 14]. But it has been rarely reported about the intravenous once within 20 minutes before effect of sodium bicarbonate on hepatic IR occlusion during surgery (Figure 1). And the injury induced by the hepatolobectomy with volume of sodium bicarbonate infused periop- inflow occlusion. To address these issues, we eratively was depending on the anesthetists’ retrospectively collected data to check wheth- experiences and decision. er intraoperative administration of sodium bi- carbonate reduced hepatic injury in patients Anesthesia management undergoing left lateral lobectomy of liver with inflow occlusion, with hopes of developing a All the patients were under general anesthesia simple and effective therapy to diminish the with tracheal intubation. They were given mid- injury. azolam (0.1-0.15 mg/kg), propofol (1.5-2 mg/ 8197 Int J Clin Exp Med 2018;11(8):8196-8204 Sodium bicarbonate and hepatic injury kg), sulfentanil (0.5-0.8 μg/kg) and cisatra- tive variables, and Fisher’s exact tests were curium (0.15 mg/kg) for routine anesthesia used for categorical variables. Results were induction. Anesthesia was all maintained with assessed using one-way analysis of variance propofol, cisatracurium, remifentanil and sevo- (ANOVA) followed by Student’s t-test. Statistic- flurane. All the patients were treated with arte- al analysis was implemented with Prism 6 rial radialis puncture for direct manometric (GraphPad Software, Inc., CA, USA), during wh- method and arterial blood gas analysis. A cen- ich p values less than 0.05 were considered tral venous catheter was indwelled for monitor- statistically significant. ing the central venous pressure and infusing of fluids or transfusion. In addition, ECG, blood Results pressure, SpO2, EtCO2 and urine volume were checked continuously as a routine during sur- We conducted a single-center, retrospective gery. Arterial blood gas analysis in the patients study of hospitalized adults from Jan 2011 to with hepatic portal interdiction during surgery Mar 2017. In total, 592 patients who under- were carried out at least three times: preopera- went left lateral lobectomy of liver + cholecys- tively, immediately after surgery and 24 hours tectomy + T-tube drainage + common bile duct after surgery. Patients were extubated once exploration were considered potential candi- awake in PACU. dates. We identified 498 subjects in the struc- tured hospital information system (HIS) of our Study outcomes institute who were diagnosed with intrahepatic stone. 94 patients were excluded with a dis- Basic characteristics such as ASA, sex, and age charge diagnosis of ‘haemangioma’ or ‘hepatic were gathered and compared between the occupied lesion’ and so on. And another 134 groups. The operation time, blood loss, occlu- patients were next ruled out, as they had hepa- sion time, urine outputs, anesthesia manage- titis, reoperation, perioperative transfusion, ment and number of patients requiring vaso- blood loss > 700 ml, occlusion time > 30 min. pressin were also compared. The comparison Finally, 364 patients underwent the operations of anesthesia management included dosages with (B and C groups, n=158) or without hepat- of different anesthetic drugs including sufent- ic portal interdiction (A group, n=206) were anil, sevoflurane and so on. Postoperative con- assessed for eligibility. And 158 patients of ditions including the hospital stay time, inci- them enrolled were divided into the sodium dence of acute liver failure, pulmonary infection, bicarbonate group (C group, n=124) who re- number of patients who had postoperative con- ceived intravenous sodium bicarbonate intra- trolled intravenous analgesia (PCIA) and num- operatively, and Control group (B group, n=34) ber of patients received hepatic protective (Figure 2). A detailed description of baseline drugs on the second day after surgery were demographic characteristics of enrolled pa- also compared. tients is given in Table 1. No significant differ- ences were found between the groups (B vs. The primary
Load more

Recommended publications
  • Metabolic Regulation of Heme Catabolism and Bilirubin Production
    Metabolic Regulation of Heme Catabolism and Bilirubin Production. I. HORMONAL CONTROL OF HEPATIC HEME OXYGENASE ACTIVITY Arne F. Bakken, … , M. Michael Thaler, Rudi Schmid J Clin Invest. 1972;51(3):530-536. https://doi.org/10.1172/JCI106841. Research Article Heme oxygenase (HO), the enzyme system catalyzing the conversion of heme to bilirubin, was studied in the liver and spleen of fed, fasted, and refed rats. Fasting up to 72 hr resulted in a threefold increase in hepatic HO activity, while starvation beyond this period led to a gradual decline in enzyme activity. Refeeding of rats fasted for 48 hr depressed hepatic HO activity to basal values within 24 hr. Splenic HO was unaffected by fasting and refeeding. Hypoglycemia induced by injections of insulin or mannose was a powerful stimulator of hepatic HO. Glucose given together with the insulin abolished the stimulatory effect of the latter. Parenteral treatment with glucagon led to a twofold, and with epinephrine to a fivefold, increase of hepatic HO activity; arginine, which releases endogenous glucagon, stimulated the enzyme fivefold. These stimulatory effects of glucagon and epinephrine could be duplicated by administration of cyclic adenosine monophosphate (AMP), while thyroxine and hydroxortisone were ineffective. Nicotinic acid, which inhibits lipolysis, failed to modify the stimulatory effect of epinephrine. None of these hormones altered HO activity in the spleen. These findings demonstrate that the enzymatic mechanism involved in the formation of bilirubin from heme in the liver is stimulated by fasting, hypoglycemia, epinephrine, glucagon, and cyclic AMP. They further suggest that the enzyme stimulation produced by fasting may be […] Find the latest version: https://jci.me/106841/pdf Metabolic Regulation of Heme Catabolism and Bilirubin Production I.
    [Show full text]
  • Jaundice Protocol
    fighting childhood liver disease Jaundice Protocol Early identification and referral of liver disease in infants fighting childhood liver disease 36 Great Charles Street Birmingham B3 3JY Telephone: 0121 212 3839 yellowalert.org childliverdisease.org [email protected] Registered charity number 1067331 (England & Wales); SC044387 (Scotland) The following organisations endorse the Yellow Alert Campaign and are listed in alphabetical order. 23957 CLDF Jaundice Protocol.indd 1 03/08/2015 18:25:24 23957 3 August 2015 6:25 PM Proof 1 1 INTRODUCTION This protocol forms part of Children’s Liver Disease Foundation’s (CLDF) Yellow Alert Campaign and is written to provide general guidelines on the early identification of liver disease in infants and their referral, where appropriate. Materials available in CLDF’s Yellow Alert Campaign CLDF provides the following materials as part of this campaign: • Yellow Alert Jaundice Protocol for community healthcare professionals • Yellow Alert stool colour book mark for quick and easy reference • Parents’ leaflet entitled “Jaundice in the new born baby”. CLDF can provide multiple copies to accompany an antenatal programme or for display in clinics • Yellow Alert poster highlighting the Yellow Alert message and also showing the stool chart 2 GENERAL AWARENESS AND TRAINING The National Institute of Health and Clinical Excellence (NICE) has published a clinical guideline on neonatal jaundice which provides guidance on the recognition, assessment and treatment of neonatal jaundice in babies from birth to 28 days. Neonatal Jaundice Clinical Guideline guidance.nice.org.uk cg98 For more information go to nice.org.uk/cg98 • Jaundice Community healthcare professionals should be aware that there are many causes for jaundice in infants and know how to tell them apart: • Physiological jaundice • Breast milk jaundice • Jaundice caused by liver disease • Jaundice from other causes, e.g.
    [Show full text]
  • Serum Levels of True Insulin, C-Peptide and Proinsulin in Peripheral Blood of Patients with Cirrhosis
    Diabetologia (1983) 25: 506-509 Diabetologia Springer-Verlag 1983 Serum Levels of True Insulin, C-Peptide and Proinsulin in Peripheral Blood of Patients with Cirrhosis T. Kasperska-Czy~ykowa 1, L. G. Heding 2 and A. Czy2yk 1 1Department of Gastroenterology and Metabolic Diseases, Medical Academy of Warsaw, Poland, and 2Novo Research Institute, Bagsvaerd, Denmark Summary. The levels of proinsulin, immunoreactive insulin, but the difference was less pronounced and only significant at true insulin (calculated from the difference, namely immuno- a few of the time points. The serum level of C-peptide was reactive insulin-proinsulin) and C-peptide were determined in very similar in both groups. These results emphasize that cir- the fasting state and during a 3-h oral glucose tolerance test af- rhosis is a condition in which the serum proinsulin level is ter administration of 100 g of glucose in 12 patients with cir- raised and that this hyperproinsulinaemia contributes greatly rhosis with normal oral glucose tolerance test (50 g) and in to the increased immunoreactive insulin levels observed in 12 healthy subjects serving as controls. In the patients with cir- patients with this disease. rhosis the serum levels of proinsulin and immunoreactive in- sulin were significantly higher in the fasting state and after Key words: Insulin, cirrhosis, C-peptide, proinsulin, oral glu- glucose loading than in the healthy subjects. The serum level cose tolerance test. of true insulin was also higher in the patients with cirrhosis, After the introduction of a radioimmunoassay for se- Patients and Methods rum (plasma) insulin determination (IRI) many authors reported raised levels of this hormone in the peripheral blood of patients with cirrhosis [1, 5-7, 9, 16-19].
    [Show full text]
  • A Novel Perspective on the Biology of Bilirubin in Health and Disease
    Opinion A Novel Perspective on the Biology of Bilirubin in Health and Disease 1,z 2,z, 3 Silvia Gazzin, Libor Vitek, * Jon Watchko, 4,5,6,7 1,8, Steven M. Shapiro, and Claudio Tiribelli * Unconjugated bilirubin (UCB) is known to be one of the most potent endogenous Trends antioxidant substances. While hyperbilirubinemia has long been recognized as Historically known for its toxicity but an ominous sign of liver dysfunction, recent data strongly indicate that mildly recently recognized as a powerful pro- tective molecule, BLB is gaining more elevated bilirubin (BLB) levels can be protective against an array of diseases attention due to its pleiotropic biomo- associated with increased oxidative stress. These clinical observations are lecular effects and those of the supported by new discoveries relating to the role of BLB in immunosuppression enzymes involved in BLB metabolism (the ‘Yellow Players’). and inhibition of protein phosphorylation, resulting in the modulation of intra- cellular signaling pathways in vascular biology and cancer, among others. Both heme oxygenase (HMOX) and bili- Collectively, the evidence suggests that targeting BLB metabolism could be verdin reductase (BLVR) (the main enzymes in BLB metabolism) act on considered a potential therapeutic approach to ameliorate a variety of numerous signaling pathways, with conditions. unsuspected biological consequences. The interconnections of such pathways highlight an incredibly complex biomo- From a Biological Waste Product to a Potent Biological Compound lecular network. Yellow player mole- UCB (see Glossary), the end product of the heme catabolic pathway, has long been recognized cules can have important physiological as a sign of liver dysfunction or a potential toxic factor causing severe brain damage in newborns.
    [Show full text]
  • (Insulin Dependent) Diabetes Mellitus Is Related to Poor Residual Cell Function
    410 Archives ofDisease in Childhood 1996;75:410-415 Ketoacidosis at the diagnosis of type 1 (insulin Arch Dis Child: first published as 10.1136/adc.75.5.410 on 1 November 1996. Downloaded from dependent) diabetes mellitus is related to poor residual cell function Jorma Komulainen, Raisa Lounamaa, Mikael Knip, Eero A Kaprio, Hans K Akerblom, and the Childhood Diabetes in Finland Study Group Abstract observed to be associated with age at diagno- The determinants of the degree of meta- sis,' degree of metabolic decompensation,9 bolic decompensation at the diagnosis of mild clinical symptoms at diagnosis,2910 and type 1 (insulin dependent) diabetes melli- strict initial blood glucose control.213 Diabetic tus (IDDM) and the possible role of ketoacidosis is a serious consequence of insuf- diabetic ketoacidosis in the preservation ficient insulin secretion.'4 In addition to possi- and recovery of residual P cell function ble acute complications, it may also influence were examined in 745 Finnish children the later outcome of diabetes. and adolescents. Children younger than 2 To study the effect of age, sex, and years or older than 10 years of age were socioeconomic factors on the clinical condition found to be more susceptible to diabetic ofthe patient at the diagnosis of IDDM, and to ketoacidosis than children between 2 and find out whether metabolic decompensation at 10 years of age (<2 years: 53.3%; 2-10 diagnosis is related to subsequent endogenous years: 16.9%; >10 years: 33.3%). Children insulin secretion and impaired metabolic con- from families with poor parental trol, 745 Finnish children and adolescents, educational level had ketoacidosis more aged 0.8-14.9 years, were evaluated at the time often than those from families with high of diagnosis of IDDM and then observed for parental educational level (24.4% v two years.
    [Show full text]
  • Understanding Your Liver Function Results
    www.healthinfo.org.nz Understanding your liver function results Your liver is a very important organ that has many jobs. Some of its jobs are to make proteins, make bile to help you digest fats, store energy, and break down some toxins and medicines. Liver function tests are done if you have symptoms of a liver condition or risk factors for liver disease such as fatty liver, viral hepatitis or high alcohol use. They are also checked if you are taking medicines that can affect how your liver works. Terms used Protein: this is the total of all the different types of protein in your blood. Albumin: this is the main protein your liver makes. It goes into your blood and helps to carry many things around your body. Bilirubin: this is something your body makes when it breaks down old red blood cells and replaces them with new ones. Bilirubin gives bile its yellow colour. Alkaline phosphatase (ALP): this is an enzyme in your liver and bones. (An enzyme is a chemical that helps to speed up other chemical processes.) GGT: this stands for gamma glutamyltransferase, which is an enzyme in your liver. ALT: this stands for alanine aminotransferase, which is another enzyme in your liver. AST: this stands for aspartate aminotransferase, which is also an enzyme in your liver. Normal result If you have a copy of your test results, it will show your results and a normal range for each test. The normal ranges may vary depending on your gender and age group and whether you're pregnant or have any underlying health conditions.
    [Show full text]
  • Hyperchloremia – Why and How
    Document downloaded from http://www.elsevier.es, day 23/05/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. n e f r o l o g i a 2 0 1 6;3 6(4):347–353 Revista de la Sociedad Española de Nefrología www.revistanefrologia.com Brief review Hyperchloremia – Why and how Glenn T. Nagami Nephrology Section, Department of Medicine, VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, United States a r t i c l e i n f o a b s t r a c t Article history: Hyperchloremia is a common electrolyte disorder that is associated with a diverse group of Received 5 April 2016 clinical conditions. The kidney plays an important role in the regulation of chloride concen- Accepted 11 April 2016 tration through a variety of transporters that are present along the nephron. Nevertheless, Available online 3 June 2016 hyperchloremia can occur when water losses exceed sodium and chloride losses, when the capacity to handle excessive chloride is overwhelmed, or when the serum bicarbonate is low Keywords: with a concomitant rise in chloride as occurs with a normal anion gap metabolic acidosis Hyperchloremia or respiratory alkalosis. The varied nature of the underlying causes of the hyperchloremia Electrolyte disorder will, to a large extent, determine how to treat this electrolyte disturbance. Serum bicarbonate Published by Elsevier Espana,˜ S.L.U. on behalf of Sociedad Espanola˜ de Nefrologıa.´ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).
    [Show full text]
  • Bicarbonate Therapy in Severe Metabolic Acidosis
    CLINICAL COMMENTARY www.jasn.org Bicarbonate Therapy in Severe Metabolic Acidosis Sandra Sabatini and Neil A. Kurtzman Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas ABSTRACT monly termed “potential” bicarbonate. The utility of bicarbonate administration to patients with severe metabolic acidosis Giving bicarbonate to a patient with a remains controversial. Chronic bicarbonate replacement is obviously indicated for true bicarbonate deficit is not controver- patients who continue to lose bicarbonate in the ambulatory setting, particularly sial. Controversy arises when the de- patients with renal tubular acidosis syndromes or diarrhea. In patients with acute crease in bicarbonate concentration is lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back the result of its conversion to another to bicarbonate if the clinical situation improves. For these patients, therapy must base, which, given time, can be converted be individualized. In general, bicarbonate should be given at an arterial blood pH back to bicarbonate. If one knew that the of Յ7.0. The amount given should be what is calculated to bring the pH up to 7.2. timely and efficient conversion of aceto- The urge to give bicarbonate to a patient with severe acidemia is apt to be all but acetate and ␤-hydroxybutyrate or lactate irresistible. Intervention should be restrained, however, unless the clinical situation back to bicarbonate would occur with- clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy out morbidity or mortality, then there for patients with severe metabolic acidosis. would be no reason even to contemplate giving bicarbonate. J Am Soc Nephrol 20: 692–695, 2009.
    [Show full text]
  • Association Between Serum Bilirubin and Albuminuria in Type 2 Diabetes Mellitus and Diabetic Nephropathy
    Original Research Article DOI: 10.18231/2394-6377.2018.0048 Association between serum bilirubin and albuminuria in type 2 diabetes mellitus and diabetic nephropathy Suryapriya Rajendran1, Manju M.2,*, Sasmita Mishra3, Rakesh Kumar4 1,4Assistant Professor, 2Associate Professor, 3Professor and HOD, Dept. of Biochemistry, 4Dept. of General Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, India. *Corresponding Author: Email: [email protected] Received: 16th February, 2018 Accepted: 20th March, 2018 Abstract Introduction: Diabetic nephropathy develops due to oxidative stress and inflammation resulting from chronic hyperglycemia. Bilirubin, a product of heme catabolism is found to have antioxidant and anti-inflammatory properties. Though previous studies have examined the relationship between total bilirubin and diabetic nephropathy, very few studies have focused on indirect and direct bilirubin levels. Hence, the present study aimed to compare serum bilirubin (total, indirect and direct) levels between non- diabetics, type 2 diabetics and diabetic nephropathy subjects and also to correlate albuminuria with serum bilirubin in type 2 diabetics and diabetic nephropathy subjects. Materials and Methods: 50 non-diabetics, 50 type 2 diabetics and 50 diabetic nephropathy subjects were included in the study. Fasting blood glucose, HbA1C, serum bilirubin (total, indirect and direct), serum creatinine, urine microalbumin and urine creatinine were measured. Estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (ACR) was calculated. Results: Total bilirubin, direct and indirect bilirubin were significantly decreased in type 2 diabetics and diabetic nephropathy subjects compared to non-diabetics. Total bilirubin and indirect bilirubin were also significantly decreased in diabetic nephropathy subjects compared to type 2 diabetics. Total bilirubin, direct and indirect bilirubin showed significant negative correlation with albuminuria (Urine ACR) in type 2 diabetics and diabetic nephropathy subjects.
    [Show full text]
  • Cholestasis and Neonatal Hypoglycaemia
    MOJ Clinical & Medical Case Reports Case Report Open Access Cholestasis and neonatal hypoglycaemia Abstract Volume 10 Issue 4 - 2020 Glucose is essential as the main brain energy source, hypoglycemia is dangerous and may Nahla Kamel Gaballa,1 Hossam Bassiouny,2 cause neuronal damage as well as siezers and acidosis. The undetectable hypoglycemia has Tahany Abdel hameed,2 Mahmoud EL serious effects if passed unnoticed specially in infants who cannot explain their sensation 3 4 1 and complain , any abnormal clinical or laboratory response should be addressed as a Moniar, Hazem Zakaria, Eman Awad, Heba 5 special entity and dealing with as if a complain that must be investigated. Abd Alla 1Lecturer of Anesthesia and intensive care department, national liver institute, Menoufia University, Egypt 2Lecturer of pediatric hepatology department, Menoufia University, Egypt 3Assistant Lecturer of Anesthesia and intensive care department, Menoufia University, Egypt 4Associate professor of hepatopancreatobiliary, surgical department national liver institute, Menoufia University, Egypt 5Lecturer of clinical pathology and hematology, clinical pathology department, Menoufia University, Egypt Correspondence: Nahla Kamel Gaballa, Lecturer of Anesthesia and intensive care department, national liver institute, Menoufia University, Egypt, Email Received: June 23, 2020 | Published: July 14, 2020 Case report -2.5ml/kg was given(short term hypoglycemia treatment) ,starting the operation and he was diagnosed as type 2 obstruction, the next hourly An infant 83 days old for Kassi operation, 4.5kg, normal growing reading of RBS was 77mg/dl and again second bolus of Glucose parameters and reactive, without mother complain regarding feeding 10% was given, then starting Glucose 10% infusion 5mg/kg/min, or suckling, normal birth history, progressive jaundice after birth and the operation lasted for 4hours including hernial repair and caudal history of blood transfusion after Hb drop in rural pediatric department.
    [Show full text]
  • Association Between Sodium Bicarbonate Consumption and Human Health: a Systematic Review
    Available online at www.ijmrhs.com International Journal of Medical Research & ISSN No: 2319-5886 Health Sciences, 2016, 5, 8:22-29 Association between sodium bicarbonate consumption and human health: A systematic review Yadolah Fakhri 1, Nazak Amanidaz 2, Yahya Zandsalimi 3, Maryam Dadar 4, Ali Moradi 5, Bigard Moradi 6, Leila Rasouli Amirhajeloo 7, Hassan Keramati 8, Athena Rafieepour 9,* 1Food and Cosmetic Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran 2Environmental Health Research Center, Golestan University of Medical Sciences, Golestan, Iran 3Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran 4Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran 5Asadabad Health and Treatment Network, Hamadan University of Medical Sciences, Hamadan, Iran 6Department of Health Public, Kermanshah University of Medical Sciences, Kermanshah, Iran 7Department of Environmental Health Engineering, School of Public Health, Qom University of Medical Sciences, Qom, Iran 8Department of Environmental Health Engineering, School of Public Health, Semnan University of Medical Sciences, Semnan, Iran 9Studends Research Office, Shahid Beheshti University of Medical sciences, Tehran, Iran *Correspondence Email: [email protected] _____________________________________________________________________________________________ ABSTRACT Sodium bicarbonate or baking soda is a chemical compound dissolved in water which is widely used as an additive in foods and mineral water and as a medicine. In Iran, due to the introduction of harmful effects of this compound, using it in baking is prohibited. Therefore, we tried to search and evaluate all health effects of using this compound with a systematic review. In this study, all available evidences on the beneficial and harmful effects of sodium bicarbonate were searched.
    [Show full text]
  • Guideline for the Evaluation of Cholestatic Jaundice
    CLINICAL GUIDELINES Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition ÃRima Fawaz, yUlrich Baumann, zUdeme Ekong, §Bjo¨rn Fischler, jjNedim Hadzic, ôCara L. Mack, #Vale´rie A. McLin, ÃÃJean P. Molleston, yyEzequiel Neimark, zzVicky L. Ng, and §§Saul J. Karpen ABSTRACT Cholestatic jaundice in infancy affects approximately 1 in every 2500 term PREAMBLE infants and is infrequently recognized by primary providers in the setting of holestatic jaundice in infancy is an uncommon but poten- physiologic jaundice. Cholestatic jaundice is always pathologic and indicates tially serious problem that indicates hepatobiliary dysfunc- hepatobiliary dysfunction. Early detection by the primary care physician and tion.C Early detection of cholestatic jaundice by the primary care timely referrals to the pediatric gastroenterologist/hepatologist are important physician and timely, accurate diagnosis by the pediatric gastro- contributors to optimal treatment and prognosis. The most common causes of enterologist are important for successful treatment and an optimal cholestatic jaundice in the first months of life are biliary atresia (25%–40%) prognosis. The Cholestasis Guideline Committee consisted of 11 followed by an expanding list of monogenic disorders (25%), along with many members of 2 professional societies: the North American Society unknown or multifactorial (eg, parenteral nutrition-related) causes, each of for Gastroenterology, Hepatology and Nutrition, and the European which may have time-sensitive and distinct treatment plans. Thus, these Society for Gastroenterology, Hepatology and Nutrition. This guidelines can have an essential role for the evaluation of neonatal cholestasis committee has responded to a need in pediatrics and developed to optimize care.
    [Show full text]