Recomendaciones preanalíticas para la medición del equilibrio ácido-base y los gases en sangre. Recomendación (2018) / Preanalytical recommendations in blood gas analysis

El análisis de gases en sangre es una prueba frecuentemente solicitada en diferentes ámbitos hospitalarios. La medida de los parámetros incluidos en este análisis puede verse afectada por un elevado número de condiciones preanalíticas y es responsabilidad del laboratorio garantizar que los resultados reflejan de forma segura el equilibrio ácido-base y el estado de oxigenación del paciente. Aunque muchas de estas condiciones son comunes al resto de las magnitudes del laboratorio, como la identificación correcta del espécimen, algunas son propias del análisis de gases debido a la estabilidad de las magnitudes incluidas en él. Este documento establece recomendaciones para el control de las condiciones preanalíticas y otras fuentes de error relacionadas con el análisis de gases en sangre, tales como las características de los materiales empleados para la toma de muestra (jeringas, agujas y anticoagulantes), tipo de muestra (sangre arterial, venosa y capilar «arterializada») y las condiciones para el manejo y transporte de la muestra, incluyendo la influencia del tiempo transcurrido entre la extracción y el análisis, la temperatura de la muestra durante el transporte y el transporte en sí

Blood gas analysis is a commonly ordered test in different hospital settings. The measurement of the parameters included in this analysis is vulnerable to a huge number of pre-analytical conditions. Laboratory staff are responsible for ensuring that these results accurately reflect the acid-base and oxygenation status of the patient. Despite many pre-analytical steps in blood gas testing being common to other laboratory tests, such as proper sample identification, others are particular for this determination, such as the stability of the analytes measured. The aim of this document is to provide recommendations for the control of the pre-analytical variables and other error sources related to blood gas analysis. These include the characteristics of the materials used to collect the blood samples (syringes, needles and anticoagulants), the sample types (arterial, venous and «arterialised» capillary blood), as well as the conditions for sample handling and transport, including the effect of the time between sampling and analysis, the temperature during transport, and the type of transport

[Hydrochemical Characteristics and Influencing Factors in Different Geological Background: A Case Study in Darongjiang and Lingqu Basin, Guangxi, China].

The observation and sampling were carried out in May 2013 to April 2014 in a hydrological year for two river basins with different geological background in upstream of Li river basin. The seasonal variations of river water chemistry and its main influencing factors were discussed in this paper. The results showed that the hydrochemistry types of both Darongjiang basin with 9% of carbonates and Lingqu basin with nearly 50% of carbonates in area belonged to Ca-HCO3 type. Ca2+ and HCO3- were the main cations and anions. The main ion concentrations were higher in winter and lower in summer, affected by the change of the flow. Ca2+, Mg2+, HCO3- were mainly sourced from the weathering of carbonates by carbonic acid. The weathering of carbonates by sulfuric acid and the weathering of silicate rocks also had contribution to the river water chemistry. In addition, comparing to the Lingqu basin, the contribution of the weathering of carbonates was much more than the percent of carbonates area, because the carbonate rocks were eroded by the allogenic water. On the other hand, K+, Na+, Cl-, NO3-, SO4(2-) were mainly affected by the atmospheric precipitation and human activities. Comparing to the Darongjiang Basin, the effects of human activities on the changes of K+, Na+, Cl-, NO3-, SO4(2-) were more significant in Lingqu Basin.

Cold acclimation induces changes in Arabidopsis tonoplast protein abundance and activity and alters phosphorylation of tonoplast monosaccharide transporters.

Because they are immotile organisms, higher plants have developed efficient strategies for adaptation to temperature changes. During cold acclimation, plants accumulate specific types of solutes to enhance freezing tolerance. The vacuole is a major solute storage organelle, but until now the role of tonoplast proteins in cold acclimation has not been investigated. In a comparative tonoplast proteome analysis, we identified several membrane proteins with altered abundance upon cold acclimation. We found an increased protein abundance of the tonoplast pyrophosphatase and subunits of the vacuolar V-ATPase and a significantly increased V-ATPase activity. This was accompanied by increased vacuolar concentrations of dicarbonic acids and soluble sugars. Consistently, the abundance of the tonoplast dicarbonic acid transporter was also higher in cold-acclimatized plants. However, no change in the protein abundance of tonoplast monosaccharide transporters was detectable. However, a generally higher cold-induced phosphorylation of members of this sugar transporter sub-group was observed. Our results indicate that cold-induced solute accumulation in the vacuole is mediated by increased acidification of this organelle. Thus solute transport activity is either modulated by increased protein amounts or by modification of proteins via phosphorylation.

Sensitivity of coccolithophores to carbonate chemistry and ocean acidification.

About one-third of the carbon dioxide (CO(2)) released into the atmosphere as a result of human activity has been absorbed by the oceans, where it partitions into the constituent ions of carbonic acid. This leads to ocean acidification, one of the major threats to marine ecosystems and particularly to calcifying organisms such as corals, foraminifera and coccolithophores. Coccolithophores are abundant phytoplankton that are responsible for a large part of modern oceanic carbonate production. Culture experiments investigating the physiological response of coccolithophore calcification to increased CO(2) have yielded contradictory results between and even within species. Here we quantified the calcite mass of dominant coccolithophores in the present ocean and over the past forty thousand years, and found a marked pattern of decreasing calcification with increasing partial pressure of CO(2) and concomitant decreasing concentrations of CO(3)(2-). Our analyses revealed that differentially calcified species and morphotypes are distributed in the ocean according to carbonate chemistry. A substantial impact on the marine carbon cycle might be expected upon extrapolation of this correlation to predicted ocean acidification in the future. However, our discovery of a heavily calcified Emiliania huxleyi morphotype in modern waters with low pH highlights the complexity of assemblage-level responses to environmental forcing factors.

Acids in combination with sodium dodecyl sulfate caused quality deterioration of fresh-cut iceberg lettuce during storage in modified atmosphere package.

Recent studies showed that sodium acid sulfate (SAS) and levulinic acid (LA) in combination with sodium dodecyl sulfate (SDS) was effective in inactivating human pathogens on Romaine lettuce. The present study investigated the effects of LA and SAS in combination with SDS (as compared with citric acid and chlorine) on the inactivation of E. coli O157:H7 and sensory quality of fresh-cut Iceberg lettuce in modified atmosphere packages during storage at 4 °C. Results showed that LA (0.5% to 3%) and SAS (0.25% to 0.75%) with 0.05% SDS caused detrimental effects on visual quality and texture of lettuce. LA- and SAS-treated samples were sensorially unacceptable due to development of sogginess and softening after 7 and 14 d storage. It appears that the combined treatments caused an increase in the respiration rate of fresh-cut lettuce as indicated by higher CO(2) and lower O(2) in modified atmosphere packages. On the positive side, the acid treatments inhibited cut edge browning of lettuce pieces developed during storage. LA (0.5%), SAS (0.25%), and citric acid (approximately 0.25%) in combination with SDS reduced population of E. coli OH157:H7 by 0.41, 0.87, and 0.58 log CFU/g, respectively, while chlorine achieved a reduction of 0.94 log CFU/g without damage to the lettuce. Therefore, compared to chlorine, LA and SAS in combination with SDS have limited commercial value for fresh-cut Iceberg lettuce due to quality deterioration during storage.

Changes in total CO2 measurement according to reagent cassette rotation in chemistry autoanalyzers.

The quality control (QC) failure rate in the serum total carbon dioxide (TCO(2)) test increases at a higher rate than in other tests over time after calibration. The causes of the increased QC failure rate in the TCO(2) test were examined. Using a TBA200RF analyzer (Toshiba Medical Systems), the TCO(2) of the QC material was measured at 2-hr intervals and was found to decrease by up to 16.5% at 10 hr after calibration. In contrast, using the P-module and D-module analyzers (Roche Diagnostics), the TCO(2) of the QC material did not change significantly during 10 hr after calibration. When the TCO(2) level of the QC material was measured hourly over 5 hr with the TBA200FR analyzer while the reagent bottle was rotated at 0, 80, 120, 160, or 200 rpm, the rate of decline of TCO(2), increased over time after calibration and with increasing reagent cassette rotation. Therefore, in a clinical laboratory using an automated analyzer with a rotating reagent cassette, it is necessary to set a limit to the calibration time interval in order to satisfy the QC goal.

Major ion chemistry and dissolved inorganic carbon cycling in a human-disturbed mountainous river (the Luodingjiang River) of the Zhujiang (Pearl River), China.

Major ion chemistry and dissolved inorganic carbon system (DIC, mainly HCO3(-) and gaseous CO2) in the Luodingjiang River, a mountainous tributary of the Zhujiang (Pearl River), China, were examined based on a seasonal and spatial sampling scheme in 2005. The diverse distribution of lithology and anthropogenic impacts in the river basin provided the basic idea to assess the effects of lithology vs. human activities on water chemistry and carbon biogeochemistry in river systems. Major ions showed great spatial variations, with higher concentrations of total dissolved solids (TDS) and DIC in the regions with carbonate rocks and clastic sedimentary rocks, while lower in the regions with metamorphic sandstones and schists as well as granites. pCO2 at all sampling sites was oversaturated in June, ranging with a factor from 1.6 to 18.8 of the atmospheric concentration, reflecting the enhanced contribution from baseflow and interflow influx as well as in situ oxidation of organic matter. However, in April and December, undersaturated pCO2 was found in some shallow, clean rivers in the upstream regions. delta13C of DIC has a narrow range from -9.07 to -13.59 per thousand, which was more depleted in the regions with metamorphic rocks and granites than in the carbonate regions. Seasonally, it was slightly more depleted in the dry season (December) than in the wet season (June). The results suggested that lithological variability had a dominant control on spatial variations of water chemistry and carbon geochemistry in river systems. Besides, anthropogenic activities, such as agricultural and urban activities and in-stream damming, as well as river physical properties, such as water depth and transparency, also indicated their impacts. The seasonal variations likely reflected the changes of hydrological regime, as well as metabolic processes in the river.

Measurement of carbonyl chemical shifts of excited protein states by relaxation dispersion NMR spectroscopy: comparison between uniformly and selectively (13)C labeled samples.

Carr-Purcell-Meiboom-Gill (CPMG) relaxation dispersion nuclear magnetic resonance (NMR) spectroscopy has emerged as a powerful method for quantifying chemical shifts of excited protein states. For many applications of the technique that involve the measurement of relaxation rates of carbon magnetization it is necessary to prepare samples with isolated (13)C spins so that experiments do not suffer from magnetization transfer between coupled carbon spins that would otherwise occur during the CPMG pulse train. In the case of (13)CO experiments however the large separation between (13)CO and (13)C(alpha) chemical shifts offers hope that robust (13)CO dispersion profiles can be recorded on uniformly (13)C labeled samples, leading to the extraction of accurate (13)CO chemical shifts of the invisible, excited state. Here we compare such chemical shifts recorded on samples that are selectively labeled, prepared using [1-(13)C]-pyruvate and NaH(13)CO(3,) or uniformly labeled, generated from (13)C-glucose. Very similar (13)CO chemical shifts are obtained from analysis of CPMG experiments recorded on both samples, and comparison with chemical shifts measured using a second approach establishes that the shifts measured from relaxation dispersion are very accurate.

Analysis of carbonyl compounds via headspace solid-phase microextraction with on-fiber derivatization and gas chromatographic-ion trap tandem mass spectrometric determination of their O-(2,3,4,5,6-pentafluorobenzyl)oxime derivatives.

An improved method for the analysis of carbonyls is described utilizing a headspace solid-phase microextraction (HS-SPME) step and on-fiber derivatization with O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine (PFBHA) hydrochloride. Thermal desorption of the oxime derivatives formed on the fiber is followed by gas chromatographic separation coupled to an ion trap tandem mass spectrometer (GC-ITMS). Selecting specific fragment ions within the electron ionization (EI(+)) mass spectra of these oxime derivatives as precursor ions for MS-MS fragmentation provides a suitable method for the target analysis of individual carbonyl classes, such as alkanals, (E)-2-alkenals, (E,E)-2,4-alkadienals, and others. Retention indices on polar as well as on apolar stationary phases along with EI(+) mass spectra patterns are presented for a large set of oxime derivatives, giving valuable information needed for unambiguous assignment of substances in complex sample matrices. The fast sample preparation and derivatization step via HS-SPME can be automated and is applicable to a variety of biological samples and foodstuffs, allowing rapid and sensitive screening analyses of important aldehydic biomarkers and aroma active compounds.

Gas chromatographic determination of carbonyl compounds in biological and oil samples by headspace single-drop microextraction with in-drop derivatisation.

A suitable method for the gas chromatographic determination of 10 characteristic carbonyls in biological and oil samples based on the in-drop formation of hydrazones by using 2,4,6-trichlorophenylhydrazine (TCPH), has been developed. The derivatisation-extraction procedure was optimized separately for aqueous and oil samples with respect to the appropriate organic drop solvent, drop volume, in-drop TCPH concentration, sample stirring rate, temperature during single-drop microextraction (SDME), reaction time and headspace-to-sample volume ratio. The optimization showed differentiation of optimum values between the studied matrices. The limits of detection were found to range from 0.001 to 0.003microgmL(-1) for the aqueous biological samples and from 0.06 to 0.20microgmL(-1) for the oil samples. The limits of quantification were in the range of 0.003-0.010microgmL(-1) and 0.020-0.059microgmL(-1) for aqueous and oil samples, respectively. The overall relative standard deviations of the within-day repeatability and between-day reproducibility were <4.4% and <8.2% for the aqueous biological samples and <3.9% and <7.4% for the oxidized oil samples.

Isolation and characterization of a novel uronic acid-containing acidic glycosphingolipid from the ascidian Halocynthia roretzi.

A novel uronic acid-containing glycosphingolipid (UGL-1) was isolated from the ascidian Halocynthia roretzi. UGL-1 was prepared from chloroform-methanol extracts and purified by the use of successive column chromatography on DEAE-Sephadex, Florisil, and Iatrobeads. Chemical structural analysis was performed using methylation analysis, gas chromatography, gas chromatography-mass spectrometry, matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry, and 1H-NMR spectra. The chemical structure of UGL-1 was determined to be a glucuronic acid-containing glycosphingolipid, Galbeta1-4(Fucalpha1-3)GlcAbeta1-1Cer. The ceramide component was composed of C16:0 and C18:0 acids and C16-, C17-, and C18-phytosphingosines as major components.

Oxidized tissue proteins after intestinal reperfusion injury in rats

OBJETIVO: Analisar se a mensuração da proteína carbonilada pode ser validada como método capaz de permitir a identificação de um estresse oxidativo intestinal causado por lesões decorrentes da isquemia e reperfusão. MÉTODOS: Vinte e cinco ratos machos da linhagem Wistar, pesando entre 200 e 250g, foram divididos em três grupos. Grupo I – controle (n = 10). Grupo II – simulação (n = 5) e grupo III (n = 10) submetido a 60 minutos de isquemia intestinal e igual intervalo para reperfusão. Para este fim clampeou-se a artéria mesentérica superior no seu terço distal. Alterações histológicas e os níveis de proteínas carboniladas foram determinados em amostras obtidas em todos os grupos. No grupo III foram estudados segmentos ileais reperfundidos e normais. RESULTADOS: Em todos os segmentos reperfundidos houve edema da mucosa e submucosa, além de infiltrado inflamatório da lâmina própria. Os níveis de proteína carbonilada aumentaram no grupo III, inclusive nos segmentos não isquemiados. A sensibilidade e a especificidade da proteína carbonilada no tecido foram, respectivamente, de 94% e 88%. CONCLUSÃO: O procedimento da proteína carbonilada é útil como marcador biológico do estresse oxidativo após isquemia e reperfusão intestinal em ratos. Também foi relevante o efeito do estresse oxidativo, observado à distância do lócus da lesão primária.

Oxidized tissue proteins after intestinal reperfusion injury in rats.

PURPOSE: To analyse if the carbonyl proteins measurement could be validated as a method that allows the identification of an intestinal oxidative stress after ischemia and reperfusion injury. METHODS: Twenty-five male Wistar rats (n = 21) weighting 200 to 250 g were divided into three groups. Group I--control (n = 10). Group II--sham (n = 5) and Group III (n = 10) subjected to 60 minutes of intestinal ischemia and equal period of reperfusion. For this purpose it was clamped the superior mesenteric artery in its distal third. Histological changes and carbonyl protein levels were determined in the samples of all groups. In group III, samples of both normal and reperfused ileal segment were studied. RESULTS: All the reperfused segments showed mucosal and submucosal swelling and inflammatory infiltrate of the lamina propria. Levels of carbonyl protein rose in group III, including in the non-ischemic segments. The sensitivity and specificity of the carbonyl protein tissue levels were respectively 94% and 88%. CONCLUSION: The carbonyl protein method is a useful biologic marker of oxidative stress after the phenomenon of intestinal ischemia and reperfusion in rats. It was also noteworthy that the effects of oxidative stress could be seen far from the locus of the primary injury.

Exhaled breath condensate acidification in acute lung injury.

Lung injury in ventilated lungs may occur due to local or systemic disease and is usually caused by or accompanied by inflammatory processes. Recently, acidification of exhaled breath condensate pH (EBC-pH) has been suggested as marker of inflammation in airway disease. We investigated pH, ammonia, Lactate, pCO2, HCO3-, IL-6 and IL-8 in EBC of 35 ventilated patients (AECC-classification: ARDS: 15, ALI: 12, no lung injury: 8). EBC-pH was decreased in ventilated patients compared to volunteers (5.85 +/- 0.32 vs. 7.46 +/- 0.48; P < 0.0001). NH4+, lactate, HCO3-, pCO2, IL-6 and IL-8 were analyzed in EBC and correlated with EBC-pH. We observed correlations of EBC-pH with markers of local (EBC IL-6: r = -0.71, P < 0.0001, EBC IL-8: r = -0.68, P < 0.0001) but not of systemic inflammation (serum IL-6, serum IL-8) and with indices of severity of lung injury (Murray's Lung Injury Severity Score; r = -0.73, P < 0.0001, paO2/FiO2; r = 0.54, P < 0.001). Among factors potentially contributing to pH of EBC, EBC-lactate and EBC-NH4+ were found to correlate with EBC-pH. Inflammation-induced disturbances of regulatory mechanisms, such as glutaminase systems may result in EBC acidification. EBC-pH is suggested to represent a marker of acute lung injury caused by or accompanied by pulmonary inflammation.

[Sanitary interest of carbonic, carbogaseous or acidulated waters]. / Interés sanitario de las aguas carbónicas, carbogaseosas o acídulas.

The intention of this Communication is to highlight the main characteristics of the carbonic, carbogaseoses or acidulated waters of the Spanish legislation, as therapeutics agent as well as bottled drinking waters. These waters stimulate the secretion and motility of the digestive apparatus and if they are given by oral way in a correct amount, they have diuretic effects. In balneation they also introduce a vasodilatation, effect due to the penetration of the gas carbonic into the skin and its contact with the vascular walls, but this practice is not common in Spain.

The effect of feeding on the respiratory activity of the sloth.

The aim of the present study was to confirm whether feeding influences the resting breathing rate and to observe possible alterations in blood gas and pH levels produced by feeding in unanesthetized sloths (Bradypus variegatus). Five adult male sloths (4.1 +/- 0.6 kg) were placed daily in an experimental chair for a period of at least 4 h for sitting adaptation. Five measurements were made for each sloth. However, the sloths one, two and five were studied once and the sloths three and four were studied twice. Breathing rate was determined with an impedance meter and the output signal was digitized. Arterial blood samples were collected for blood gas analysis with a BGE electrolytes analyzer and adjusted for the animal's body temperature and hemoglobin content. The data are reported as mean +/- SD and were collected during the resting period (8:00-10:00 h) and during the feeding period (16:00-18:00 h). The mean breathing rate increased during mastication of ymbahuba leaves (rest: 5.0 +/- 1, feeding: 10 +/- 1 bpm). No significant alterations were observed in arterial pH (rest: 7.42 +/- 0.05, feeding: 7.45 +/- 0.03), PCO2 (rest: 35.2 +/- 5.3, feeding: 33.3 +/- 4.4 mmHg) or PO2 (rest: 77.5 +/- 8.2, feeding: 78.4 +/- 5.2 mmHg) levels. These results indicate that in unanesthetized sloths 1) feeding evokes an increase in breathing rate without a significant change in arterial pH, PCO2 or PO2 levels, and 2) the increase in breathing rate produced by feeding probably is due to the act of mastication.

Separation of 4-dimethylamino-6-(4-methoxy-1-naphthyl)-1,3,5-triazine-2-hydrazine derivatives of carbonyl compounds by reversed-phase capillary electrochromatography.

4-Dimethylamino-6-(4-methoxy-1-naphthyl)-1,3,5-triazine-2-hydrazine (DMNTH) is a novel derivatizing reagent specially designed for the determination of carbonyl compounds. In this work, we describe the separation of DMNTH-derivatized carbonyl compounds by reversed-phase capillary electrochromatography (CEC). After systematic investigations of the effects of experimental conditions viz. pH and concentration of buffer, type of stationary phase, injection volume of sample, organic modifier, and temperature, optimal conditions were found. The sample compounds, which were separated with gradient high performance liquid chromatography (HPLC), were separated by CEC under isocratic elution due to the high efficiency. Comparisons of separations by CEC and micellar electrokinetic chromatography (MEKC) were made.

Determination of carbonate in marine solid samples by FTIR-ATR spectroscopy.

A method for detecting carbonate in marine solid samples (sediments, corals) by Fourier transform infrared spectroscopy (FTIR) coupled to the total attenuated reflectance (ATR) technique is described. Compared to other techniques, the proposed method is not based on the measurement of CO2 evolved by combustion or acidification of the sample, but on the direct measurement of carbonate present in the sample. For this reason, the method by FTIR-ATR spectroscopy does not require any chemical pre-treatment. The proposed method allows determination of carbonate in the range 6-100% (w/w) as Na2CO3 and gives comparable results with the determination of inorganic carbon by elemental analysis.