Abstract
In previous studies from this laboratory the principles for the determination of the balance (intake minus output) of non-carbonic, non-metabolizable, non-metabolized acid (net acid) have been validated and applied to healthy, growing infants. To determine NAB requires the independent measurement of all components of net acid intake (sulfuric and organic acid production plus net acid generated by skeletal mineralization minus net base intake) and net acid output (renal net acid excretion).
In the present study NAB was determined over 3–8 day balance periods in 11 infants developing (n = 3) or recovering from (n = 8) diarrhea, ileostomy, renal or late metabolic acidosis. Four studies on infants having no significant change in acid-base status over the period of study served as controls. MAB was significantly positive during the development of acidosis and negative during recovery. A close (r > 0.9) linear relationship was found between NAB (mEq/kg) and the measured change in blood base excess (Δ BE, mEq/l) over the period of study such that the virtual volume of retained net base or acid approximated 50% of the body weight suggesting considerable involvement of non-ECF buffers. To our knowledge this study represents the first complete quantitative measurement of the total magnitude and the separate components of net base retained (during recovery) or net acid retained (during development) in metabolic acidosis.
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Winters, R., Chan, J., Klenk, E. et al. Net acid balance (NAB) in metabolic acidosis. Pediatr Res 5, 395 (1971). https://doi.org/10.1203/00006450-197108000-00100
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DOI: https://doi.org/10.1203/00006450-197108000-00100