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Franz Schaefer - One of the best experts on this subject based on the ideXlab platform.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal Transport Kinetics in children. Background Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). Methods Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m 2 , dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. Results While intraperitoneal pH was constant at 7.41 ± 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 ± 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, β 2 -microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. Conclusion The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:BACKGROUND: Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). METHODS: Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m2, dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. RESULTS: While intraperitoneal pH was constant at 7.41 +/- 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 +/- 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, beta2-microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. CONCLUSION: The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
Claus Peter Schmitt - One of the best experts on this subject based on the ideXlab platform.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal Transport Kinetics in children. Background Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). Methods Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m 2 , dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. Results While intraperitoneal pH was constant at 7.41 ± 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 ± 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, β 2 -microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. Conclusion The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:BACKGROUND: Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). METHODS: Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m2, dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. RESULTS: While intraperitoneal pH was constant at 7.41 +/- 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 +/- 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, beta2-microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. CONCLUSION: The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
Philippa Mary Warren - One of the best experts on this subject based on the ideXlab platform.
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oxygen Transport Kinetics underpin rapid and robust diaphragm recovery following chronic spinal cord injury
The Journal of Physiology, 2021Co-Authors: Philippa Mary Warren, Roger W P Kissane, Stuart Egginton, Jessica C F Kwok, Graham N AskewAbstract:Key points Spinal treatment can restore diaphragm function in all animals 1 month following C2 hemisection induced paralysis. Greater recovery occurs the longer after injury the treatment is applied. Through advanced assessment of muscle mechanics, innovative histology and oxygen tension modelling, we have comprehensively characterized in vivo diaphragm function and phenotype. Muscle work loops reveal a significant deficit in diaphragm functional properties following chronic injury and paralysis, which are normalized following restored muscle activity caused by plasticity-induced spinal reconnection. Injury causes global and local alterations in diaphragm muscle vascular supply, limiting oxygen diffusion and disturbing function. Restoration of muscle activity reverses these alterations, restoring oxygen supply to the tissue and enabling recovery of muscle functional properties. There remain metabolic deficits following restoration of diaphragm activity, probably explaining only partial functional recovery. We hypothesize that these deficits need to be resolved to restore complete respiratory motor function. Abstract Months after spinal cord injury (SCI), respiratory deficits remain the primary cause of morbidity and mortality for patients. It is possible to induce partial respiratory motor functional recovery in chronic SCI following 2 weeks of spinal neuroplasticity. However, the peripheral mechanisms underpinning this recovery are largely unknown, limiting development of new clinical treatments with potential for complete functional restoration. Utilizing a rat hemisection model, diaphragm function and paralysis was assessed and recovered at chronic time points following trauma through chondroitinase ABC induced neuroplasticity. We simulated the diaphragm's in vivo cyclical length change and activity patterns using the work loop technique at the same time as assessing global and local measures of the muscles histology to quantify changes in muscle phenotype, microvascular composition, and oxidative capacity following injury and recovery. These data were fed into a physiologically informed model of tissue oxygen Transport. We demonstrate that hemidiaphragm paralysis causes muscle fibre hypertrophy, maintaining global oxygen supply, although it alters isolated muscle Kinetics, limiting respiratory function. Treatment induced recovery of respiratory activity normalized these effects, increasing oxygen supply, restoring optimal diaphragm functional properties. However, metabolic demands of the diaphragm were significantly reduced following both injury and recovery, potentially limiting restoration of normal muscle performance. The mechanism of rapid respiratory muscle recovery following spinal trauma occurs through oxygen Transport, metabolic demand and functional dynamics of striated muscle. Overall, these data support a systems-wide approach to the treatment of SCI, and identify new targets to mediate complete respiratory recovery.
Graham N Askew - One of the best experts on this subject based on the ideXlab platform.
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oxygen Transport Kinetics underpin rapid and robust diaphragm recovery following chronic spinal cord injury
The Journal of Physiology, 2021Co-Authors: Philippa Mary Warren, Roger W P Kissane, Stuart Egginton, Jessica C F Kwok, Graham N AskewAbstract:Key points Spinal treatment can restore diaphragm function in all animals 1 month following C2 hemisection induced paralysis. Greater recovery occurs the longer after injury the treatment is applied. Through advanced assessment of muscle mechanics, innovative histology and oxygen tension modelling, we have comprehensively characterized in vivo diaphragm function and phenotype. Muscle work loops reveal a significant deficit in diaphragm functional properties following chronic injury and paralysis, which are normalized following restored muscle activity caused by plasticity-induced spinal reconnection. Injury causes global and local alterations in diaphragm muscle vascular supply, limiting oxygen diffusion and disturbing function. Restoration of muscle activity reverses these alterations, restoring oxygen supply to the tissue and enabling recovery of muscle functional properties. There remain metabolic deficits following restoration of diaphragm activity, probably explaining only partial functional recovery. We hypothesize that these deficits need to be resolved to restore complete respiratory motor function. Abstract Months after spinal cord injury (SCI), respiratory deficits remain the primary cause of morbidity and mortality for patients. It is possible to induce partial respiratory motor functional recovery in chronic SCI following 2 weeks of spinal neuroplasticity. However, the peripheral mechanisms underpinning this recovery are largely unknown, limiting development of new clinical treatments with potential for complete functional restoration. Utilizing a rat hemisection model, diaphragm function and paralysis was assessed and recovered at chronic time points following trauma through chondroitinase ABC induced neuroplasticity. We simulated the diaphragm's in vivo cyclical length change and activity patterns using the work loop technique at the same time as assessing global and local measures of the muscles histology to quantify changes in muscle phenotype, microvascular composition, and oxidative capacity following injury and recovery. These data were fed into a physiologically informed model of tissue oxygen Transport. We demonstrate that hemidiaphragm paralysis causes muscle fibre hypertrophy, maintaining global oxygen supply, although it alters isolated muscle Kinetics, limiting respiratory function. Treatment induced recovery of respiratory activity normalized these effects, increasing oxygen supply, restoring optimal diaphragm functional properties. However, metabolic demands of the diaphragm were significantly reduced following both injury and recovery, potentially limiting restoration of normal muscle performance. The mechanism of rapid respiratory muscle recovery following spinal trauma occurs through oxygen Transport, metabolic demand and functional dynamics of striated muscle. Overall, these data support a systems-wide approach to the treatment of SCI, and identify new targets to mediate complete respiratory recovery.
Börje Haraldsson - One of the best experts on this subject based on the ideXlab platform.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:Effects of pH-neutral, bicarbonate-buffered dialysis fluid on peritoneal Transport Kinetics in children. Background Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). Methods Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m 2 , dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. Results While intraperitoneal pH was constant at 7.41 ± 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 ± 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, β 2 -microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. Conclusion The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
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effects of ph neutral bicarbonate buffered dialysis fluid on peritoneal Transport Kinetics in children
Kidney International, 2002Co-Authors: Claus Peter Schmitt, Börje Haraldsson, Jutta Passlickdeetjen, Rouven Doetschmann, Mirjam Zimmering, Christine Greiner, M Boswald, Gunter Klaus, Franz SchaeferAbstract:BACKGROUND: Due to their superior biocompatibility, pH-neutral solutions are beginning to replace acidic lactate-buffered peritoneal dialysis (PD) fluids. We hypothesized that pH-neutral and acidic solutions might differentially affect peritoneal Transport in the early dwell phase, due to differences in ionic shifts and initial peritoneal vasodilation. Such differences may become clinically relevant in patients with frequent short cycles on automated PD (APD). METHODS: Twenty-five children were treated with a lactate-buffered (35 mmol/L, pH 5.5) or a bicarbonate-buffered PD solution (34 mmol/L, pH 7.4) in randomized order on two sequential days. Each day a four-hour Standardized Permeability Analysis (SPA) was performed, followed by overnight APD (7 cycles, fill volume 1000 mL/m2, dwell time 75 min). Functional peritoneal surface area was dynamically assessed using the three-pore model. RESULTS: While intraperitoneal pH was constant at 7.41 +/- 0.03 throughout the SPA with bicarbonate fluid, the dialysate remained acidic for more than one hour with lactate solution (pH 7.12 +/- 0.08 at 1 h). Total pore area was 60% higher during the first 30 minutes of the dwell than under steady-state conditions, without a difference between acidic and pH-neutral fluid. Net base gain, intraperitoneal volume Kinetics, glucose absorption, ultrafiltration rate, effective lymphatic absorption and the Transport of urea, potassium, beta2-microglobulin and albumin were similar with both fluids. However, phosphate and creatinine elimination were 10% lower with bicarbonate PD fluid, resulting in corresponding significant decreases in the 24-hour clearances of these solutes. CONCLUSION: The peritoneal surface area is not measurably influenced by pH-neutral PD fluid. Creatinine and phosphate elimination appears to be slightly reduced with bicarbonate fluid; this observation awaits clarification in extended therapeutical trials.
