sodium-bicarbonate and Diarrhea

Intestinal alkalization could prevent irinotecan associated diarrhea modulating some chemical equilibria between irinotecan metabolites. The aim of this study was to evaluate the efficacy of this procedure in advanced gastrointestinal cancer patients (GICP).. In this prospective study advanced GICP, receiving irinotecan based chemotherapy regimens, were well trained to add sodium bicarbonate to the water intake in order to accomplish intestinal alkalization.. A total of twenty four advanced GICP were enrolled. Grade III-IV diarrhea has been observed in four patients (16%), some of whom had several risk factors for diarrhea. Only one out of seventeen colorectal cancer patients, receiving the irinotecan combination as first line therapy, had grade III-IV diarrhea. No side effects of the procedure have been appreciated.. Intestinal alkalization may be effective as a preventive treatment for irinotecan associated diarrhea in chemotherapy regimens used in GICP. This procedure deserves further investigation.

Topics: Adult; Aged; Antineoplastic Agents, Phytogenic; Camptothecin; Diarrhea; Female; Gastrointestinal Neoplasms; Humans; Irinotecan; Male; Middle Aged; Pilot Projects; Prospective Studies; Sodium Bicarbonate

Iron poisoning continues to be a major toxicologic problem, with major impact on the gastrointestinal and circulatory systems. Failure to recognize the severity of iron intoxication may result in an inappropriate level of intervention. By using estimates of the total body burden of iron, clinical symptoms, and the serum iron concentration, an appropriate decision can be made to initiate aggressive chelation therapy with deferoxamine. In severe intoxication, the use of intravenous deferoxamine is indicated, along with supportive care, with particular attention to maintaining the intravascular volume. Other important measures include correction of acidosis and disorders of coagulation and replacement of blood components when there is evidence of gastrointestinal hemorrhage. Under rare circumstances in which large numbers of iron tablets are present in the gastrointestinal tract, surgical removal may be indicated. In addition, measures such as hemodialysis and exchange transfusion should be reserved for those unusual poisonings in which more conservative therapy is unsuccessful. In rare cases of iron intoxication, late sequelae such as hepatic necrosis and gastrointestinal scarring with obstruction may occur. The prompt recognition and initiation of management of children with acute iron poisoning is the single most critical element in decreasing the morbidity and mortality associated with these products.

Topics: Absorption; Bicarbonates; Chemical and Drug Induced Liver Injury; Child, Preschool; Deferoxamine; Diarrhea; Female; Fluid Therapy; Gastric Lavage; Gastrointestinal Hemorrhage; Humans; Infant; Ipecac; Iron; Necrosis; Renal Dialysis; Shock; Sodium; Sodium Bicarbonate; Vomiting

Gastrointestinal side effects are the main problem with sodium bicarbonate (SB) use in sports. Therefore, our study assessed the effect of a new SB loading regimen on anaerobic capacity and wrestling performance. Fifty-eight wrestlers were randomized to either a progressive-dose regimen of up to 100 mg∙kg

Topics: Adolescent; Adult; Anaerobic Threshold; Athletes; Athletic Performance; Blood Glucose; Diarrhea; Dietary Supplements; Double-Blind Method; Exercise Tolerance; Female; Humans; Lactic Acid; Male; Nausea; Performance-Enhancing Substances; Poland; Reproducibility of Results; Sodium Bicarbonate; Sports Nutritional Physiological Phenomena; Wrestling; Young Adult

Acidemia and electrolyte imbalances such as hyperkalemia are common in neonatal calves with diarrhea. Acidemia negatively affects the cellular response to insulin and may therefore result in deranged glucose, potassium, and phosphorus homeostasis. The primary aim of this study was to compare indices that characterize the dynamic glucose and insulin response between acidemic and nonacidemic neonatal diarrheic calves and a healthy control group during an intravenous glucose tolerance test (IVGTT) that consisted of i.v. administration of 0.3 g of glucose per kg of body weight. Secondary aims were to characterize the associated changes in plasma potassium and phosphorus concentrations. The effect of correction of profound acidemia with a sodium bicarbonate containing infusion on these parameters was also assessed. Thirty calves (age ≤21 d) were purposively assigned to one of the following groups: 10 calves with diarrhea and profound acidemia (venous blood pH <7.20) where an IVGTT was performed before and after treatment with sodium bicarbonate, 10 calves with diarrhea and minimal acid-base disturbance (venous blood pH >7.35), and 10 healthy control calves. Profoundly acidemic diarrheic calves (jugular venous blood pH 6.99 ± 0.10) had a similar initial increase in plasma insulin concentration to that in healthy control calves or nonacidemic calves with diarrhea. However, insulin concentrations remained relatively stable in acidemic calves between 15 and 60 min after the start of the IVGTT, whereas a marked decrease in plasma insulin concentrations occurred in all other groups during the same period of time. We conclude that acidemia does not alter cell glucose availability or the dynamic response of glucose, phosphorus, and potassium to insulin; however, acidemia markedly prolongs plasma insulin concentrations following an IVGTT through an unidentified mechanism. Results of this study emphasize the importance of correcting acidemia and metabolic acidosis in neonatal calves with diarrhea.

Topics: Acidosis; Animals; Animals, Newborn; Cattle; Cattle Diseases; Diagnostic Tests, Routine; Diarrhea; Glucose; Glucose Tolerance Test; Hyperkalemia; Insulin; Phosphorus; Phosphorus, Dietary; Potassium; Sodium Bicarbonate

Although a considerable amount of literature exists on the ergogenic potential of ingesting sodium bicarbonate (NaHCO3) before short-term, high-intensity exercise, very little exists on optimal loading times before exercise. The purpose of this study was to determine the influence of NaHCO3 supplementation timing on repeated sprint ability (RSA). Eight men completed 3 (randomized and counterbalanced) trials of ten 10-second sprints separated by 50 seconds of active recovery (1:5 work-to-rest) on a nonmotorized treadmill. Before each trial, the subjects ingested 0.3 g·kg(-1) body weight of NaHCO3 at 60 (H1), 120 (H2), or 180 (H3) minutes before exercise. Additionally, the subjects were assessed for any side effects (gastrointestinal [GI] discomfort) from the NaHCO3 ingestion via a visual analog scale (VAS). Blood buffering was assessed using a 2-way analysis of variance (ANOVA) with repeated measures, whereas repeated sprint performance and GI discomfort were assessed via a 1-way ANOVA with repeated measures. Blood-buffering capacity was not different at preexercise times (HCO3(-) [millimoles per liter] H1: 30.2 ± 0.4, H2: 30.9 ± 0.6, H3: 31.2 ± 0.6; p > 0.74). Average speed, average power, and total distance covered progressively declined over the 10 sprints; however, there was no difference between conditions (p > 0.22). The incidence of GI discomfort was significantly higher (p < 0.05) from preingestion at all time points with the exception of 180 minutes, whereas severity was only different between 90 and 180 minutes. Ingestion times (between 60 and 180 minutes) did not influence the blood buffering or the ergogenic potential of NaHCO3 as assessed by RSA. However, VAS scores indicated that at 180 minutes postingestion, an individual is less prone to experiencing significant GI discomfort.

Topics: Adult; Alkalosis; Analysis of Variance; Athletic Performance; Buffers; Colic; Diarrhea; Eructation; Exercise Test; Flatulence; Humans; Male; Nausea; Recovery of Function; Running; Sodium Bicarbonate; Vomiting; Young Adult

Enterotoxigenic Escherichia coli (ETEC) is the leading cause of travelers' diarrhea. The aim of this study was to investigate the ability of a powdered extract of hyperimmune bovine colostrum to protect against diarrhea in volunteers challenged with ETEC.. Tablets were manufactured from a colostrum extract from cattle immunized with 14 ETEC strains, including serogroup O78. Two separate randomized, double-blind, placebo-controlled trials involving 90 healthy adult volunteers were performed to investigate the ability of different tablet formulations to protect against diarrhea following an oral challenge with an O78 ETEC strain.. The first study with 30 participants evaluated the efficacy of tablets, containing 400 mg of colostrum protein, taken thrice daily with bicarbonate buffer. This regimen conferred 90.9% protection against diarrhea in the group receiving the active preparation compared with the placebo group (p = 0.0005). The second study examined the efficacy of tablets containing 400 mg colostrum protein given with buffer (83.3% protection; p = 0.0004) or without buffer (76.7% protection; p = 0.007), and tablets containing 200 mg colostrum protein given without buffer (58.3% protection; p = 0.02), compared with placebo. The difference between buffered and unbuffered treatments was not significant (p > 0.1).. Active tablet formulations were significantly more effective than placebo in protecting volunteers against the development of diarrhea caused by ETEC. These results suggest that administration of a tablet formulation of hyperimmune bovine colostrum containing antibodies against ETEC strains may reduce the risk of travelers' diarrhea.

Topics: Adult; Animals; Antibodies, Bacterial; Buffers; Cattle; Colostrum; Diarrhea; Double-Blind Method; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Humans; Sodium Bicarbonate; Tablets

Intestinal alkalization could prevent irinotecan associated diarrhea modulating some chemical equilibria between irinotecan metabolites. The aim of this study was to evaluate the efficacy of this procedure in advanced gastrointestinal cancer patients (GICP).. In this prospective study advanced GICP, receiving irinotecan based chemotherapy regimens, were well trained to add sodium bicarbonate to the water intake in order to accomplish intestinal alkalization.. A total of twenty four advanced GICP were enrolled. Grade III-IV diarrhea has been observed in four patients (16%), some of whom had several risk factors for diarrhea. Only one out of seventeen colorectal cancer patients, receiving the irinotecan combination as first line therapy, had grade III-IV diarrhea. No side effects of the procedure have been appreciated.. Intestinal alkalization may be effective as a preventive treatment for irinotecan associated diarrhea in chemotherapy regimens used in GICP. This procedure deserves further investigation.

Topics: Adult; Aged; Antineoplastic Agents, Phytogenic; Camptothecin; Diarrhea; Female; Gastrointestinal Neoplasms; Humans; Irinotecan; Male; Middle Aged; Pilot Projects; Prospective Studies; Sodium Bicarbonate

We conducted a phase I/II study in patients with advanced non-small-cell lung cancer (NSCLC) to increase the therapeutic index of the cisplatin-irinotecan combination by institution of an anti-late-diarrhoeal program (ADP). A total of 77 chemotherapy-naive patients with advanced NSCLC were enrolled. The cisplatin dose was fixed at 60 mg m(-2) (Day 1). Irinotecan was escalated in 5 mg m(-2) increments, starting from 60 mg m(-2) (Days 1 and 8). ADP consisted of oral sodium bicarbonate, magnesium oxide, basic water, and ursodeoxycholic acid, and was administered orally for 4 days with each dose of irinotecan. In the phase I portion, irinotecan pharmacokinetics was also examined. After the recommended dose of irinotecan with ADP was determined, a phase II study was conducted to evaluate the response. Maximum tolerated dose was reached at an irinotecan dose of 80 mg m(-2) (Grade 4 diarrhoea and neutropenia). Pharmacokinetic studies show that the maximum concentration and the area under the curve of both irinotecan and SN38 (active metabolite of irinotecan) tend to increase in the dose-dependent manner of irinotecan. The phase II portion of the study included 48 patients, who were treated with 75 mg m(-2) of irinotecan. Grade 3/4 toxicities included neutropenia in 65%, leucopenia in 33%, and late diarrhoea in 6% of the patients. During this treatment, PS did not change in 65% of patients. At the end of the chemotherapy, PS did not decline in 90% of patients. In the phase II portion, a response occurred in 63% (95% confidential interval (CI), 47-76%) of patients. Median time to progression was 19 weeks (95% CI, 15-22 weeks), and median survival was 52 weeks (95% CI, 39-64 weeks). This regimen of irinotecan and cisplatin with ADP resulted in promising efficacy with acceptable toxicity for patients with advanced NSCLC. This regimen is a candidate for the experimental arm towards future phase III studies.

Topics: Administration, Oral; Adult; Aged; Antacids; Antidiarrheals; Antineoplastic Combined Chemotherapy Protocols; Area Under Curve; Camptothecin; Carcinoma, Non-Small-Cell Lung; Cholagogues and Choleretics; Cisplatin; Diarrhea; Disease Progression; Female; Humans; Infusions, Intravenous; Irinotecan; Lung Neoplasms; Magnesium Oxide; Male; Maximum Tolerated Dose; Middle Aged; Sodium Bicarbonate; Survival Analysis; Ursodeoxycholic Acid

It has been reported that 7-ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy-camptothecin (CPT-11) and its active metabolite, 7-ethyl-10-hydroxy-camptothecin (SN-38), have absorption characteristics of weakly basic drugs, suggesting that alkalization of the intestinal lumen might reduce reabsorption and its attendant side effects. Furthermore, stasis of stools containing these compounds is thought to induce damage to the intestinal mucosa. The prevention of CPT-11-induced side effects by oral alkalization (OA) combined with control of defecation (CD) was estimated in a case-control study of lung cancer patients. Coinciding with day 1 of CPT-11 infusion and for 4 days thereafter, OA and CD were practiced utilizing orally administered sodium bicarbonate, magnesium oxide, basic water and ursodeoxycholic acid. OA involved the daily use of all four therapeutics, and CD required doses of up to 4.0 g/day of magnesium oxide and 2 L/day of excess basic water. From three ongoing prospective phase I/II studies, we selected 37 consecutive patients who were treated with CPT-11 in combination with cisplatin in the presence of OA and CD (group B). Thirty-two control subjects who were matched to the background characteristics of the case patients were treated with the same regimen in the absence of OA and CD (group A). Toxicities induced by the CPT-11/cisplatin combination were evaluated and analyzed in group A and group B in a case-control format. The use of OA and CD resulted in significantly higher stool pH (p < 0.0001), while reducing the incidence of delayed diarrhea (> or = grade 2: group A 32.3% versus group B 9.4%; p = 0.005), nausea (p = 0.0001), vomiting (p = 0.001) and myelotoxicity, especially granulocytopenia (p = 0.03) and lymphocytopenia (p = 0.034). In addition, dose intensification was well tolerated in patients receiving OA and CD, allowing dose escalation from 35.6 +/- 6.0 to 39.9 +/- 5.6 mg/m(2)/week (p < 0.001). Tumor response rates for non-small cell lung cancer were 59.3% (16/27 patients) in group B compared with 38.5% (10/26 patients) in group A. Multivariate analysis revealed that the risk of CPT-11-induced delayed diarrhea greater than grade 2 was associated with OA and CD (odds ratio for delayed diarrhea, 0.14 with use of OA and CD; 95% confidence interval, 0.05 to 0.4; p = 0.0002) and age (odds ratio, 1.08 per increase in age; 95% confidence interval, 1.02 to 1.15; p = 0.009). OA and CD appear to be useful in preventing the dose-limiting si

Topics: Adult; Aged; Antacids; Antineoplastic Agents, Phytogenic; Bone Marrow; Buffers; Camptothecin; Case-Control Studies; Defecation; Diarrhea; Digestive System; Female; Humans; Hydrogen-Ion Concentration; Irinotecan; Lung Neoplasms; Magnesium Oxide; Male; Middle Aged; Risk Factors; Sodium Bicarbonate; Ursodeoxycholic Acid

Rice based oral rehydration therapy (ORT) solutions have been shown to be superior to glucose oral rehydration salts (World Health Organisation (WHO) ORS) in reducing stool volume and duration of diarrhoea in children and adults. Rice based ORT has been used only sparingly in young infants, however, because of theoretical concerns about digestibility. A randomised controlled trial of rice based ORT (50 g rice and electrolytes identical to WHO ORS) and WHO ORS was carried out in 52 male infants less than 6 months old with moderately severe acute diarrhoea to evaluate efficacy and digestibility. Nineteen (70%) of 27 children who received rice based ORT and 18 (72%) of 25 children who received WHO ORS were treated successfully. The mean (SD) diarrhoeal stool output for the first 24 hours of treatment was significantly lower in the infants receiving the rice based ORT than in those receiving WHO ORS (101.0 (60.5) v 137.1 (74.6) g/kg). The stool output was also significantly less in the rice based ORT group in the second 24 hours. Infants in the rice based ORT group drank significantly less rehydration solution than infants in the WHO ORS group (mean (SD) 165.4 (77.4) v 217.9 (86.1) during the first 24 hours of treatment. There was no difference in the duration of diarrhoea between the groups. The volume of breast and formula feeding was similar in the two groups. No difference was seen in the frequency of finding reducing substances or acid pH in the stools of either group of children. The results suggest that rice based ORT is as effective as WHO ORS in infants with moderately severe diarrhoea and that rice based ORT is as well tolerated as WHO ORS in infants.

Topics: Citrates; Citric Acid; Copper Sulfate; Diarrhea; Drug Combinations; Feces; Fluid Therapy; Humans; Hydrogen-Ion Concentration; Indicators and Reagents; Infant; Male; Oryza; Prospective Studies; Rehydration Solutions; Sodium Bicarbonate

Secretory diarrhoea is a major cause of morbidity and mortality worldwide. However, there is no biologically relevant test system in man for assessing new anti-diarrhoeal therapies prior to clinical trial. We have used highly purified cholera toxin in combination with the triple lumen jejunal perfusion technique to establish a subclinical model of cholera in man. Cholera toxin was administered either by mouth with sodium bicarbonate or directly into a 30 cm 'open' or 'closed' (isolated between two inflated balloons) jejunal segment in healthy adult volunteers. Both oral dosing and direct delivery into an 'open' jejunal segment failed to produce consistent secretion of water and electrolytes. In contrast 15 micrograms or 25 micrograms of cholera toxin elicited secretion of water and sodium 3 h after instillation into the balloon occluded 'closed' jejunal segment (P less than 0.05 vs. controls). The rate of secretion was constant over the maximal period studied (4.5 h) and was similar to that reported in human cholera. None of the subjects experienced troublesome diarrhoea. We believe this model offers a relevant test system for assessing anti-diarrhoeal therapy in man.

Topics: Administration, Oral; Adolescent; Adult; Bicarbonates; Cholera Toxin; Diarrhea; Drug Administration Routes; Humans; Jejunum; Male; Models, Biological; Secretory Rate; Sodium; Sodium Bicarbonate; Water

Topics: Adolescent; Adult; Bicarbonates; Child; Cholera; Citrates; Citric Acid; Diarrhea; Double-Blind Method; Escherichia coli Infections; Fluid Therapy; Humans; Male; Middle Aged; Rehydration Solutions; Sodium; Sodium Bicarbonate; Time Factors

Ninety four children aged less than 5 years with diarrhoeal dehydration and acidosis were treated randomly with either World Health Organisation (WHO) oral rehydration solution containing sodium chloride, potassium chloride, sodium bicarbonate and glucose or an oral solution with tripotassium citrate monohydrate replacing the sodium bicarbonate and potassium chloride in the WHO solution. Fifty five children (58%) were hypokalaemic (potassium less than 3.5 mmol/l) on admission. All but two in the citrate group were successfully treated. There were no significant differences in rehydration solution intake, stool output, gain in body weight, and fall in plasma specific gravity and haematocrit between the two treatment groups after 48 hours' treatment. Significant improvement in the serum potassium concentration was observed in the hypokalaemic children receiving potassium citrate solution compared with children receiving WHO solution after 24 and 48 hours' treatment. None developed hyperkalaemia. Although children receiving potassium citrate solution corrected their acidosis at a slower rate than the WHO solution group during the first 24 hours, by 48 hours satisfactory correction was observed in all. Tripotassium citrate can safely replace sodium bicarbonate and potassium chloride and may be the most useful and beneficial treatment for diarrhoea and associated hypokalaemia.

Topics: Acidosis; Bicarbonates; Child, Preschool; Citrates; Citric Acid; Clinical Trials as Topic; Diarrhea; Double-Blind Method; Feces; Fluid Therapy; Humans; Hypokalemia; Infant; Infant, Newborn; Potassium Chloride; Sodium; Sodium Bicarbonate

Forty patients with moderate degrees of dehydration and acidosis because of acute watery diarrhoea were successfully treated randomly with either WHO recommended oral rehydration solution containing 2.5 g sodium bicarbonate or an oral solution containing 2.94 g sodium citrate in place of sodium bicarbonate per litre of oral rehydration rehydration solution. Efficacies were compared by measuring oral fluid intake, stool and vomitus output, change in body weight, hydration status, and rate of correction of acidosis during a period of 48 hours. Seventy five per cent (21 cases) in the citrate group and 83% (19 cases) in the bicarbonate group were successfully rehydrated (p greater than 0.05). There were no significant differences in intake, output, gain in body weight, fall in haematocrit and plasma specific gravity, and correction of acidosis between the two groups of patients within 48 hours after initiation of therapy. The solution with sodium citrate base was as effective as WHO-oral rehydration solution for management of diarrhoea. This study shows the efficacy, safety, and acceptability of citrate containing oral rehydration solution for rehydration and correction of acidosis in diarrhoea.. 40 patients with moderate degrees of dehydration and acidosis because of acute watery diarrhea were successfully treated randomly with either World Health Organization (WHO) recommended oral rehydration solution containing 2.5 g sodium bicarbonate or an oral solution containing 2.94 g sodium citrate in place of sodium bicarbonate/liter of oral rehydration solution. Efficacies were compared by measuring oral fluid intake, stool and vomitus output, change in body weight, hydration status, and rate of correction of acidosis during a 48 hour period. 75% (21 cases) in the citrate group and 83% (19 cases) in the bicarbonate group were successfully rehydrated (P 0.05). There were no significant differences in intake, output, gain in body weight, fall in hematocrit, and plasma specific gravity, and correction of acidosis between the 2 groups of patients within 48 hours after therapy initiation. The solution with sodium citrate base was as effective as WHO-oral rehydration solution for diarrhea management. This study shows the efficacy, safety, and acceptability of citrate-containing oral rehydration solution for rehydration and correction of acidosis in diarrhea.

Topics: Acidosis; Acute Disease; Adolescent; Adult; Antacids; Bicarbonates; Carbon Dioxide; Child; Child, Preschool; Citrates; Citric Acid; Diarrhea; Fluid Therapy; Humans; Sodium Bicarbonate

Potassium-competitive acid blockers and proton pump inhibitors/sodium bicarbonate can rapidly increase intragastric pH. In this study, we aimed to compare the clinical outcomes of tegoprazan-based and esomeprazole/sodium bicarbonate-based triple therapies in the treatment of Helicobacter pylori infection.. We retrospectively reviewed the data of patients with H. pylori infection treated with a 14-day tegoprazan-based triple therapy or 14-day esomeprazole/sodium bicarbonate-based triple therapy. The primary end point was the H. pylori eradication rate with first-line treatment in an intention-to-treat analysis. Secondary end points included the eradication rate with first-line therapy in the per-protocol analysis and adverse events associated with eradication therapy.. Of the 854 included patients, 435 were treated with tegoprazan-based therapy, and 419 received esomeprazole/sodium bicarbonate-based therapy. In the intention-to-treat population, no significant difference in eradication rate was detected between the tegoprazan-treated and esomeprazole/sodium bicarbonate-treated groups (78.6% [95% confidence interval (CI), 74.6-82.3%] vs 81.4% [95% CI, 77.4-84.9%], P = 0.313). The per-protocol analysis also revealed a similar eradication rate between groups (tegoprazan vs esomeprazole/sodium bicarbonate: 85.5% [95% CI, 81.8-87.5%] vs 87.8% [95% CI, 84.1-90.7%], P = 0.339). However, abdominal discomfort and diarrhea were more common in the esomeprazole/sodium bicarbonate-treated group than in the tegoprazan-treated group (abdominal discomfort: 1.1% vs 3.8%, P = 0.012; diarrhea: 9.9% vs 21.2%, P < 0.001).. The efficacy of the esomeprazole/sodium bicarbonate-based triple therapy for H. pylori eradication was comparable with that of the tegoprazan-based triple therapy. However, esomeprazole/sodium bicarbonate-based therapy exhibited a higher risk of abdominal discomfort and diarrhea than tegoprazan-based therapy.

Topics: Anti-Bacterial Agents; Bicarbonates; Diarrhea; Esomeprazole; Helicobacter Infections; Helicobacter pylori; Humans; Retrospective Studies; Sodium Bicarbonate

Calf diarrhea can commonly lead to dehydration and metabolic acidosis due to the loss of fluid and electrolytes. The objective of this randomized clinical trial was to examine differences between treating male dairy calves experiencing diarrhea with either a basic bicarbonate electrolyte powder (BBP) composed of sodium bicarbonate (50.7 mmol/L); a mixed buffer powder (MBP) including sodium bicarbonate (33.8 mmol/L), sodium citrate (8.4 mmol/L), sodium acetate (6.3 mmol/L), and potassium citrate (1.9 mmol/L); or a liquid electrolyte (HAL) composed of sodium acetate (50.1 mmol/L). All 3 electrolyte solutions were standardized to provide 50 mmol/L blood buffers and a similarly strong ion difference (74.4, 74.9, and 82.6 mEq/L for BBP, MBP, and HAL, respectively). Holstein male calves (n = 80) were sourced from auction barns or local farms and delivered in 1 batch to the research facility. Calves were housed in individual pens and fed a 24% crude protein and 17% fat calf milk replacer (CMR) twice daily. Starter grain and water were offered ad libitum. Calves were randomly enrolled in 1 of the 3 treatments when experiencing either 2 consecutive days of a fecal score of 2 (runny, spreads easily) or 1 d with a fecal score of 3 (liquid devoid of solid material). Calves were blocked by the different enrollment criteria. The respective electrolyte solution was administered via esophageal tube 1 h after feeding CMR until the fecal score returned to 0 (normal consistency) or 1 (semiformed or pasty). Blood gas measurements were taken at 1, 8, and 24 h post the initial electrolyte feeding, and weight was measured at 1, 2, 7, 14, and 28 d postenrollment. Mixed repeated measure linear regression models were built to assess the effect that the electrolyte solutions had on the blood gas measurements and body weight. A total of 45 calves were enrolled in the trial with 14, 16, and 15 calves randomly assigned to the MBP, HAL, and BBP groups, respectively. As compared with BBP, MBP increased blood CO

Topics: Animal Feed; Animals; Body Weight; Cattle; Cattle Diseases; Diarrhea; Diet; Electrolytes; Feces; Male; Milk; Sodium Acetate; Sodium Bicarbonate

We describe the feasibility and safety of an oral administration schedule of hydration, alkalinization and leucovorin rescue with an ambulatory high-dose methotrexate regimen.. From January 2016 to June 2018, 49 ambulatory high-dose methotrexate courses were given to 18 patients. No dose reduction was required afterwards. All patients completed succesfully the planned three doses in an outpatient basis, except four patients, one of them due to pneumonitis. Previous to methotrexate infusion, urinary pH > 7 was achieved in 35 (79.5%) cycles. Methotrexate clearance was achieved by 72 h in 35 courses (71.4%), and by 96 h in 100%. Neutropenia/trombocytopenia grades III/IV were observed in four cycles (8.16%) and two (4.08%) cycles, respectively. Around 20.40% were associated with stomatitis, 14.20% vomiting, 10.20% asthenia, 8.16% diarrhea and 6.12% with renal toxicity.. Ambulatory administration of high-dose methotrexate as CNS prophylaxis is safe and feasible following the described approach, allowing us to optimize healthcare resources.

Topics: Adult; Aged; Ambulatory Care Facilities; Diarrhea; Female; Humans; Leucovorin; Lymphoma, Non-Hodgkin; Male; Methotrexate; Middle Aged; Neutropenia; Prospective Studies; Sodium Bicarbonate; Vomiting; Young Adult

SN-38, an active metabolite of irinotecan, is reabsorbed by the intestinal tract during excretion, causing diarrhoea and neutropenia. In addition, the association between blood levels of SN-38 and neutropenia has been reported previously, and the rapid excretion of SN-38 from the intestinal tract is considered to prevent neutropenia. Oral alkalization drugs are used as prophylactic agents for suppressing SN-38 reabsorption. The relationship between oral alkalization drugs and neutropenia, however, has not been well studied. The aim of this study was to investigate the relationship between oral alkalization drugs and neutropenia in irinotecan-treated patients.. Patients with cervical or ovarian cancer were administered irinotecan and investigated by medical chart reviews to determine whether oral alkalization drugs were effective at ameliorating irinotecan-induced neutropenia. The drug combination in the oral alkalization drugs-ursodeoxycholic acid, magnesium oxide, and sodium hydrogen carbonate-significantly improved neutrophil counts and reduced dose intensity compared with those of non-users. In the large-scale Japanese Adverse Drug Event Report database, the reporting odds ratio of irinotecan-induced neutropenia was significantly lower when irinotecan had been given in combination with oral alkalization drugs.. These data indicate that oral alkalization drugs may reduce the frequency of neutropenia caused by irinotecan administration, making it possible to increase the dose safely.

Topics: Adult; Aged; Antacids; Antineoplastic Agents, Phytogenic; Buffers; Camptothecin; Cholagogues and Choleretics; Diarrhea; Female; Humans; Intestines; Irinotecan; Magnesium Oxide; Male; Middle Aged; Neutropenia; Retrospective Studies; Sodium Bicarbonate; Topoisomerase I Inhibitors; Ursodeoxycholic Acid; Uterine Cervical Neoplasms; Uterine Neoplasms

The aim of this study was to compare effect of combinations of intravenous isotonic sodium bicarbonate (NaHCO3), acetate Ringer, lactate Ringer and small-volume hypertonic sodium chloride (NaCI) solutions along with oral electrolyte solutions (OES) on the treatment of neonatal calf diarrhea with moderate dehydration and metabolic acidosis. Thirty-two calves with diarrhea were used in the study. Calves were randomly assigned to receive acetate Ringer solution (n=8), lactate Ringer solution (n=8), isotonic NaHCO3 (n=8) and 7.2% saline solutions (n=8), and two liters of OES were administrated to all calves orally at the end of intravenous administration. Blood samples for blood gas and biochemical analyses were collected at 0 hours and at 0.5, 1, 2, 4, 6 and 24 hours intervals. All the calves had mild to moderate metabolic acidosis on admission. Increased plasma volume and sodium concentration, but decreased serum total protein were observed within 0.5 hours following administration of hypertonic 7.2% NaCI + OES, compared to other 3 groups. In conclusion, administration of intravenous hypertonic 7.2% NaCI solution in small volume along with OES provided fast and effective improvement of dehydration and acid-base abnormalities within short time in treatment of calf diarrhea with moderate dehydration and metabolic acidosis.

Topics: Acetates; Acidosis; Administration, Intravenous; Animals; Animals, Newborn; Cattle; Cattle Diseases; Diarrhea; Lactates; Ringer's Solution; Sodium Bicarbonate; Sodium Chloride

Enterotoxigenic Escherichia coli (ETEC) is an important cause of acute watery diarrhoea in developing countries. Colonization factors (CFs) on the bacterial surface mediate adhesion to the small intestinal epithelium. Two of the most common CFs worldwide are coli surface antigens 5 and 6 (CS5, CS6). In this study we investigated the expression of CS5 and CS6 in vivo, and the effects of bile and sodium bicarbonate, present in the human gut, on the expression of CS5. Five CS5+CS6 ETEC isolates from adult Bangladeshi patients with acute diarrhoea were studied. The level of transcription from the CS5 operon was approximately 100-fold higher than from the CS6 operon in ETEC bacteria recovered directly from diarrhoeal stool without sub-culturing (in vivo). The glyco-conjugated primary bile salt sodium glycocholate hydrate (NaGCH) induced phenotypic expression of CS5 in a dose-dependent manner and caused a 100-fold up-regulation of CS5 mRNA levels; this is the first description of NaGCH as an enteropathogenic virulence inducer. The relative transcription levels from the CS5 and CS6 operons in the presence of bile or NaGCH in vitro were similar to those in vivo. Another bile salt, sodium deoxycholate (NaDC), previously reported to induce enteropathogenic virulence, also induced expression of CS5, whereas sodium bicarbonate did not.

Topics: Bile Acids and Salts; Diarrhea; Enterotoxigenic Escherichia coli; Escherichia coli Proteins; Feces; Fimbriae Proteins; Humans; RNA, Messenger; Sodium Bicarbonate; Up-Regulation

The aim of the present prospective study was to investigate whether a decision tree based on basic clinical signs could be used to determine the treatment of metabolic acidosis in calves successfully without expensive laboratory equipment. A total of 121 calves with a diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital were included in the study. The dosages of sodium bicarbonate administered followed simple guidelines based on the results of a previous retrospective analysis. Calves that were neither dehydrated nor assumed to be acidemic received an oral electrolyte solution. In cases in which intravenous correction of acidosis and/or dehydration was deemed necessary, the provided amount of sodium bicarbonate ranged from 250 to 750 mmol (depending on alterations in posture) and infusion volumes from 1 to 6.25 liters (depending on the degree of dehydration). Individual body weights of calves were disregarded. During the 24 hour study period the investigator was blinded to all laboratory findings.. After being lifted, many calves were able to stand despite base excess levels below -20 mmol/l. Especially in those calves, metabolic acidosis was undercorrected with the provided amount of 500 mmol sodium bicarbonate, which was intended for calves standing insecurely. In 13 calves metabolic acidosis was not treated successfully as defined by an expected treatment failure or a measured base excess value below -5 mmol/l. By contrast, 24 hours after the initiation of therapy, a metabolic alkalosis was present in 55 calves (base excess levels above +5 mmol/l). However, the clinical status was not affected significantly by the metabolic alkalosis.. Assuming re-evaluation of the calf after 24 hours, the tested decision tree can be recommended for the use in field practice with minor modifications. Calves that stand insecurely and are not able to correct their position if pushed require higher doses of sodium bicarbonate, if there is clinical evidence of a marked D-lactic acidosis. In those calves, determining the degree of loss of the palpebral reflex was identified as a useful decision criterion to provide an additional amount of 250 mmol sodium bicarbonate. This work demonstrates the clinical relevance of the discovery that D-lactate is responsible for most of the clinical signs expressed in neonatal diarrheic calves suffering from metabolic acidosis.

Topics: Acidosis; Animals; Animals, Newborn; Cattle; Cattle Diseases; Decision Trees; Diarrhea; Electrolytes; Lactic Acid; Prospective Studies; Reproducibility of Results; Sodium Bicarbonate; Statistics, Nonparametric

To determine and compare the effects of 4 oral replacement therapy (ORT) solutions on acid-base balance, abomasal emptying rate, and plasma volume expansion in calves with naturally acquired diarrhea and moderate dehydration.. Prospective study.. 20 calves.. 20 calves up to 45 days of age were randomly allocated (n = 5/group) to receive 2 L of 1 of 4 treatments via oroesophageal intubation: sodium bicarbonate (150 mmol/L or 300 mmol/L) or sodium acetate (150 mmol/L or 300 mmol/L). The 4 test solutions contained acetaminophen (50 mg/kg [22.7 mg/lb]) and 50 g of glucose monohydrate. Jugular venous blood samples were obtained periodically before and after administration of the ORT solution. Abomasal emptying rate was determined by use of the time to maximal plasma acetaminophen concentration.. Plasma bicarbonate concentration increased more rapidly in calves administered bicarbonate-containing ORT solutions, whereas the rate of systemic alkalinization, as assessed via blood pH, did not differ consistently among treatments. The 300 mmol/L ORT solutions were emptied at a significantly slower rate from the abomasum than 150 mmol/L ORT solutions, with no difference in emptying rate between acetate and bicarbonate-containing ORT solutions of similar molality. The 300 mmol/L sodium acetate ORT solution significantly increased plasma volume.. Clinically important differences in the resuscitative response to 300 mmol/L or 150 mmol/L ORT solutions of sodium acetate or sodium bicarbonate were not identified.

Topics: Abomasum; Acid-Base Equilibrium; Acidosis; Animals; Animals, Newborn; Cattle; Cattle Diseases; Dehydration; Diarrhea; Dose-Response Relationship, Drug; Fluid Therapy; Prospective Studies; Random Allocation; Sodium Acetate; Sodium Bicarbonate; Treatment Outcome

Five hypernatremic, diarrheic, neonatal calves were treated mainly by the intravenous administration of 5% dextrose alone or with isotonic sodium bicarbonate. All calves recovered without complications. The average reduction rate of serum sodium concentration was about 4 times that recommended and has not been tried successfully before in hypernatremic scouring calves.

Topics: Animals; Animals, Newborn; Cattle; Cattle Diseases; Diarrhea; Female; Glucose; Hypernatremia; Sodium Bicarbonate; Treatment Outcome

Twelve diarrhoeic calves were treated intravenously with an isotonic solution containing sodium bicarbonate, and their oxygen equilibrium curves (OECS) were calculated under standard conditions and compared with those of a group of healthy calves. The relationships between the OECS for arterial and venous blood and the oxygen extraction ratio were investigated. In the diarrhoeic calves, the affinity of haemoglobin for oxygen, measured under standard conditions, was increased compared with the healthy animals. During the infusion, the standard partial oxygen pressure at 50 per cent saturation of haemoglobin (P50) values stayed below the values recorded in the healthy animals. At the end of the infusion the mean standard P50 of the diarrhoeic calves was lower than before the infusion. The combined effects of all the regulating factors on blood oxygen binding resulted in the OECS of the arterial and jugular venous blood of the diarrhoeic calves remaining unchanged compared with the healthy calves. However, the administration of the infusion decreased the P50 of both the arterial and venous blood to below the value recorded in the healthy calves. Oxygen extraction by the tissues was impaired in the diarrhoeic calves throughout the infusion, and they remained dehydrated and depressed until 120 minutes after the infusion began.

Topics: Animals; Animals, Newborn; Carbon Dioxide; Case-Control Studies; Cattle; Cattle Diseases; Dehydration; Diarrhea; Hemoglobins; Infusions, Intravenous; Oxygen; Oxyhemoglobins; Partial Pressure; Random Allocation; Sodium Bicarbonate

Alkalization of the intestinal tract by oral administration of sodium bicarbonate has been reported to be a promising method for preventing delayed diarrhea, a dose-limiting toxicity in patients receiving chemotherapy with irinotecan hydrochloride. However, it is feared that this method may adversely affect the pharmacokinetics of irinotecan by inhibiting its intestinal absorption and that of its active metabolites. We compared the pharmacokinetics and toxicity of irinotecan with and without oral alkalization in a cross-over study that enrolled 10 colorectal cancer patients. We found that alkalization did not decrease the blood levels of irinotecan and its active metabolite. In fact, the area under concentration versus time curves (AUCs) of irinotecan and 7-ethyl-10-hydroxycamptothecin glucuronide (SN-38G) were statistically equivalent both with and without oral alkalization. Also, the AUC of SN-38 with alkalization was statistically equivalent or larger than that without alkalization. Oral alkalization reduced the incidence of diarrhea and gastrointestinal symptoms, and these adverse effects were not worsened by long-term administration. These results suggest that oral alkalization can control diarrhea and gastrointestinal toxicity without decreasing the blood levels of irinotecan and its active metabolites, thus improving the tolerability of long-term chemotherapy without reducing efficacy.

Topics: Administration, Oral; Aged; Antineoplastic Agents, Phytogenic; Area Under Curve; Camptothecin; Colorectal Neoplasms; Cross-Over Studies; Diarrhea; Drug Administration Schedule; Female; Humans; Irinotecan; Male; Middle Aged; Quality of Life; Sodium Bicarbonate; Surveys and Questionnaires

Irinotecan and its active metabolite, SN-38, were reported to have the absorption characteristics of weakly basic drugs. Moreover, stasis of these compounds is thought to induce damage to the intestinal mucous membrane. The purpose of this report was to examine whether oral alkalization (OA) combined with control of defecation (CD) might prevent irinotecan-induced side effects. From day one of irinotecan infusion to day four, OA & CD were practiced using orally administered sodium bicarbonate, magnesium oxide, basic water, and ursodeoxycholic acid. Thirty-two lung cancer patients were treated with irinotecan in combination with cisplatin in the absence of OA & CD (Group A). Thirty-seven patients matched for background characteristics were treated with the same regimen in the presence of OA & CD (Group B). Group B had a reduced incidence of delayed diarrhea (Grade 2 < or = Group A 32.3% vs. Group B 9.4%), nausea, vomiting, and myelotoxicity, especially granulocytopenia compared with Group A. In addition, dose intensification was well-tolerated in Group B. Tumor response rates for non-small cell lung cancer were 59.3% (16/27 patients) in Group B against 38.5% (10/26 patients) in Group A. OA & CD appears to reduce the irinotecan-induced side effects, especially delayed diarrhea. Risk factors statistically associated with delayed diarrhea include advanced age and the use of irinotecan without OA & CD.

Topics: Administration, Oral; Antacids; Antineoplastic Agents, Phytogenic; Camptothecin; Carcinoma, Non-Small-Cell Lung; Case-Control Studies; Defecation; Diarrhea; Female; Humans; Irinotecan; Lung Neoplasms; Magnesium Oxide; Male; Middle Aged; Sodium Bicarbonate; Ursodeoxycholic Acid

The therapeutic efficacy of irinotecan (CPT-11), a DNA topoisomerase inhibitor, is often limited by the induction of severe late-onset diarrhea. This prodrug and its active metabolite, 7-ethyl-10-hydroxy-camptothecin (SN-38), have a labile alpha-hydroxy-lactone ring that undergoes pH-dependent reversible hydrolysis. At physiological pH and higher, equilibrium favors the less toxic carboxylate form, whereas at acidic pH, the more potent lactone form is favored. We have reported previously that the initial uptake rate of CPT-11 and SN-38 by intestinal cells was significantly different between the respective lactone and carboxylate form. Results from the present study in HT-29 cells further demonstrate the correlation between the CPT-11/SN-38 initial uptake rate and the induced toxicity, cell cycle alteration, apoptosis, and colony-forming efficiency. The exposure of HT-29 cells to SN-38 for a limited period of time (<2 h) was sufficient to induce these events. Because the decreased initial uptake of SN-38 carboxylate resulted in a reduced cellular toxicity, we postulated that the CPT-11-induced diarrhea was preventable by influencing the equilibrium toward the carboxylate form and, thus, reducing its intestinal uptake. In the golden Syrian hamster model, p.o. sodium bicarbonate supplementation (5 mg/ml in drinking water) led to alkalization of the intestinal contents. In addition, this alkalization resulted in the reduction of the histopathological damage to the mucosa of the small and large intestine, as well as a 20% reduction of the intestinal SN-38 lactone concentration of animals receiving CPT-11 (20-50 mg/kg x 7 days). Taken together, these results from in vitro and in vivo studies support intestinal alkalization by sodium bicarbonate supplementation as a preventive mechanism against CPT-11-induced diarrhea. In addition, this provides a strong rationale for the usage of this measure as an adjunct to CPT-11 treatment.

Topics: Animals; Antineoplastic Agents, Phytogenic; Apoptosis; Camptothecin; Carboxylic Acids; Cell Cycle; Cell Division; Cricetinae; Diarrhea; Glucuronides; HT29 Cells; Humans; Hydrogen-Ion Concentration; Intestinal Mucosa; Intestines; Irinotecan; Lactones; Male; Mesocricetus; Sodium Bicarbonate

Thirty-seven of 53 diarrhoeic calves hospitalised for intravenous fluid therapy were classified as very severely acidotic (total carbon dioxide less than 8 mmol/litre) by using a Harleco apparatus. All the calves were given intravenously 10 to 20 litres of electrolyte solution which contained 144 mmol/litre sodium, 4 mmol/litre potassium, 113 mmol/litre chloride and 35 mmol/litre bicarbonate, and in addition the 37 very severely acidotic calves received 400 ml of 1M sodium bicarbonate in the first 5 litres of fluid administered. Sixteen of the 37 very severely acidotic calves had a distended right flank, suggesting the presence of a dilated fluid-filled viscus. Neither their history nor other clinical signs were useful predictors of the distension. The distended calves had significantly higher plasma concentrations of sodium and chloride, and significantly lower plasma creatinine concentrations than the calves which were not distended. Treatment was successful in all the 21 non-distended calves but four of the distended calves died despite treatment. The resolution of the distension in the successfully treated calves, coincided with a significant increase in plasma bicarbonate concentration and the passage of large amounts of malodorous mucoid faeces.

Topics: Abomasum; Acidosis; Animals; Anions; Blood Glucose; Blood Urea Nitrogen; Carbon Dioxide; Cattle; Cattle Diseases; Creatinine; Diarrhea; Electrolytes; Gastric Dilatation; Infusions, Intravenous; Isotonic Solutions; Lactic Acid; Sodium Bicarbonate

We report the case of a newborn Indian girl with congenital sodium diarrhoea (CSD) who presented typically in utero, in whom diagnosis was made from markedly raised stool sodium in the presence of an alkaline stool. Treatment with sodium citrate normalised her metabolic and electrolyte status but resulted in transient uremia necessitating supplementation with sodium bicarbonate instead. She died at 11 weeks old following re-admission in a moribund state with grossly increased abdominal distension. Her fatal outcome in infancy suggests that CSD has a wide spectrum of clinical severity.

Topics: Citrates; Diarrhea; Fatal Outcome; Female; Humans; Infant, Newborn; Prenatal Diagnosis; Sodium; Sodium Bicarbonate; Sodium Citrate

Sixteen head of 7 to 10 days old calves of the Black-Pied breed with clinical diagnosis of gastroenteritis acuta were examined for their clinical and laboratory findings before i. v. application of 8.4% solution of NaHCO3 and after it, using the well-known formula: live weight in kg x 0.6 x base deficit. The calves presented clinical symptoms of severe dehydration with profuse diarrhea. Dominant symptoms of the calf dehydration syndrome involved enophthalmos, lying down, lowered surface body temperature and strong exsiccosis of the organism. The values of pH, PCO2, HCO3, ABE, SBC were determined as acid-base indicators in venous blood. The most important adjustment of acid-base indicators was observed in pH, ABE and SB; their increases were statistically significant within the 3rd and/or 24th hour after intravenous application of 8.4% NaHCO3 solution at a significance level of p < 0.05 and/or p < 0.01. Buffering capacity of NaHCO3 was relatively strongly reflected in all indicators under observation when they were determined as reference values in 24 hours after application. The adjustment of acid-base indicators was accompanied by general improvement of calf health while the sucking reflex was resumed, which provided the conditions for accelerated replacement of fluids and electrolytes by i. v. as well as p. o. application forms.

Topics: Acidosis; Animals; Cattle; Cattle Diseases; Diarrhea; Sodium Bicarbonate

Glucose-based oral rehydration salt (ORS) is an appropriate and cost-effective tool to treat diarrhoeal dehydration. In patients with a high purging rate, particularly due to cholera, rice-based ORS has been shown to substantially reduce stool output compared to glucose ORS. However, it is not used in the hospitals or diarrhoea treatment centres largely because of the non-availability of a ready-to-use inexpensive packaged product and because of the problem of cooking. In a large diarrhoea treatment centre in Bangladesh (with an annual ORS consumption of approximately 140,000 litres), we have maintained in-house production of rice ORS and used it routinely for more than 600,000 patients over the last nine years. Semi-literate health workers cook rice ORS and supervise mothers in its use. Rice ORS is less costly (US $0.15 per patient treated compared with US $0.37 for glucose ORS) and is well accepted. It is an attractive alternative to glucose ORS in many fixed facility treatment centres in countries where rice is a staple and cholera is endemic. The process of its in-house preparation and use is described in this report which may assist hospitals wishing to use rice ORS in treating diarrhoea patients. Availability of a low cost ready-to-use rice ORS packet (which needs no cooking) with adequate shelf-life will increase its use at fixed facilities.

Topics: Bangladesh; Cholera; Citrates; Citric Acid; Costs and Cost Analysis; Diarrhea; Flour; Fluid Therapy; Humans; Oryza; Potassium Chloride; Quality Control; Rehydration Solutions; Sodium Bicarbonate; Sodium Chloride

Acid-base balance was evaluated in calves with experimentally induced viral diarrhea. When blood pH decreased to less than 7.200, calves were assigned to treatment groups and fed milk replacer, electrolyte solution without bicarbonate, or electrolyte solution containing bicarbonate. Calves in the electrolyte treatment groups had lower mortality (P less than 0.05), were better hydrated (P less than 0.05), and were less acidotic (P less than 0.05) than calves fed milk replacer. Bicarbonate-containing electrolyte solution restored acid-base balance (P less than 0.05) and corrected depression better (P less than 0.05) than electrolyte solution that did not contain bicarbonate. Both electrolyte solutions were equally good at correcting dehydration.

Topics: Acidosis; Animals; Bicarbonates; Blood Gas Analysis; Cattle; Cattle Diseases; Dehydration; Diarrhea; Electrolytes; Fluid Therapy; Hematocrit; Hydrogen-Ion Concentration; Male; Microcomputers; Random Allocation; Sodium; Sodium Bicarbonate; Software

Topics: Alkalosis; Aluminum Hydroxide; Antacids; Bicarbonates; Brain Diseases; Calcium; Constipation; Diarrhea; Drug Interactions; Humans; Hydrogen-Ion Concentration; Hypercalcemia; Kidney Calculi; Magnesium Hydroxide; Osteomalacia; Phosphates; Sodium; Sodium Bicarbonate; Urine; Water-Electrolyte Imbalance

Thirty-six dehydrated diarrheic neonatal calves were used to study the effects of various alkalinizing compounds on acid-base status, the changes in central venous pressure (CVP) in response to rapid IV infusion of large volumes of fluid, and the correlation of acid-base (base deficit) status, using a depression scoring system with physical determinants related to cardiovascular and neurologic function. Calves were allotted randomly to 4 groups (9 calves/group). Over a 4-hour period, each calf was given two 3.6-L volumes (the first 3.6 L given in the first hour) of a polyionic fluid alone (control group) or were given the polyionic fluid with sodium bicarbonate, sodium L-lactate, or sodium acetate added (50 mmol/L). Acid-base status, hematologic examination, and biochemical evaluations were made immediately before infusion of each fluid (at entry) and after 3.6, 4.8, and 7.2 L of fluid had been given. Compared with control values, bicarbonate, lactate, and acetate had significantly greater alkalinizing effects on pH (P less than 0.01) and base deficit (P less than 0.01) after 3.6, 4.8, and 7.2 L of fluid were given. Bicarbonate had the most rapid alkalinizing effect and induced greater changes in base deficit (P less than 0.01) than did acetate or lactate at each of the 3 administered fluid volumes evaluated. Acetate and lactate had similar alkalinizing effects on blood. Rehydration alone did not improve acid-base status. The CVP was elevated in 10 (28%) of the 36 calves after 1 hour of fluid (3.6 L) administration, but significant differences in body weight, PCV, and clinical condition or depression score at entry were not found between calves with elevated CVP and those with normal CVP.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acetates; Acetic Acid; Acidosis; Animals; Bicarbonates; Cattle; Cattle Diseases; Diarrhea; Double-Blind Method; Female; Fluid Therapy; Hydrogen-Ion Concentration; Lactates; Lactic Acid; Male; Sodium; Sodium Bicarbonate; Sodium Chloride

Effects of feeding waste milk from antibiotic-treated cows on growth, feed efficiency, and incidence of scours of dairy calves were studied. Twenty-four newborn Holstein heifer calves were assigned at random to one of the following treatments: 1) fresh normal milk, 2) fresh waste milk, 3) fermented waste milk, or 4) fermented waste milk plus sodium bicarbonate. Means for fat, crude protein, and total solids in normal milk (3.25, 3.05, and 11.84%) were lower than the same components for fresh waste milk (3.82, 3.42, and 12.59%) and fermented waste milk (4.02, 3.42, and 12.74%). Mean pH's for normal milk, fresh waste milk, and fermented waste milk were 6.6, 6.6, and 5.1. Calves were fed colostrum the first 3 days of life, and their respective treatment milk at 10% of body weight for 42 days. Dry calf feed was offered ad libitum beginning on day 4, and water was available at all times. Mean weight gains (kg) and ratios of average dry feed to gain (kg/kg) for the 42-day treatments were: 1) 19.2, .6; 2) 17.6, .6; 3) 19.6, .7; and 4) 20.1, .6. Incidence of scours was measured as number of days that scours were present per calf during the 42 days. Mean scour days for each group were: 1) 2.0, 2) 1.8, 3) 3.0, and 4) 4.8. There were no detrimental effects on calves fed fresh or fermented milk from cows treated with antibiotics. Addition of sodium bicarbonate did not affect acceptance of fermented milk by calves.

Topics: Animals; Anti-Bacterial Agents; Bicarbonates; Body Weight; Cattle; Cattle Diseases; Diarrhea; Diet; Fermentation; Milk; Sodium Bicarbonate

Topics: Bicarbonates; Child; Child, Preschool; Diarrhea; Diarrhea, Infantile; Fluid Therapy; Glucose; Humans; Infant; Isotonic Solutions; Potassium Chloride; Sodium Bicarbonate; Sodium Chloride

An oral rehydration solution (ORS) containing glucose, sodium and potassium chloride, and sodium bicarbonate, forms the basis of an oral rehydration therapy (ORT) regime which is detailed. The regime can be modified for adults, older children, younger children and neonates, and may be used in combination with other methods of augmented fluid intake such as juices and plain water supplements. Milk and soft foods should be added to the regimen. Guidelines for patients include methods of assessing rehydration. The harmful effects of 'therapeutic' starvation are stressed.

Topics: Administration, Oral; Adult; Bicarbonates; Child, Preschool; Diarrhea; Dose-Response Relationship, Drug; Drug Therapy, Combination; Fluid Therapy; Glucose; Humans; Infant; Infant, Newborn; Potassium Chloride; Sodium Bicarbonate; Sodium Chloride; Solutions; Travel; Water-Electrolyte Balance