PubMed · 11322113
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R Zander. 2001. [Physiological erythrocyte protection solution].. https://doi.org/10.1055/s-2001-11840
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The aim of the present study was to determine maximal oxygen uptake (VO2max) directly during uphill walking exercise and to compare these values with those achieved during running and cycling exercise. Forty untrained students (20 males and 20 females) took part in three exercise tests. The running test was performed on a horizontal treadmill and the speed was gradually increased by 0.3 m . s(-1) every 3 min. The walking test was conducted on a treadmill inclined at 12% (speed of 1.8 m . s(-1)). The load was further increased every 3 min by the addition of a mass of one-twentieth of the body mass of the participant (plastic containers filled with water and added to a backpack carried by the participant). During the bicycle ergometry test, the workload was increased by 20 W every 2 min. All tests were performed until volitional exhaustion. During all tests, oxygen uptake, minute ventilation, tidal volume, respiratory frequency, heart rate, hydrogen ion concentration, base excess, and blood lactate concentration were analysed. The Pearson correlation coefficients between the weighted walking test and the commonly applied running and bicycle ergometry tests indicate a strong association with the new test in evaluating maximal oxygen uptake. The negligible differences in VO2max between the three tests for the male participants (running: 61.0 ml . kg(-1) . min(-1); walking: 60.4 ml . kg(-1) . min(-1); cycling: 60.2 ml . kg(-1) . min(-1)), and the fact that the females achieved better results on the walking test than the cycle ergometer test (running: 45.0 ml . kg(-1) . min(-1); walking: 42.6 ml . kg(-1) . min(-1); cycling: 40.1 ml . kg(-1) . min(-1)), confirm the suitability of the new method for evaluating aerobic power. The weighted walking test could be useful in the assessment of aerobic power in individuals for whom running is not advised or is difficult. In addition, the new test allows for determination of VO2max on small treadmills with a limited speed regulator, such as those found in specialist physiotherapy and fitness centres.
OBJECTIVE: To determine the effect of a mandatory protocol for treating diabetic ketoacidosis. DESIGN: Chart review of patients treated before and after protocol implementation. SETTING: University-affiliated U.S. public teaching hospital. PATIENTS: A total of 241 consecutive nonpregnant patients >18 yrs old admitted to a medical intensive care unit for diabetic ketoacidosis between January 2000 and January 2005. INTERVENTION: Implementation of a mandatory treatment protocol in May 2003. MEASUREMENTS: Intensive care unit and hospital lengths of stay, time to correction of anion gap and ketone clearance, and hypoglycemic episodes. RESULTS: Before protocol implementation, the mean +/- sd intensive care unit and hospital lengths of stay were 44 +/- 28 hrs and 91 +/- 73 hrs, respectively. After implementation, intensive care unit and hospital lengths of stay decreased 23% and 30%, to 34 +/- 18 hrs and 64 +/- 41 hrs, respectively (both p < .007). Time to anion gap closure and ketone clearance also decreased (both p < .05). No difference in the number of hypoglycemic episodes was observed. CONCLUSION: Implementing a mandatory protocol for treating adult patients with diabetic ketoacidosis decreases intensive care and hospital lengths of stay and time to anion gap closure and ketone clearance, without increasing the rate of hypoglycemia.
HISTORY AND CLINICAL FINDINGS: A 31-year-old female with known type 1 diabetes mellitus was referred because of symptomatic hyperglycemia. On admission she was delirious and impressed with marked Kussmaul breathing. All other vital signs were normal. INVESTIGATIONS: Blood serum glucose concentration was 26.4 mmol/l. Arterial blood gas analysis revealed massive metabolic acidosis (pH 6.80) with an elevated anion gap (21 mmol/l) and a marginally increased osmolar gap (21,5 mOsm/l). TREATMENT AND COURSE: Despite normalization of the serum glucose and acidemia after administration of normal saline, insulin and bicarbonate, the delirium persisted, and the possibility of an additional intoxication had to be considered. Serum headspace analysis for intoxication with solvents (gas chromatography) finally detected a "ghost peak", which could not be assigned to any established substance. The same peak was, however, found in a healthy subject's serum and was found to be a "toluene peak". Toluene is contained as "contaminator" in gels in blood collection tubes. The patient gradually regained consciousness and "merely" suffered from diabetic ketoacidosis associated with cocaine use. CONCLUSION: The differential diagnosis of high anion gap metabolic acidosis includes among other reasons intoxications with different kinds of solvents. When looking for solvents in the serum when poisoning is suspected (headspace analysis), only blood collection tubes without gel (EDTA plasma) should be used, because all gels contain solvents (in this case toluene).