Comparison of the utility of the classic model (the Henderson-Hasselbach equation) and the Stewart model (Strong Ion Approach) for the diagnostics of acid-base balance disorders in dogs with right sided heart failure

Abstract

Classically, the acid-base balance (ABB) is described by the Henderson-Hasselbach equation, where the blood pH is a result of a metabolic components--the HCO3(-) concentration and a respiratory component--pCO2. The Stewart model assumes that the proper understanding of the organisms ABB is based on an analysis of: pCO2, Strong Ion difference (SID)--the difference strong cation and anion concentrations in the blood serum, and the Acid total (Atot)--the total concentration of nonvolatile weak acids. Right sided heart failure in dogs causes serious haemodynamic disorders in the form of peripheral stasis leading to formation of transudates in body cavities, which in turn causes ABB respiratory and metabolic disorders. The study was aimed at analysing the ABB parameters with the use of the classic method and the Stewart model in dogs with the right sided heart failure and a comparison of both methods for the purpose of their diagnostic and therapeutic utility. The study was conducted on 10 dogs with diagnosed right sided heart failure. Arterial and venous blood was drawn from the animals. Analysis of pH, pCO2 and HCO3(-) was performed from samples of arterial blood. Concentrations of Na+, K+, Cl(-), P(inorganic), albumins and lactate were determined from venous blood samples and values of Strong Ion difference of Na+, K+ and Cl(-) (SID3), Strong Ion difference of Na+, K+, Cl(-) and lactate (SID4), Atot, Strong Ion difference effective (SIDe) and Strong Ion Gap (SIG4) were calculated. The conclusions are as follows: 1) diagnosis of ABB disorders on the basis of the Stewart model showed metabolic alkalosis in all dogs examined, 2) in cases of circulatory system diseases, methodology based on the Stewart model should be applied for ABB disorder diagnosis, 3) if a diagnosis of ABB disorders is necessary, determination of pH, pCO2 and HCO3(-) as well as concentrations of albumins and P(inorganic) should be determined on a routine basis, 4) for ABB disorder diagnosis, the classic model should be used only when the concentrations of albumins and P(inorganic) are normal.