A modified Gamblegram for the visual representation of acid-base disorders according to the Stewart-Figge approach.

The Gamblegram consists of two bars, each of which represents the sum of the charges of individual positively and negatively charged ions and is commonly used for visualizing changes in acid-base and electrolyte charges. However, according to the Stewart-Figge theory, the metabolic independent acid-base variables include the strong ion difference ([SID]) and the total concentrations of weak acids (albumin and inorganic phosphate), which are not shown in the conventional Gamblegram. Thus, the Gamblegram in its current form is unsuitable for visualizing acid-base perturbations using the Stewart-Figge approach.

Functional Comorbidity Index and health-related quality of life in patients with obstructive sleep apnea.

Introduction: The role of comorbidities in determining health-related quality of life (HRQL) in obstructive sleep apnea (OSA) pa-tients has not been thoroughly investigated. Commonly used comorbidity tools, such as Charlson Comorbidity Index (CCI), have been designed with mortality as the outcome variable. A new tool, the Functional Comorbidity Index (FCI), has been especially developed to assess the effect of comorbidities on the "physical functioning" subscale of the Medical Outcomes Short Form-36 Health Survey (SF-36).

Effect of periodontal therapy on COPD outcomes: a systematic review.

Background: Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients.

Methods: A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted.

Respiratory Involvement in Patients with Neuromuscular Diseases: A Narrative Review.

Respiratory muscle weakness is a major cause of morbidity and mortality in patients with neuromuscular diseases (NMDs). Respiratory involvement in NMDs can manifest broadly, ranging from milder insufficiency that may affect only sleep initially to severe insufficiency that can be life threatening. Patients with neuromuscular diseases exhibit very often sleep-disordered breathing, which is frequently overlooked until symptoms become more severe leading to irreversible respiratory failure necessitating noninvasive ventilation (NIV) or even tracheostomy.

Comparison of a new simplified acid-base tool to the original Stewart-Figge approach: a study on cardiac surgical patients.

Purpose: To suggest a simplified method for strong ion gap ([SIG]) calculation.

Patients And Methods: To simplify [SIG] calculation, we used the following assumptions: (1) the major determinants of apparent strong ion difference ([SID]) are [Na], [K] and [Cl] (2) [Ca] and [Mg] do not contribute significantly to [SID] variation and can be replaced by their reference concentrations (3) physiologically relevant pH variation is at the order of 10 and therefore we can assume a standard value of 7.4.

Successful management of drug-induced hypercapnic acidosis with naloxone and noninvasive positive pressure ventilation.

A 74-year-old man was referred to our hospital due to deteriorating level of consciousness and desaturation. His Glasgow Coma Scale was 6, and his pupils were constricted but responded to light. Chest radiograph was negative for significant findings.

Effect of the independent acid base variables on anion gap variation in cardiac surgical patients: a Stewart-Figge approach.

Purpose: To determine the effect of each of independent acid base variables on the anion gap (AG) value in cardiac surgical patients.

Methods: This retrospective study involved 128 cardiac surgical patients admitted for postoperative care. The variation of AG (AGvar) between the day of admission and the first postoperative day was correlated via a multiple linear regression model with the respective variations of the independent acid base variables, that is, apparent strong ion difference (SIDa), strong ion gap (SIG), carbon dioxide (PCO2), and albumin and phosphate concentrations.

The base excess gap is not a valid tool for the quantification of unmeasured ions in cardiac surgical patients: a retrospective observational study.

Background: The base excess gap (BE(gap)) method is commonly used for the quantification of unmeasured ions in critically ill patients. However, it has never been validated against the standard quantitative acid-base approach.

Objective: To compare the BE(gap) as a tool for the prediction of the excess of unmeasured ions with the offset of strong ion gap (SIG) from its reference value.

Ventilator-associated sinusitis in adults: systematic review and meta-analysis.

Objective: To review the epidemiology, risk factors for, treatment and outcome of ventilator-associated sinusitis (VAS).

Methods: We performed a systematic review and meta-analysis of available data without time restrictions. A conservative random effects model was employed to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs).

Strong ion reserve: a viewpoint on acid base equilibria and buffering.

Evidence suggests that strong ions can exist reversibly bound to proteins in a pH-dependent manner and that they can be recruited into the biological solution, modulating its strong ion difference in a process that opposes the acid base disturbances imposed on the system. These recruitable strong ions represent the solution's 'strong ion reserve'. The physiologic [corrected] role of these protein-bound strong ions [corrected] in the buffering of acid base disorders is discussed.

Frequency, prevention, outcome and treatment of ventilator-associated tracheobronchitis: systematic review and meta-analysis.

Objective: To clarify issues regarding the frequency, prevention, outcome, and treatment of patients with ventilator-associated tracheobronchitis (VAT), which is a lower respiratory tract infection involving the tracheobronchial tree, while sparing the lung parenchyma.

Methods: We performed a systematic review and meta-analysis of relevant available data, gathered though searches of PubMed, Scopus, and reference lists, without time restrictions. A conservative random effects model was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI).

Infections related to airway stenting: a systematic review.

Background: Airway stenting is nowadays an established method for the palliative and/or curative treatment of central airways obstruction. However, complications related to the use of airway stents have been reported.

Objective: We endeavored to systematically evaluate the currently available evidence regarding the infections associated with airway stenting.

Administration of antibiotics via the respiratory tract as monotherapy for pneumonia.

There is increasing interest in applying alternatives to the systemic modes of administration of antimicrobial agents for the treatment of patients with pneumonia. We endeavored to accumulate and evaluate the published evidence on the role of aerosolized antimicrobials administered as monotherapy for patients with pneumonia through searches of PubMed, Scopus and relevant bibliographies. Seven relevant studies (one randomized controlled trial, four case series and two case reports), including 63 patients, were identified; 37% (23 out of 63) and 63% (40 out of 63) of these patients suffered from community-acquired and nosocomial (including ventilator-associated) pneumonia, respectively.