Metabolic Acidosis and Other Determinants of Hemoglobin-Oxygen Dissociation in Severe Childhood Plasmodium falciparum Malaria
Metabolic acidosis is a common complication of severe malaria caused by Plasmodium falciparum. The factors contributing to the acidosis were assessed in 62 children with severe falciparum malaria (cases) and in 29 control children who had recently recovered from mild or moderate malaria. The acidosi...
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| Veröffentlicht in: | The American journal of tropical medicine and hygiene 2007-08, Vol.77 (2), p.256-260 |
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| container_title | The American journal of tropical medicine and hygiene |
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| creator | Sasi, Philip Burns, Shamus P Waruiru, Catherine English, Michael Hobson, Claire L King, Christopher G Mosobo, Moses Beech, John S Iles, Richard A Boucher, Barbara J Cohen, Robert D |
| description | Metabolic acidosis is a common complication of severe malaria caused by Plasmodium falciparum. The factors contributing to the acidosis were assessed in 62 children with severe falciparum malaria (cases) and in 29 control children who had recently recovered from mild or moderate malaria. The acidosis was largely caused by the accumulation of both lactic and 3-hydroxybutyric acids. The determinants of oxygen release to the tissues were also examined; although there was no difference between cases and controls in respect of 2,3-bisphosphoglycerate and mean corpuscular hemoglobin concentration, there was a marked increase in P(50) in the cases, caused by pyrexia, low pH, and base deficit. There was substantial relative or actual hypoglycemia in many cases. The relationship of these observations to therapeutic strategy is discussed. |
| doi_str_mv | 10.4269/ajtmh.2007.77.256 |
| format | Article |
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The factors contributing to the acidosis were assessed in 62 children with severe falciparum malaria (cases) and in 29 control children who had recently recovered from mild or moderate malaria. The acidosis was largely caused by the accumulation of both lactic and 3-hydroxybutyric acids. The determinants of oxygen release to the tissues were also examined; although there was no difference between cases and controls in respect of 2,3-bisphosphoglycerate and mean corpuscular hemoglobin concentration, there was a marked increase in P(50) in the cases, caused by pyrexia, low pH, and base deficit. There was substantial relative or actual hypoglycemia in many cases. 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The factors contributing to the acidosis were assessed in 62 children with severe falciparum malaria (cases) and in 29 control children who had recently recovered from mild or moderate malaria. The acidosis was largely caused by the accumulation of both lactic and 3-hydroxybutyric acids. The determinants of oxygen release to the tissues were also examined; although there was no difference between cases and controls in respect of 2,3-bisphosphoglycerate and mean corpuscular hemoglobin concentration, there was a marked increase in P(50) in the cases, caused by pyrexia, low pH, and base deficit. There was substantial relative or actual hypoglycemia in many cases. The relationship of these observations to therapeutic strategy is discussed.</description><subject>2,3-Diphosphoglycerate - blood</subject><subject>3-Hydroxybutyric Acid - blood</subject><subject>Acidosis, Lactic - blood</subject><subject>Acidosis, Lactic - metabolism</subject><subject>Acidosis, Lactic - parasitology</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hemoglobins - metabolism</subject><subject>Human protozoal diseases</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Lactates - blood</subject><subject>Malaria</subject><subject>Malaria, Falciparum - blood</subject><subject>Malaria, Falciparum - metabolism</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Oxygen - blood</subject><subject>Parasitic diseases</subject><subject>Plasmodium falciparum</subject><subject>Plasmodium falciparum - growth & development</subject><subject>Protozoal diseases</subject><subject>Statistics, Nonparametric</subject><issn>0002-9637</issn><issn>1476-1645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFuEzEQhi0EoqHwAFyQL3DbMLY39vpYpUCRWgUJOFuztjfryrsO9obQA-_Opo2UI6cZjb7_n8NHyFsGy5pL_RHvp6FfcgC1VGrJV_IZWbBayYrJevWcLACAV1oKdUFelXIPwBrO2EtywZTUILRckL93fsI2xWDplQ0ulVAojo5upt5neu0nn4cw4jgVmjp644e0jakNY7X587D1I70OpSQbcApppGGk3_1vnz1d9yG6PiVHv0UsQ3JhP9AOow07zPN6hxFzwNfkxXws_s1pXpKfnz_9WN9Ut5svX9dXt5UVGqaq5dBoFGA1ulYJ8MxytNytVGtdpwU0ggkUdWtRSw5asE46zWzXNK6DlotL8uGpd5fTr70vkxlCsT5GHH3aFyMbVuuVgP-CHFSjG8lmkD2BNqdSsu_MLocB84NhYI5yzKMcc5RjlDKznDnz7lS-bwfvzomTjRl4fwKwWIxdxtGGcuYarXkt4cz1YdsfQvamDBjjXMvM4XA4vnt8-A8Dfafh</recordid><startdate>20070801</startdate><enddate>20070801</enddate><creator>Sasi, Philip</creator><creator>Burns, Shamus P</creator><creator>Waruiru, Catherine</creator><creator>English, Michael</creator><creator>Hobson, Claire L</creator><creator>King, Christopher G</creator><creator>Mosobo, Moses</creator><creator>Beech, John S</creator><creator>Iles, Richard A</creator><creator>Boucher, Barbara J</creator><creator>Cohen, Robert D</creator><general>ASTMH</general><general>Allen Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>20070801</creationdate><title>Metabolic Acidosis and Other Determinants of Hemoglobin-Oxygen Dissociation in Severe Childhood Plasmodium falciparum Malaria</title><author>Sasi, Philip ; 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| subjects | 2,3-Diphosphoglycerate - blood 3-Hydroxybutyric Acid - blood Acidosis, Lactic - blood Acidosis, Lactic - metabolism Acidosis, Lactic - parasitology Animals Biological and medical sciences Blood Glucose - metabolism Child Child, Preschool Female Hemoglobins - metabolism Human protozoal diseases Humans Hydrogen-Ion Concentration Infant Infectious diseases Lactates - blood Malaria Malaria, Falciparum - blood Malaria, Falciparum - metabolism Male Medical sciences Oxygen - blood Parasitic diseases Plasmodium falciparum Plasmodium falciparum - growth & development Protozoal diseases Statistics, Nonparametric |
| title | Metabolic Acidosis and Other Determinants of Hemoglobin-Oxygen Dissociation in Severe Childhood Plasmodium falciparum Malaria |
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