Consideraciones clínicas y regulación del equilibrio ácido-base en ganado bovino
Clinical considerations and regulation of acid-base balance in cattle
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El entendimiento de los disturbios electrolíticos y ácido-base depende de la comprensión de los mecanismos fisiológicos que los regulan y de la interpretación de los cambios en el pH sanguíneo. Algunas enfermedades producen un patrón constante de pérdidas de fluidos y electrolitos con cambios predecibles en el volumen y la concentración. Además, uno o más de los componentes que los regulan pueden estar comprometidos, lo cual, puede resultar en desórdenes del estado ácido-base. Actualmente existen tres enfoques para la evaluación clínica del estado ácido-base: la ecuación de Henderson-Hasselbach, el modelo de iones fuertes y el modelo de iones fuertes simplificado, quedando a consideración del clínico su utilización. La manipulación de la diferencia entre cationes y aniones en la dieta (DCAD) es definida como los mili-equivalentes de (Na + K) - (Cl + S) por kilogramo (mEq/kg) de materia seca (MS) y tiene un impacto directo sobre el estado ácido-base, siendo el cloruro de amonio la sal con más poder acidificante y el sulfato de magnesio la sal aniónica más palatable, teniendo en cuenta que el pH urinario es una herramienta útil para evaluar el grado de acidosis metabólica impuesto por las sales aniónicas. Los valores de laboratorio interpretados por cualquier modelo son solo un paso en el análisis electrolítico y ácido-base del paciente. Para tomar decisiones racionales, se deben correlacionar estos valores con el cuadro clínico y el conocimiento de la bioquímica y fisiología subyacente, utilizando los importantes principios de la medicina, basada en la evidencia.
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