Metabolic alkalosis historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marufa Marium, M.B.B.S[2]
Overview
Alkalosis is defined as elevation of physiologic blood pH above 7.45. Metabolic alkalosis is caused by metabolic imbalance causing alkalosis by trapping Bicarbonate ions or loss of hydrogen in body. The discovery of electrochemistry of gas and electricity was first explored in 17th and 18th centuries . Later in late 1880s definition of acid was first developed and modified by numerous scientists from 1880s to 1950s until the epidemic era of Polio. Stewart combined all the ideas from pre-1950 and proposed a way of studying acid-base balance in clinical settings.
Historical Perspective
In the beginning era of exploration of acid-base physiology, there are contribution of many scientists from 1880s to modern time. In 1880s Arrhenius defined acid for the first time as a substance which helped in increasing hydrogen ions concentration when dissolving with water. Naunyn combined definitions from Arrhenius and Faraday and came up with ideas of electrolytes determining acid-base physiology.[1] Van Slyke modified the definition of acid by Naunyn in 1920. Bronsted and Lowry defined acid as a substance donating hydrogen ion just after World War One, whereas Lewis suggested acid as acceptor of electron pair. Henderson and Hasselbalch contributed in development of Henderson-Hasselbalch equation linking pH, PCO2, HCO3 concentration in 1908 and 1916 respectively. The role of HCO3 in acid-base physiology first came up in 1950s.[2][3]
Discovery
A group of physicians from Denmark erroneously discovered metabolic alkalosis by using bicarbonate concentration in plasma during the emergence of polio epidemic in 1952.[4]
Outbreaks
The Polio epidemic triggered the development of glass electrode and detection of pH by Astrup in blood. He worked with Siggard-Anderson to build the foundation od clinical acid-base balance.[5]
Landmark Events in the Development of Treatment Strategies
From 1970 to 1980s Stewart showed detailed integration of clinical acid-base physiology and applied HCO3 centered in clinical settings.[6]
References
- ↑ RELMAN AS (October 1954). "What are acids and bases?". Am J Med. 17 (4): 435–7. doi:10.1016/0002-9343(54)90118-7. PMID 13197407.
- ↑ Severinghaus JW (1993). "Siggaard-Andersen and the "Great Trans-Atlantic Acid-Base Debate"". Scand J Clin Lab Invest Suppl. 214: 99–104. PMID 8332859.
- ↑ Siggaard-Andersen O, Fogh-Andersen N (1995). "Base excess or buffer base (strong ion difference) as measure of a non-respiratory acid-base disturbance". Acta Anaesthesiol Scand Suppl. 107: 123–8. doi:10.1111/j.1399-6576.1995.tb04346.x. PMID 8599264.
- ↑ Story DA (August 2004). "Bench-to-bedside review: a brief history of clinical acid-base". Crit Care. 8 (4): 253–8. doi:10.1186/cc2861. PMC 522833. PMID 15312207.
- ↑ Severinghaus JW, Astrup PB (October 1985). "History of blood gas analysis. II. pH and acid-base balance measurements". J Clin Monit. 1 (4): 259–77. doi:10.1007/BF02832819. PMID 3913750.
- ↑ Kellum JA (2000). "Determinants of blood pH in health and disease". Crit Care. 4 (1): 6–14. doi:10.1186/cc644. PMC 137247. PMID 11094491.