The possibility that an inadequate response of the pulmonary system might limit high intensity exercise in man has received increasing attention over the past few years. However, very few scientific investigations have focused systematically on pulmonary function during high intensity constant-load exercise. Furthermore, many studies have examined only one part of the pulmonary system during exercise and some have not included blood gas measurements as a measure of the adequacy of pulmonary function. The studies reported in this thesis were designed to investigate the possible failure of the gas exchanging and pump functions of the pulmonary system during high intensity constant-load exercise. In particular, the aim was to determine the extent to which the pulmonary system might be a factor causing fatigue during this form of exercise.

Tobacco smoke particulate matter (PM) is a complex mixture of condensed organic compounds, with about 5 to 10% water. Its general properties are similar in some respects to that of atmospheric organic aerosol PM and thus provides a useful surrogate when studying atmospheric PM. Due to its ability to undergo acid-base chemistry, nicotine is of particular interest in the tobacco smoke system. The gas/particle partitioning of nicotine depends on the protonation state of nicotine in the particles, so the distribution of nicotine between these phases provides a means of understanding the acid-base balance in the tobacco smoke system. The goal of this work is to develop an acid-base balance for mainstream tobacco smoke that accounts for the extent of protonation of nicotine. Samples of extracted smoke particulate matter from seven brands of cigarettes were analyzed by ion chromatography (IC) and titration by both acid (HCl) and base (lithium phenoxide) for comparison with nicotine data collected by colleagues. IC analysis was used to quantify tracers of known acidic and basic species in tobacco smoke. Anion tracers for acids included: glycolate, acetate, formate, lactate, chloride, nitrite, sulfate, and nitrate. The cation tracers for base were ammonium, sodium, and potassium. The tobacco smoke extracts were also analyzed after acidification by the HCl titrant for changes in ammonia and organic acid concentrations to determine whether "bound" forms of these compounds were present in the PM. The titration data provided total concentrations of weak acid and bases in the samples. This titration data was compared with the concentrations of the tracers for weak acids and bases (along with the quantification of total nicotine by colleagues) to determine whether the IC analyses were accounting for all of the important species. The results of this comparison show that these analyses missed relevant species in the tobacco smoke system. As tobacco smoke PM is a complex organic mixture, the ability of acid species to protonate nicotine will be different than in aqueous media. The acidic species of interest were assumed to be either strong or weak, with the strong species assumed to be fully ionized after protonation of nicotine. Some portion of the weak acid species could then protonate any available nicotine. An electroneutrality equation (ENE) was developed for the tobacco smoke PM and populated using the IC data and the nicotine data obtained by colleagues. Using this ENE, the extent ionization of the weak acids species (α1A) and the net reaction constant for the protonation of nicotine by these weak acids (K*) was estimated. However, interpretation of the results were complicated by the underrepresentation of the pertinent weak acid species in our IC analyses. This study concluded that further work is needed to identify the missing weak acid and base species to obtain a better representation of the acid-base balance in tobacco smoke PM and to understand the ability of these weak acid species to protonate nicotine.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv., 2008. / Härtill 5 uppsatser.

Effects of fat adaptation and NaHC0₃ supplementation on acid-base homeostasis were quantitated during repeated sprint exercise in horses. Contribution of strong ions ([SID]), Pco₂, and weak electrolytes ([A_tot]) to changes in plasma [H⁺] and the role of erythrocytes in acid-base balance were examined at rest and during exercise. Effects on plasma glucose and blood lactate [Lac⁻] concentrations due to sample handling were also assessed. During exercise, blood [Lac⁻] was higher when horses received NaHC0₃ compared to water prior to exercise (P=0.0024), and in fat adapted horses compared to horses fed a control diet (P=0.0240). Blood [Lac-] was higher in fat adapted horses given NaHC0₃ compared to other diet/treatment combinations (P=0.0276). Plasma [SID] was higher during exercise when horses were given NaHC0₃ compared to plain water (P=0.0054), which contributed to decreasing [H⁺] and increasing [HC0₃⁻] during exercise (P=0.0001). Plasma Pco₂ contributed less to increasing plasma [H⁺] during exercise in fat-adapted horses compared to horses fed the control diet (P=0.0282). Intraerythrocyte [SID] decreased (P=0.0160) and [Atod increased (P=0.0002) which contributed to increasing [H⁺] within the cell (P=0.0228). / Ph. D.

The fundamental study of Lewis acid/base interactions presented in this dissertation demonstrates the role of these interactions in adhesive phenomena. The model systems investigated were representative of real substrates and soft, viscoelastic adhesives where, in one case, favorable acid/base interactions were possible which were not possible in the other. Inverse gas chromatography (IGC) and Infrared spectroscopy (IR) techniques were used to analyze the model adhesive in terms of its acid/base nature. The results of both experiments indicated, through negative enthalpies of acid/base interaction with acidic solvents, that the model adhesive poly(2-ethyl hexyl methacrylate) (PEHMA) exhibits the properties of a Lewis base. The near quantitative agreement of the results from both experiments validate these methods of determining acid/base interactions in polymeric systems. Fitting the enthalpies for acid/base interaction to Drago’s and Gutmann’s models brought out the importance of the electrostatic component of the interactions investigated. Furthermore, they illustrated the need to expand the existing datasets beyond organo-meta1lic compounds, and include more common organic solvents. Results from X-ray photoelectron spectroscopy (XPS) and scanning transmission electron microscopy (STEM) analysis of the model substrate, grade 2 titanium, pretreated via chromic acid (CAA) or sodium hydroxide anodization (PSHA), confirmed that oxides of very similar topology can be produced. Indicator dye studies revealed the CAA-Ti had a surface pH of below 3.0 and the PSHA-Ti had a surface pH of above 8.0. Bonds constructed from these analyzed materials were tested in peel and both systems exhibited good adhesion. However, the bonds in which favorable interactions were possible demonstrated superior interfacial performance. This improvement was seen in the bond’s ability to resist adhesive (interfacial) failure at debond rates at which other bonds failed. When the test geometry was changed such that the stress intensity at the interface was increased, the bonds in which acid/base interactions were favorable supported a higher peel load. / Ph. D.

Acid-base equilibria in organic particulate matter (PM) are poorly understood, but have important implications for air quality and public health. First, acid-base reactions in organic particulate matter affect the gas/particle partitioning of organic compounds in the atmosphere, and these processes are not currently represented in atmospheric and climate change models. Second, the acid-base balance of tobacco smoke affects the amount of nicotine absorbed by the smoker, and a greater understanding of this balance would help to relate cigarette smoke composition to the addictive properties of cigarettes. This work presents data related to both air quality and tobacco smoke modeling. The gas/particle partitioning behavior of organic acids and bases is highly dependent on acid-base equilibria and speciation between neutral and ionic forms, because ionic compounds do not volatilize. Descriptions of acid dissociation behavior in atmospheric PM have, to date, focused primarily on phases in which the solvent is water; however, atmospheric PM may include up to 90% organic matter. Data is presented here describing the acid dissociation behavior of organic acids and protonated amines in organic/aqueous mixtures (chosen to approximate the characteristics of organic PM) with varying levels of water content. In such mixtures, the preferential solvation of ions and neutral molecules (by the aqueous portion or the organic portion, respectively) affects the acid-base equilibria of the solutes. It is demonstrated that neutralization reactions between acids and bases that create ions are likely to have non-negligible effects on gas/particle partitioning under certain atmospheric conditions. Thus, including acid-base reactions in organic gas/particle partitioning models could result in a greater proportion of acidic and basic compounds partitioning to the particulate phase. In addition, the acid dissociation constants (pKa values) of atmospherically-relevant acids and bases vary with water content. Specifically, as water content increases, the pKa values of organic acids decrease dramatically, while the pKa values of protonated amines changes only slightly. This situation can result in drastically different speciations and partitioning behavior depending on water content. This second part of this work reports some of the data needed to develop an acid-base balance for tobacco smoke PM using electroneutrality as a governing principle. Five brands of cigarettes were sampled and the smoke PM extracted. Cations (sodium, potassium, and ammonia) and anions (organic acids, nitrate, nitrite, and chloride) were measured using ion chromatography. Ammonia and organic acids were also re-measured after the acidification of the sample in order to determine whether "bound" forms of these compounds exist in cigarette PM. Weak acids were determined by acid-base titration to determine whether or not all of the weak acids (including organic acids) had been accounted for by the ion chromatography. Weak bases were also determined by acid-base titration, and the majority of weak base is expected to be accounted for by total nicotine (to be measured in a separate analysis). In terms of total acidic species and total basic species, two of the five cigarette brands measured were relatively basic, and three were relatively acidic. Between 50% and 89% of the titrated acids were accounted for by the anionic species measured in ion chromatography. Based on samples tested after sample acidification, about half of the potential ammonia in tobacco smoke PM exists in "bound" form. The speciation of weak acids and bases in tobacco smoke PM cannot be determined from this data alone, because the equilibrium constants of acid-base reactions are not understood in complex organic media. The data presented here, when combined with data from free-base and total nicotine analyses, represent a first step toward a predictive model of acid-base behavior in tobacco smoke PM.

Justificativa e Objetivos: Acidose é uma desordem muito frequente em pacientes cirúrgicos. Neste cenário, permanecem incertas as implicações clínicas da acidose e características de cada tipo. Portanto, é relevante tentar elucidar o papel de cada tipo de acidose no prognóstico de pacientes cirúrgicos de alto risco. Método: Trata-se de estudo multicêntrico observacional prospectivo, realizado em três diferentes hospitais. Os pacientes que necessitassem no pós-operatório de cuidados intensivos foram incluídos no estudo consecutivamente. Pacientes com baixa expectativa de vida (câncer sem perspectiva de tratamento), pacientes com insuficiência hepática (child B ou C), insuficiência renal (Clearence de creatinina < 50 mL/min ou hemodiálise prévia), diagnóstico de diabetes previamente foram excluídos. Os pacientes classificados na admissão da UTI quanto ao tipo de acidose que desenvolviam no pós-operatório imediato foram acompanhados até 30 dias e alta hospitalar. Tal classificação avaliou acidose metabólica, pela quantificação da diferença de base menor que -4 mmol/L, anion gap corrigido pela albumina (AG) e lactato aumentados, quando maiores que 12 e 2 mmo/L, respectivamente. Então, os pacientes foram classificados como acidose metabólica hiperlactatemica, aumentado e normal (hipercloremica) anion gap corrigido pela albumina. Resultados: O total de 618 pacientes foram incluídos durante dois anos. A incidência de acidose metabólica foi 59,1% na UTI, porém 148 (23,9%) apresentaram hipercloremica, 131 (21,2%) revelaram hiperlactatemia, 86 (13,9%) AG aumentado e em 253 (40,9%) não ocorreu acidose metabólica. Dentre todas as cirurgias, pacientes de cirurgia gastrointestinal foram associados a maiores porcentagens de acidose metabólica 46,2% versus 19,8% sem acidose, P < 0,05. Interessantemente, acidose com hipercloremia apresentou mais altos valores de cloro na admissão da UTI 115,0 ± 5,7 meq/L (P < 0,05) e receberam maiores quantidades de solução fisiológica 0,9% no intraoperatório 3000,0 (2000,0 - 4000,0) mL (P < 0,05). Entretanto, apesar dos pacientes não apresentarem diferenças entre escores de gravidade (SAPS 3, SOFA e ASA), idade e tempo cirúrgicos, ocorreram diferenças em relação a complicações e mortalidade no pós-operatório quando os pacientes mantinham acidose após 12 horas de pós-operatório. Pacientes com lactato e AG aumentados no pós-operatório imediato apresentaram maiores complicações, seguido dos pacientes com hipercloremia, e os sem acidose, respectivamente 68,8%; 68,6%; 65,8% e 59,3%, P = 0,03. Cardiovascular e renal disfunções foram as principais complicações e o grupo hiperlactatemia mostrou maior incidência em comparação aos outros grupos. O mesmo foi verificado em relação à mortalidade hospitalar e em 30 dias de seguimento os grupos hiperlactatemia, AG aumentado, hipercloremicos e sem acidose foram respectivamente 30,1% (HR 1,61, IC 95% 1,02 - 2,53); 24,3% (HR 1,37, IC 95% 0,76 - 2,46); 18,4% (HR 1,55, IC 95% 0,90 - 2,67) e 10,3%, Log-Rank = 0,03. Conclusão: A incidência de acidose metabólica em pacientes cirúrgicos de alto risco no pós-operatório é elevada, principalmente a do tipo hipercloremia. Pacientes cirúrgicos que desenvolvem acidose metabólica, dependendo das características, apresentam piores prognósticos em relação aos pacientes sem acidose, além disso, este estudo demonstra que diferentes etiologias de acidose metabólica estão associadas com diferentes taxas de mortalidade e morbidade no pós-operatório / Background: Acidosis is a very frequent disorder in surgical patients. In this patient set there remains uncertainty the clinic implications from acidosis and characteristics postoperatively. Therefore, it is very important to evaluate the role of each acidosis type in outcome for high-risk surgical patients. Methods: Multicenter prospective observational study was performed in three different hospitals. The patients who needed postoperative ICU were involved in the study consecutively. Patients with low life expectancy (cancer without treatment), hepatic failure, renal failure, and diabetic diagnosis were excluded. The patients were followed until 30 days and hospital discharge. On ICU admission, immediately postoperative period, the patients were classified to each type of acidosis. The classification evaluated metabolic acidosis as base excess < -4 mmol/L and high albumin-corrected anion gap (AG) and hyperlactatemia, both > 12 and > 2 mmol/L, respectively. So, the metabolic acidosis classification patients were related to hyperlactatemic, high and normal (hyperchloremic) albumin-corrected anion gap. Results: The study enrolled 618 patients during 2 years. Overall, the acidosis incidence was 59.1% on ICU admission, 148 (23.9%) hyperchloremic, 131 (21.2%) hyperlactatemia, 86 (13.9%) a high anion gap and in 253 (40.9%) there was no metabolic acidosis. The hyperchloremic group presented the highest chlorine level, 115.0 ± 5.7 meq/L (P < 0.05) and highest administration of 0.9% physiologic solution intraoperatively, 3000,0 (2000,0 - 4000,0) mL (P < 0.05). However, in spite of patients didn\'t present difference in profile demographic and score prognostic, those who remain after 12 hours with acidosis, depend on groups classification in postoperatively showed greater ICU complications, respectively, hyperlactatemia group 68.8%; high anion gap 68.6%; hyperchloremic 65.8% and no acidosis 59.3%, P = 0.03. Cardiovascular and renal dysfunctions were the main complications and hyperlactatemia group showed the highest in all of them. The same was verified in related to 30 days follow-up and hospital mortality rate respectively 30.1% (HR 1.61, IC 95% 1.02 - 2.53) hyperlactatemic; 24.3% (HR 1.55, IC 95% 0.90 - 2.67) high anion gap; 18.4% (HR 1.37, IC 95% 0.76 - 2.46) hyperchloremic and 10.3% no acidosis group, Log-Rank = 0.03. Conclusions: Metabolic acidosis in surgical patients is a very important complication postoperatively, mainly hyperchloremic. Patients who developed metabolic acidosis postoperatively depend on group classification presented worst outcomes compared to no acidosis patients; this result showed that different kinds of acidosis represented different outcomes postoperatively

O principal interesse desta pesquisa foi descrever e analisar o resultado do aprendizado de conceitos relacionados ao tema equilíbrio químico buscando as concepções dos alunos, sobre aspectos gerais dos sistemas em equilíbrio químico e os aspectos gerais de sistemas ácido base em equilíbrio químico. Para isso acompanhamos e gravamos o áudio das aulas referentes ao ensino do conceito de equilíbrio químico ao longo das disciplinas de Química Geral II e Química Analítica I, no IQUSP. Ao longo das disciplinas aplicamos avaliações iniciais, progressivas e finais. Os resultados foram apresentados em três itens, no primeiro apresentamos a análise da avaliação inicial (AI) e avaliação final (AF), aplicadas na disciplina de Química Geral II (QGII), onde discutimos as concepções sobre aspectos gerais dos sistemas em equilíbrio químico. No segundo item, apresentamos a discussão da avaliação inicial (AI) e avaliação final (AF) aplicada na disciplina de Química Analítica I (QAI), nestas avaliações investigamos os aspectos gerais de sistemas ácido base em equilíbrio químico. No terceiro item, apresentamos a análise das respostas de um aluno, que respondeu todos os testes ao longo das disciplinas de Química Geral II e Química Analítica I, buscando uma reflexão sobre o processo de aprendizagem sobre os modelos do equilíbrio químico e os modelos ácido base, as constantes de equilíbrio químico, as forças de ácidos e bases, solução tampão, e as possíveis alterações promovidas em um sistema em equilíbrio químico, que são conceitos relacionados ao tema equilíbrio químico. A análise dos dados permitem concluir que, após as aulas de Química Geral, referentes ao tema, os alunos passaram a caracterizar corretamente o equilíbrio químico nos níveis macroscópicos e microscópicos, e a comparar o coeficiente de reação com a constante de equilíbrio para fazer previsões de uma mistura reacional. Entretanto, alguns alunos ainda não demonstram uma boa compreensão do significado e das possíveis aplicações da constante de equilíbrio, definindo-a apenas a partir da descrição da sua fórmula matemática. Também não relacionam a constante de equilíbrio químico com a temperatura, aplicando apenas o Principio de Le Chatelier para prever as alterações no sistema em equilíbrio químico. Observamos também que há uma dificuldade para descrever e explicar ácido e base, a partir de um nível eletrônico, usando o modelo de Lewis. Identificamos também algumas dificuldades conceituais e concepções alternativas, que permaneceram mesmo após instrução, tais como: confusões nos modelos que definem ácidos e bases, confusões com a aplicação dos conceitos dissociação e ionização e concepções alternativas referente ao equilíbrio ácido base. Com relação as alterações promovidas em um sistema em equilíbrio químico, observamos que os alunos, de forma geral, justificam o deslocamento do equilíbrio destacando principalmente o Princípio de Le Chatelier. Esperamos favorecer uma reflexão para o ensino e aprendizagem sobre aspectos relacionados ao tema Equilíbrio Químico / The main interest of this research was describe and analyze the results of the learning concepts about chemical equilibrium, seeking the general students concepts related to, chemical equilibrium and acid-base reactions in a stage of equilibrium. To do this we followed an recorded the classes which approach the equilibrium chemical systems at disciplines General Chemistry II and Analytical Chemistry I for IQUSP chemistry students. Initial e final tests were applied throughout disciplines. The results was showed in a three sets, we present first the analysis of initial evaluation (AI) and final evaluations, applied to General Chemistry discipline, discussing concepts about general aspects in chemical equilibrium systems. Then we showed discussing initial and final evaluations applied at analytical chemistry discipline, we search in this evaluations the concepts about an acid-base reactions in chemical equilibrium. In a third step we present the answers analysis of one single student that participated of all tests throughout General II and Analytical I disciplines, seeking a reflection about the learning process on the following topics, chemical equilibrium and acid-base models, the constants, the acid-base strengths and buffer solutions, and the possible changes promoted in a chemical equilibrium system that are important concepts related to the theme. The analysis of this dates suggesting, after the General Chemistry classes, that approach the theme, that students are able to correctly characterize the chemical equilibrium at macroscopic and microscopic levels and compare the coefficient and the constant of equilibrium chemical reactions to make previsions in this systems. However some students didn´t showed a fine concept about possible the applications of theses constants, and only defining through the mathematic relation. They also couldn´t not relationed the alteration in a equilibrium constant with the temperature, appling only the Le Chatelier Principle to make previsions about the alterations in a chemical equilibrium system. We also observe the difficult to analyze and explain the acid-base models starting from electronic level, using a Lewis model. We also identified some conceptual difficulties and misconceptions, which remained even after instructions, like: confusing model which explain acid-base models, confusing at applications of dissociation and ionization concepts and alternative conceptions about acid base equilibrium systems. In relation of promoted alterations that offered to a chemical equilibrium system, we observed the students, generally, justify the displacement of equilibrium particularly focusing on Le Chatelier Principle. This work favors discussions in teaching and learning aspects concepts about the chemical equilibrium.

Justificativa e Objetivos: Acidose é uma desordem muito frequente em pacientes cirúrgicos. Neste cenário, permanecem incertas as implicações clínicas da acidose e características de cada tipo. Portanto, é relevante tentar elucidar o papel de cada tipo de acidose no prognóstico de pacientes cirúrgicos de alto risco. Método: Trata-se de estudo multicêntrico observacional prospectivo, realizado em três diferentes hospitais. Os pacientes que necessitassem no pós-operatório de cuidados intensivos foram incluídos no estudo consecutivamente. Pacientes com baixa expectativa de vida (câncer sem perspectiva de tratamento), pacientes com insuficiência hepática (child B ou C), insuficiência renal (Clearence de creatinina < 50 mL/min ou hemodiálise prévia), diagnóstico de diabetes previamente foram excluídos. Os pacientes classificados na admissão da UTI quanto ao tipo de acidose que desenvolviam no pós-operatório imediato foram acompanhados até 30 dias e alta hospitalar. Tal classificação avaliou acidose metabólica, pela quantificação da diferença de base menor que -4 mmol/L, anion gap corrigido pela albumina (AG) e lactato aumentados, quando maiores que 12 e 2 mmo/L, respectivamente. Então, os pacientes foram classificados como acidose metabólica hiperlactatemica, aumentado e normal (hipercloremica) anion gap corrigido pela albumina. Resultados: O total de 618 pacientes foram incluídos durante dois anos. A incidência de acidose metabólica foi 59,1% na UTI, porém 148 (23,9%) apresentaram hipercloremica, 131 (21,2%) revelaram hiperlactatemia, 86 (13,9%) AG aumentado e em 253 (40,9%) não ocorreu acidose metabólica. Dentre todas as cirurgias, pacientes de cirurgia gastrointestinal foram associados a maiores porcentagens de acidose metabólica 46,2% versus 19,8% sem acidose, P < 0,05. Interessantemente, acidose com hipercloremia apresentou mais altos valores de cloro na admissão da UTI 115,0 ± 5,7 meq/L (P < 0,05) e receberam maiores quantidades de solução fisiológica 0,9% no intraoperatório 3000,0 (2000,0 - 4000,0) mL (P < 0,05). Entretanto, apesar dos pacientes não apresentarem diferenças entre escores de gravidade (SAPS 3, SOFA e ASA), idade e tempo cirúrgicos, ocorreram diferenças em relação a complicações e mortalidade no pós-operatório quando os pacientes mantinham acidose após 12 horas de pós-operatório. Pacientes com lactato e AG aumentados no pós-operatório imediato apresentaram maiores complicações, seguido dos pacientes com hipercloremia, e os sem acidose, respectivamente 68,8%; 68,6%; 65,8% e 59,3%, P = 0,03. Cardiovascular e renal disfunções foram as principais complicações e o grupo hiperlactatemia mostrou maior incidência em comparação aos outros grupos. O mesmo foi verificado em relação à mortalidade hospitalar e em 30 dias de seguimento os grupos hiperlactatemia, AG aumentado, hipercloremicos e sem acidose foram respectivamente 30,1% (HR 1,61, IC 95% 1,02 - 2,53); 24,3% (HR 1,37, IC 95% 0,76 - 2,46); 18,4% (HR 1,55, IC 95% 0,90 - 2,67) e 10,3%, Log-Rank = 0,03. Conclusão: A incidência de acidose metabólica em pacientes cirúrgicos de alto risco no pós-operatório é elevada, principalmente a do tipo hipercloremia. Pacientes cirúrgicos que desenvolvem acidose metabólica, dependendo das características, apresentam piores prognósticos em relação aos pacientes sem acidose, além disso, este estudo demonstra que diferentes etiologias de acidose metabólica estão associadas com diferentes taxas de mortalidade e morbidade no pós-operatório / Background: Acidosis is a very frequent disorder in surgical patients. In this patient set there remains uncertainty the clinic implications from acidosis and characteristics postoperatively. Therefore, it is very important to evaluate the role of each acidosis type in outcome for high-risk surgical patients. Methods: Multicenter prospective observational study was performed in three different hospitals. The patients who needed postoperative ICU were involved in the study consecutively. Patients with low life expectancy (cancer without treatment), hepatic failure, renal failure, and diabetic diagnosis were excluded. The patients were followed until 30 days and hospital discharge. On ICU admission, immediately postoperative period, the patients were classified to each type of acidosis. The classification evaluated metabolic acidosis as base excess < -4 mmol/L and high albumin-corrected anion gap (AG) and hyperlactatemia, both > 12 and > 2 mmol/L, respectively. So, the metabolic acidosis classification patients were related to hyperlactatemic, high and normal (hyperchloremic) albumin-corrected anion gap. Results: The study enrolled 618 patients during 2 years. Overall, the acidosis incidence was 59.1% on ICU admission, 148 (23.9%) hyperchloremic, 131 (21.2%) hyperlactatemia, 86 (13.9%) a high anion gap and in 253 (40.9%) there was no metabolic acidosis. The hyperchloremic group presented the highest chlorine level, 115.0 ± 5.7 meq/L (P < 0.05) and highest administration of 0.9% physiologic solution intraoperatively, 3000,0 (2000,0 - 4000,0) mL (P < 0.05). However, in spite of patients didn\'t present difference in profile demographic and score prognostic, those who remain after 12 hours with acidosis, depend on groups classification in postoperatively showed greater ICU complications, respectively, hyperlactatemia group 68.8%; high anion gap 68.6%; hyperchloremic 65.8% and no acidosis 59.3%, P = 0.03. Cardiovascular and renal dysfunctions were the main complications and hyperlactatemia group showed the highest in all of them. The same was verified in related to 30 days follow-up and hospital mortality rate respectively 30.1% (HR 1.61, IC 95% 1.02 - 2.53) hyperlactatemic; 24.3% (HR 1.55, IC 95% 0.90 - 2.67) high anion gap; 18.4% (HR 1.37, IC 95% 0.76 - 2.46) hyperchloremic and 10.3% no acidosis group, Log-Rank = 0.03. Conclusions: Metabolic acidosis in surgical patients is a very important complication postoperatively, mainly hyperchloremic. Patients who developed metabolic acidosis postoperatively depend on group classification presented worst outcomes compared to no acidosis patients; this result showed that different kinds of acidosis represented different outcomes postoperatively

O principal interesse desta pesquisa foi descrever e analisar o resultado do aprendizado de conceitos relacionados ao tema equilíbrio químico buscando as concepções dos alunos, sobre aspectos gerais dos sistemas em equilíbrio químico e os aspectos gerais de sistemas ácido base em equilíbrio químico. Para isso acompanhamos e gravamos o áudio das aulas referentes ao ensino do conceito de equilíbrio químico ao longo das disciplinas de Química Geral II e Química Analítica I, no IQUSP. Ao longo das disciplinas aplicamos avaliações iniciais, progressivas e finais. Os resultados foram apresentados em três itens, no primeiro apresentamos a análise da avaliação inicial (AI) e avaliação final (AF), aplicadas na disciplina de Química Geral II (QGII), onde discutimos as concepções sobre aspectos gerais dos sistemas em equilíbrio químico. No segundo item, apresentamos a discussão da avaliação inicial (AI) e avaliação final (AF) aplicada na disciplina de Química Analítica I (QAI), nestas avaliações investigamos os aspectos gerais de sistemas ácido base em equilíbrio químico. No terceiro item, apresentamos a análise das respostas de um aluno, que respondeu todos os testes ao longo das disciplinas de Química Geral II e Química Analítica I, buscando uma reflexão sobre o processo de aprendizagem sobre os modelos do equilíbrio químico e os modelos ácido base, as constantes de equilíbrio químico, as forças de ácidos e bases, solução tampão, e as possíveis alterações promovidas em um sistema em equilíbrio químico, que são conceitos relacionados ao tema equilíbrio químico. A análise dos dados permitem concluir que, após as aulas de Química Geral, referentes ao tema, os alunos passaram a caracterizar corretamente o equilíbrio químico nos níveis macroscópicos e microscópicos, e a comparar o coeficiente de reação com a constante de equilíbrio para fazer previsões de uma mistura reacional. Entretanto, alguns alunos ainda não demonstram uma boa compreensão do significado e das possíveis aplicações da constante de equilíbrio, definindo-a apenas a partir da descrição da sua fórmula matemática. Também não relacionam a constante de equilíbrio químico com a temperatura, aplicando apenas o Principio de Le Chatelier para prever as alterações no sistema em equilíbrio químico. Observamos também que há uma dificuldade para descrever e explicar ácido e base, a partir de um nível eletrônico, usando o modelo de Lewis. Identificamos também algumas dificuldades conceituais e concepções alternativas, que permaneceram mesmo após instrução, tais como: confusões nos modelos que definem ácidos e bases, confusões com a aplicação dos conceitos dissociação e ionização e concepções alternativas referente ao equilíbrio ácido base. Com relação as alterações promovidas em um sistema em equilíbrio químico, observamos que os alunos, de forma geral, justificam o deslocamento do equilíbrio destacando principalmente o Princípio de Le Chatelier. Esperamos favorecer uma reflexão para o ensino e aprendizagem sobre aspectos relacionados ao tema Equilíbrio Químico / The main interest of this research was describe and analyze the results of the learning concepts about chemical equilibrium, seeking the general students concepts related to, chemical equilibrium and acid-base reactions in a stage of equilibrium. To do this we followed an recorded the classes which approach the equilibrium chemical systems at disciplines General Chemistry II and Analytical Chemistry I for IQUSP chemistry students. Initial e final tests were applied throughout disciplines. The results was showed in a three sets, we present first the analysis of initial evaluation (AI) and final evaluations, applied to General Chemistry discipline, discussing concepts about general aspects in chemical equilibrium systems. Then we showed discussing initial and final evaluations applied at analytical chemistry discipline, we search in this evaluations the concepts about an acid-base reactions in chemical equilibrium. In a third step we present the answers analysis of one single student that participated of all tests throughout General II and Analytical I disciplines, seeking a reflection about the learning process on the following topics, chemical equilibrium and acid-base models, the constants, the acid-base strengths and buffer solutions, and the possible changes promoted in a chemical equilibrium system that are important concepts related to the theme. The analysis of this dates suggesting, after the General Chemistry classes, that approach the theme, that students are able to correctly characterize the chemical equilibrium at macroscopic and microscopic levels and compare the coefficient and the constant of equilibrium chemical reactions to make previsions in this systems. However some students didn´t showed a fine concept about possible the applications of theses constants, and only defining through the mathematic relation. They also couldn´t not relationed the alteration in a equilibrium constant with the temperature, appling only the Le Chatelier Principle to make previsions about the alterations in a chemical equilibrium system. We also observe the difficult to analyze and explain the acid-base models starting from electronic level, using a Lewis model. We also identified some conceptual difficulties and misconceptions, which remained even after instructions, like: confusing model which explain acid-base models, confusing at applications of dissociation and ionization concepts and alternative conceptions about acid base equilibrium systems. In relation of promoted alterations that offered to a chemical equilibrium system, we observed the students, generally, justify the displacement of equilibrium particularly focusing on Le Chatelier Principle. This work favors discussions in teaching and learning aspects concepts about the chemical equilibrium.