Alcohol Lactic Acidosis Mechanism

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Hemodynamic Consequences Of Severe Lactic Acidosis In Shock States: From Bench To Bedside

Hemodynamic consequences of severe lactic acidosis in shock states: from bench to bedside Kimmoun et al.; licensee BioMed Central.2015 The Erratum to this article has been published in Critical Care 2017 21:40 Lactic acidosis is a very common biological issue for shock patients. Experimental data clearly demonstrate that metabolic acidosis, including lactic acidosis, participates in the reduction of cardiac contractility and in the vascular hyporesponsiveness to vasopressors through various mechanisms. However, the contributions of each mechanism responsible for these deleterious effects have not been fully determined and their respective consequences on organ failure are still poorly defined, particularly in humans. Despite some convincing experimental data, no clinical trial has established the level at which pH becomes deleterious for hemodynamics. Consequently, the essential treatment for lactic acidosis in shock patients is to correct the cause. It is unknown, however, whether symptomatic pH correction is beneficial in shock patients. The latest Surviving Sepsis Campaign guidelines recommend against the use of buffer therapy with pH 7.15 and issue no recommendation for pH lev Continue reading >>

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Popular Questions

  1. frederichnietzsche

    Hi everyone!
    I've been researching keto to death since last year, but I was wondering about calorie restriction.
    Most studies on calorie restriction show that it slows metabolism down for a permanent period of time (reversible only by longer term fasting- see The Obesity Code by Dr. Fung, he's also got a series of blog posts on this that are very interesting, also see Upton Sinclair, Dr. Salisbury, Jesus, the Buddha, Mohammed and more...).
    But I was curious to know if anyone had any resources on ketosis and caloric restriction's combined effect on metabolism, and whether it was similar to what is typically seen in the semi-permanent reduction of BMR.
    Most calorie restriction metabolism studies are probably done on a diet of ~50% carbs. However, it is possible that the therapeutic effect of ketones could act as a buffer to prevent this damage. Do you think it would be possible to prevent or even to reverse it ketogenically? Technically longer term water fasting brings you into a ketogenic state- typically slightly higher levels of ketones-allowing you to increase insulin sensitivity and regenerate your immune system and BMR. The two are theoretically similar, although the recycling of dead or harmful cells within the body probably occurs at a slower pace if at all. (This is probably the mechanism allowing a rebuilding of the metabolism).
    Long story short: does calorie restriction in ketosis affect the metabolic rate in a negative way?
    What do you guys think?

  2. simsalabimbam

    Large deficits and extreme exercise cause a very wide energy deficiency gap, leading to fat weight loss, like on TBL. What happens here is that the body quite naturally tries to everything possible to conserve lean body mass. You don't want your heart muscle to decrease in effectiveness.
    As for keto, the same thing is possible if you try the same kind of crash diet and extreme exercise. However, if you follow the guidelines here - modest deficit - then this slow down does not happen. In fact eating at deficit is a misnomer. What people could do is eat the calories appropriate for their goal weight. Weight loss will be slower, but the eating habits will be infinitely more sustainable.
    There is evidence to show that cyclical calorie restriction, such as alternate day fasting or 5:2 fasting results in the required calorie deficit (averaged over a week) without any of the negative consequences. Dr. Fung wrote about this.
    However, what he mentions in passing is far more interesting. He notes that the ketogenic diet did not produce any slowing of the metabolism.

  3. frederichnietzsche


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