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Metabolic Acidosis

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Acid/base Disorders: Metabolic Acidosis

Are there clinical practice guidelines to inform decision-making? Does this patient have metabolic acidosis? Metabolic acidosis is generally defined by the presence of a low serum bicarbonate concentration (normal range 22-28 mEq/L), although occasionally states can exist where the serum bicarbonate is normal with an elevated anion gap (e.g., patients with a lactic acidosis who have received a bicarbonate infusion or patients on hemodialysis). In general, a metabolic acidosis is associated with a low urine pH but depending on the presence or absence of a respiratory alkalosis, this may also be normal or elevated. Thus, a patient can have an acidosis but not be acidemic. Metabolic acidoses occur when there is excess acid in the plasma. In the basal state, the body generates about 12,000 to 13,000 mmol of carbon dioxide (CO2), and 1-1.5 mmol per kilogram body weight of nonvolatile acid. The body has a large buffering capacity, with CO2-HCO3 as the major buffer system. The two major routes of acid excretion are the lungs (for CO2) and the kidneys (for nonvolatile acids) A metabolic acidosis can be caused by three major mechanisms: 1) increased acid production; 2) bicarbonate loss; an Continue reading >>

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Popular Questions

  1. red_reader

    Neonatal ketosis -

    Neonatal ketosis -
    Suckling Ketogenesis (Williams, 1997)
    After normal blood glucose decline in first 3 hours, brisk ketogenic response in breastfed infants
    Ketone bodies provide alternative energy source for neonatal brain
    Breastfed babies tolerate lower blood glucose levels because their ketone body levels are elevated
    LGA infants of non-diabetic mothers will mount a sufficient ketogenic response to low blood sugar levels Link to PDF I realize this is not an actual study. I am looking for those specific references.
    AND
    Quote:
    Babies are in deep ketosis at birth and continue to be so until they are weaned off breast milk. I haven't looked to see how fast that decline out of ketosis happens after babies are weened off breast milk.
    Link to a list of scientific studies
    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )

  2. bollockitis

    This leads me to believe that being in ketosis is actually the natural state, and out of ketosis is a result of excessive carbs ... ( crap your body doesn't need )
    The research is interesting, but I don't think it warrants that conclusion. Using that logic, you could say that because babies drink only breast milk, drinking breast milk is the natural state and eating anything else is unnatural.

  3. red_reader

    My conclusion is slightly different. Since breast milk is so high in fat ( causing the ketosis ) I feel that our natural diet should consist of high fat. Of note is that as soon as babies are taken off of breast milk and placed on ( man made ) formula, they fall out of ketosis.

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