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Metabolic Acidosis Pathophysiology Diagnosis And Management

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Bicarbonate Therapy In Severe Metabolic Acidosis

Abstract The utility of bicarbonate administration to patients with severe metabolic acidosis remains controversial. Chronic bicarbonate replacement is obviously indicated for patients who continue to lose bicarbonate in the ambulatory setting, particularly patients with renal tubular acidosis syndromes or diarrhea. In patients with acute lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back to bicarbonate if the clinical situation improves. For these patients, therapy must be individualized. In general, bicarbonate should be given at an arterial blood pH of ≤7.0. The amount given should be what is calculated to bring the pH up to 7.2. The urge to give bicarbonate to a patient with severe acidemia is apt to be all but irresistible. Intervention should be restrained, however, unless the clinical situation clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy for patients with severe metabolic acidosis. Metabolic acidosis is an acid-base disorder characterized by a primary consumption of body buffers including a fall in blood bicarbonate concentration. There are many causes (Table 1), and there are multiple mechanisms that mi Continue reading >>

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Popular Questions

  1. MiKetoAF

    What are you eating to make sure you keep your levels up, or are you supplementing? I woke up this morning dizzy and realized I was feeling terribly dehydrated. I drank a bunch of water, ate an avocado, and drank some broth. I'm feeling a little better but I'm looking for ways to make sure this doesn't happen again.

  2. Izerian

    Daily multivitamin, lite salt if I need to salt some food. (Potassium/Sodium) Make sure you drink plenty of water, that's always true.
    Speaking for myself, just got some blood tests back and levels are are well within range.

    *your mileage may vary. Consult your Doc!

  3. Ketoberry

    Some ideas for electrolytes here

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