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Alcohol Associated Lactic Acidosis

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Metformin-associated Lactic Acidosis Presenting As An Ischemic Gut In A Patient Who Then Survived A Cardiac Arrest: A Case Report

Ncomanzi et al.; licensee BioMed Central Ltd.2014 Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients. It is recognized as a potential complication of metformin use, particularly in patients with risk factors such as renal dysfunction, liver disease, and heavy alcohol ingestion. These conditions are associated with systemic hypoxemia, which may be caused by cardiorespiratory disease, major surgery, sepsis, dehydration, old age, and overdose. The reported frequency of lactic acidosis is 0.06 per 1000 patient-years, mostly in patients with predisposing factors. This case is important because it details the seriousness of metformin-associated lactic acidosis in a critically ill patient and because, to the best of our knowledge, our patient survived with minimal residual defect despite experiencing a cardiac arrest. A 66-year-old Caucasian woman presented to our hospital with profound lactic acidosis, which was initially thought to be ischemic gut. She then survived an in-hospital pulseless electrical activity arrest. Metformin-associated lactic acidosis is a diagnosis by exclusion; however, a high degree of clinical suspicion supplemented by prompt Continue reading >>

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  1. Amanda_Burton

    So, the other day, I had a run-in with a group of people hell-bent on shaming me for using the word Ketogenic in a Facebook group post. As it was a parenting group claiming to support scientific, evidence-based topics only, it caught me completely by surprise when a comment I made created such a backlash.
    I wasn't even promoting the WOE but I was instead trying to advocate for a little understanding between family members who "research" online and come up with very differing information. Because the OP referenced the dietary restrictions (some of which were keto and some of which weren't) in regards to autism spectrum disorder, I did state that there is some support of the Ketogenic WOE for people with ASD and perhaps this could be the root of the disagreement. At this point I was ridiculed as a "newb" who clearly believed in pseudo-science, berated for posting a second clarifying post (emphasizing that I was not advocating a dietary change, but addressing the main concern of other family members "parenting" when not asked) and specifically named as someone to be banned from the group.

    Needless to say, I was a bit rattled thinking I had found a parenting group where I could find support and instead being belittled and accused of buying into pseudo-science. I immediately removed myself from that group (as I do not need that negativity) and felt the need to reconnect here on the forums. Has anyone else had to deal with this type of bullying online or IRL?

  2. Fiorella

    But, don't be discouraged. You did the right thing from removing yourself from the group. It is wise to gauge the situation and determine which conflicts are worth your time or not. Groups that allow discussion and reflection are good to coach ketogenic woe...otherwise, the other groups with stubborn bullies are not.

  3. Amanda_Burton

    I will have to do some digging, as it is a topic I have only recently been researching and have not saved links or anything. In the context of my post in the parenting group, I simply stated that I had seen support for it and that the OP's family member may have come across this information​ as well and that I had come to keto for a completely different issue. I will post links this week when I get a chance.

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Survival From Profound Alcohol-related Lactic Acidosis - Sciencedirect

Survival from profound alcohol-related lactic acidosis Author links open overlay panel DavidLienMDa Timothy JMaderMDa Get rights and content We present the case of a patient with profound alcohol-related lactic acidosis (lactate = 16.1 mmol/L; pH = 6.67) associated with a multitude of metabolic derangements who made a remarkable recovery following aggressive management. The patient was in extremis upon arrival in the emergency department (ED), and resuscitation was begun immediately. While in the ED, the problem list generated included: acute alcohol intoxication, severe lactic acidosis, dehydration, hypothermia, hypoglycemia, acute renal insufficiency, and hepatic failure. Resuscitation continued in the intensive care unit with remarkable improvement and satisfactory outcome. In this patient, the severe lactic acidosis and associated abnormalities were all attributed to acute and chronic effects of ethanol. A brief summary of the proposed mechanism by which these metabolic derangements developed and an outline of her management follows. Continue reading >>

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Metabolic Abnormalities In Alcoholic Patients: Focus On Acid Base Andelectrolyte Disorders

E-mail: [emailprotected] , [emailprotected] Received Date: December 20, 2014; Accepted Date: January 24, 2015; Published Date: January 27, 2015 Citation: Moses Elisaf MD, Rigas Kalaitzidis MD (2015) Metabolic Abnormalities in Alcoholic Patients: Focus on Acid Base and Electrolyte Disorders. J Alcohol Drug Depend 3:185. doi:10.4172/2329-6488.1000185 Copyright: 2015 Moses Elisaf MD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Alcoholic patients commonly develop a variety of acid-base and electrolyte disturbances. The aim of this review is to describe the most commonly encountered abnormalities and their significant role in the patients morbidity and mortality. Physicians should be aware of these clinically important disturbances caused by alcohol abuse and their underlying pathophysiological mechanisms involved for their appropriate management. Alcoholic Keto Acidosis (AKA) is a medical emergency is more common than previously thought and is characterized by an increased anion gap metabo Continue reading >>

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  1. leeleelee

    I have been water fasting for 4 days so far (my goal is 40 days) but am finding myself a little hungry..
    what types of things can I drink that will not cause me to loose the ketosis I am in?
    Thanks

  2. givemehipbones_

    Story if this sounds dumb but what is ketosis?

  3. leeleelee

    From what I understand It's a state where your body burns excess fat for fuel and not muscle or any other foods that you have recently eaten... usually occurs during fasting!!!

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