Can Sepsis Cause Metabolic Acidosis?

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Hypercapnia And Acidosis In Sepsis:a Double-edged Sword? | Anesthesiology | Asa Publications

The effects of hypercapnia in sepsis may be a function of the hypercapnia or the acidosis per se . As discussed, the effects of HCA on the immune response seem to be predominantly a function of the acidosis, rather than the hypercapnia per se , but the fact that the acidosis is hypercapnic rather than metabolic is of importance. The potential exists for hypercapnia to exert direct effects, independent of pH changes. A specific example is the binding of carbon dioxide to free amine groups on proteins to form carbamates, which can alter certain protein behavior or activity. The classic example is hemoglobin in which carbamino formation alters HbO2affinity. In addition, the potential for buffering of a HCA to modulate its effects in sepsis is also of importance. Buffered hypercapnia, that is, hypercapnia in the presence of normal pH, seems to worsen lung injury induced by intrapulmonary bacterial instillation. 36 To avoid the confounding effects of the administration of exogenous acid and/or alkali, animals were first exposed to environmental hypercapnia until renal buffering had restored pH to the normal range. These animals were then subjected to intrapulmonary inoculation of E. co Continue reading >>

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  1. qmotion

    A website with weekly "Keto Plans"

    Hi Guys,
    At the moment I'm busy working on a website where me and a Keto buddy of mine would send out weekly "Keto Plans".
    Basically what it is is a website with info & tools on Keto, a collection of recipes but we would also make plans consisting of:
    - Shopping list with all necessary ingredients for the week
    - Meal plans (so which meal should be cooked/eaten at which time in the week)
    - Recipes, each meal plan would have a variety of meals throughout the week and you would have the recipe for each meal.
    What we are trying to do is to make it easier for people to follow Keto. We both thought it was difficult at times to find out what to eat and to keep a variety of different foods in the diet without a plan to follow.
    So basically you have your entire week planned out for you and wouldnt need to think about what to eat anymore (plus we're focussing on getting the best recipes and utilizing leftovers for meals)
    If you were new to Keto (or already following keto), what would you look for on a website like the one mentioned above. Is there anything specific you would want to receive/know/learn?
    Let me hear your ideas guys. Would it be something you would be interested in?

  2. GazzyB

    Sounds like a great idea. If I were you I'd stress the simplicity of everything, because at first it can be a bit overwhelming!

  3. qmotion

    Originally Posted by GazzyB
    Sounds like a great idea. If I were you I'd stress the simplicity of everything, because at first it can be a bit overwhelming!

    Yes that's exactly what we were thinking! It can be overwhelming in the beginning, but when you get the basic gist of it you can see that it can be easy too!
    Thanks for the feedback

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Physicochemical Characterization Of Metabolic Acidosis Induced By Normal Saline Resuscitation Of Patients With Severe Sepsis And Septic Shock

OBJECTIVE: The aim of this study was to characterize and quantify metabolic acidosis that was caused by initial volume expansion during the reanimation of patients with severe sepsis and septic shock. METHODS: A blood sample was drawn for physicochemical characterization of the patient's acid-base equilibrium both before and after volume expansion using 30 mL/kg 0.9% saline solution. The diagnosis and quantification of metabolic acidosis were based on the standard base excess (SBE). RESULTS: Eight patients with a mean age of 58 13 years and mean APACHE II scores of 20 4 were expanded using 2,000 370 mL of 0.9% saline solution. Blood pH dropped from 7.404 0.080 to 7.367 0.086 (p=0.018), and PCO2 increased from 30 5 to 32 2 mmHg (p=0.215); SBE dropped from -4.4 5.6 to -6.0 5.7 mEq/L (p=0.039). The drop in SBE was associated with the acidifying power of two factors, namely, a significant increase in the strong ion gap (SIG) from 6.1 3.4 to 7.7 4.0 mEq/L (p = 0.134) and a non-significant drop in the apparent inorganic strong ion differences (SIDai) from 40 5 to 38 4 mEq/L (p = 0.318). Conversely, the serum albumin levels decreased from 3.1 1.0 to 2.6 0.8 mEq/L (p = 0.003) with an alka Continue reading >>

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  1. peuleu

    Hi fellow ketoers of Reddit!
    I've been doing Keto for about a month (practice what you preach, eh?) so I'm still a noobie. I've been pretty strict recording everything and keeping carbs <30g. I've noticed the changes as to where I know I've entered ketosis. I've been on (an active) vacation for a week, doing lazy keto. Think I've stayed under 30g a day in food, but might have gone over a bit with alcohol (red wine), though I don't think I've gone over 50g total. The thing I'm finding difficult to figure out is if I can tell if my body is out of ketosis or not. A lot of people here say stuff like they can eat up to 80-100g on an active day and still be in ketosis. I gather this is different for everyone, especially if you're not Keto adapted yet, but my question is: how do you KNOW you're still in ketosis when you eat that many carbs? What happens to your body and how you feel when you go over?
    TL;DR: how can you tell if your body is out of ketosis? What changes do you experience?
    Edit: thanks for all the responses! To clarify: I'm not worried at all! Just curious! I'm on a vacation where I hike all day and visit vineyards. I know I'm not gonna be strict Keto at the moment. I will be when I get back. I just noticed some bodily changes, and wanted to know what people experienced when they're out of ketosis. KCKO!

  2. anbeav

    Most don't, they speculate. If they gain any water weight or feel more hungry than usual, they conclude they are not in ketosis when that's not necessarily true. I wouldn't stress it, avoid the ketosis anxiety and focus on how you feel.

  3. peuleu

    Good to know! Thanks!

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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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  1. marlobean

    Hello all! I am looking for the literature on being in fast mode and feast mode. I know @meganjramos speaks about it. but i am looking on how exactly that works? i searched the forum to no avail.
    also would like to see how you all practice 'feast and famine'? how do you define it?

    thanks for reading!

  2. collaroygal

    Here is the link to the podcast she did with the 2dudes. She explains it pretty well. Eat extra fat the day before your fast to rev up your metabolism, then fast, and after a little fat to break the fast, eat as you normally eat at the next meal.
    It is feasting or fasting. You are either eating or you are fasting. Keep it simple.
    Carl wrote about his experience with really feasting before and after fasting here:
    Fast/Feast cycling

    I can tell you, this is really working for me after a week of cycling. Here's my data so far: Before I started, I was eating keto to satiety and slowly gaining weight. I was eating a lot at night, eating lots of macadamias, and drinking wine (prolly too much) at night, also. My first day of a 3-day fast started with keto coffee (lots of coconut oil and a pinch of cayenne). I don't measure or count calories, either. Mid-day I had a mug of bone broth with a Tbsp of butter melted in it. At ni…

  3. marlobean

    Have you tried it?

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