diabetestalk.net

Compensated Metabolic Acidosis Abg

Share on facebook

A discussion of the anion gap, including its calculation and its use in categorizing metabolic acidoses, including multiple examples of acid-base interpretation.

Abg Interpretation

Arterial blood gas (ABG) interpretation is something many medical students find difficult to grasp (we’ve been there). We’ve created this guide, which aims to provide a structured approach to ABG interpretation whilst also increasing your understanding of each results relevance. The real value of an ABG comes from its ability to provide a near immediate reflection of the physiology of your patient, allowing you to recognise and treat pathology more rapidly. To see how to perform an arterial blood gas check out our guide here. If you want to put your ABG interpretation skills to the test, check out our ABG quiz here. Normal ranges pH: 7.35 – 7.45 PaCO2: 4.7-6.0 kPa PaO2: 11-13 kPa HCO3-: 22-26 mEg/L Base excess: -2 to +2 mmol/L Patient’s clinical condition Before getting stuck into the details of the analysis, it’s important to look at the patient’s current clinical status, as this provides essential context to the ABG result. Below are a few examples to demonstrate how important context is when interpreting an ABG. A normal PaO2 in a patient on high flow oxygen – this is abnormal as you would expect the patient to have a PaO2 well above the normal range with this leve Continue reading >>

Share on facebook

Popular Questions

  1. austinpsycho

    So I have discovered, and devoured quite a few episodes of 2 keto dudes. There's some really great information about the metabolic rate and how it relates to longer fasts. Maybe I just haven't gotten far enough in the show yet, but I am really interested in how the metabolism responds to both intermittent fasting, and more generally, how the presumably lower calorie count maintained on keto affects said rate.
    I've been on keto for about a month now, and I worry that as I eat less, my body will become more efficient with those calories, and I'll need to eat even less and so on. I very much appreciate any information you guys can provide, or point me at. Thanks so much.

  2. devhammer

    austinpsycho:


    I am really interested in how the metabolism responds to both intermittent fasting, and more generally, how the presumably lower calorie count maintained on keto affects said rate.
    This would be an incorrect assumption, at least to the extent that the point of keto and/or IF is not to reduce calories. For those who have a good deal of body fat from which to draw energy, once they've gotten insulin sufficiently low to make that energy source available, reduced foot intake may be an effect of keto. Hopefully, that distinction is clear. The point is not to maintain a "lower calorie count". The point is to eat fewer foods (i.e. carbs) that stimulate insulin production, and more foods that don't (i.e. fat) while eating sufficient protein to maintain lean body mass.
    austinpsycho:


    I worry that as I eat less, my body will become more efficient with those calories, and I'll need to eat even less and so on.
    If you restrict calories, your body doesn't "become more efficient" per se. It slows your metabolism to compensate. So you may feel cold or sluggish, or other effects. But if you eat a well-formulated ketogenic diet, how much you eat is determined by whether or not you are sated.
    You'll see this formula repeated often, because it is easy to remember, easy for most folks to follow, and it usually works:
    No more than 20g of carbs per day (important, not a percentage, but a hard limit of 20g, which will allow most folks to get into ketosis)
    Sufficient protein to maintain lean body mass (approx. 0.5-1g per kg of lean body mass)
    Fat to sateity.

    Don't worry about calories. And if you've only been at this for a month, don't worry about fasting yet. Keep it simple, and KCKO (Keep Calm and Keto On).

  3. BGdiving

    devhammer:


    Don't worry about calories. And if you've only been at this for a month, don't worry about fasting yet. Keep it simple, and KCKO (Keep Calm and Keto On).

    It almost seems like most people doing Keto need to fast in order to continue loosing weight. When I was doing "my version" of the Atkins induction diet I definitely felt like I ate more and more often was never hungry and could loose weight as long as I was consistent. I hate food journaling, but for the 8 or 10 days that I did journal I was eating at least a couple of large meals a day and some low carb snacking. Several of those days I had a late night 20 oz rib eye and logged a little over 5000 calories per day and was loosing weight rapidly (didn't loose on 6000+ cal days) and this is after I had already lost over 100 pounds. BUT now after I started some intermittent fasting and backing down on the protein consumption I feel as if my metabolism has slowed way down and I have to be much more restrictive in how much I eat if I want to loose weight or even hold even. I do Not feel lethargic and I definitely am not cold just seems I have messed up my metabolism like @austinpsycho is concerned about, definitely cheaper I don't snack during the day and I skip meals but kind of inconvenient and discouraging having to be more restrictive if I don't want to gain weight say nothing of trying to loose those extra pounds I still need to get rid of.

  4. -> Continue reading
read more
Share on facebook

10 arterial blood gas problems worked using the tic-tac-toe method.

Arterial Blood Gas (abg) Analyzer

This analyzer should not substitute for clinical context. Sodium and chloride are required for anion gap calculation. While the analyzer can often help with analysis, the history of the patient is critical for accurate interpretation. NOTE: Normal albumin levels are typically 4 g/dL in US units and 40 g/L in SI units. A venous blood gas often correlates well with arterial blood gas findings (except for PaO2) unless values are extremely abnormal, and can often be used successfully as a screening tool. This tool, developed by Jonathan Chen, MD first determines the primary process by looking at the pH and the PCO2. It then calculates compensations to determine chronicity, compensatory, and co-existing acid-base disturbances. Diabetic Ketoacidosis (check serum ketones) Propylene Glycol (in BZD drips) or Paraldehydes Oxoporin (reflects fatty liver damage from glutathione consumption, e.g. acetaminophen toxicity) Renal Tubular Acidosis (Type 1 Distal or Type 2 Proximal) Jonathan Chen, MD, PhD is a research fellow in medical informatics, based at the Veteran Affairs Hospital in Palo Alto and Stanford University. He completed the Stanford Internal Medicine residency program and was in the Continue reading >>

Share on facebook

Popular Questions

  1. JeiCR

    I am sad to discover that I must stop doing 5:2 intermittent fasting because it appears to have caused my blood pressure to become uncontrollably high. I had lost 10 pounds (4.5 kg) over the course of 12 weeks, which I was very happy about. I found the program to be very easy, and the hunger pangs not that difficult to endure, and was enjoying the results of the program so much that I did not want to believe that my steadily rising blood pressure could be caused by 5:2. I am a 53 year old female who has been controlling my tendency toward high blood pressure through weight loss, diet, and exercise. My BMI was on the upper half of the healthy range when I started the fast diet, but I wanted to start training to run a 5k, and thought it would be helpful to first lose some unnecessary weight I was carrying. My goal was to lose 15 pounds (6.8 kg)…still keeping my BMI within the healthy range. I was, fortunately, keeping an eye on my BP with my home blood pressure monitor, had I not been monitoring it, I would not have known it had reached over 180/100! For the first time in my life I had to go on blood pressure medication! Even then, the medication still was not keeping it under control. My husband pointed out that the only change I had made was the 5:2 diet, so I reluctantly stopped, and after about a week my blood pressure returned to normal, and is still normal now, after two weeks. I am very relieved, as it was quite scary to have it so out of control, but at the same time I am disappointed because the Fast Diet had been such an easy way for me to lose weight. I still have 5(2.3 kg) pounds to go, and at least want maintain the weight I have lost, so I need to figure out a plan that doesn’t involve fasting. I don’t know for certain why 5:2 was apparently raising my BP, but it vaguely felt as if the level of stress hormones in my body kept rising over time the longer I was on the diet, my pulse had also been higher than normal. I am wondering if anyone else has experienced this problem?

  2. char6

    Hi, JeiCR. I am a doctor, and that really does sound strange! Do you think extra sodium could have been sneaking into your diet, such as in soups? Or a lot of extra caffeine? Were you taking a decongestant medication, by any chance, or any weight loss supplements that could contain stimulants? Are your ankles swelling a lot, in which case you would need to get your kidneys checked? (I know you said nothing else had changed, but just checking.)
    What is your current BMI? Could it be that you are stressing your body by trying to force it too low (although I don’t think I have ever heard of such a thing)?
    If your BMI is well within the normal range, maybe you could maintain your loss just by training for the 5K, or by fasting only 6:1.

  3. SAMM

    I don’t have a medical opinion.
    Im wondering about wether you were close to your TDEE on non fasting days. Also curious as to the foods on fasting days and feeding days.
    The only thing I can think of is your protein intake may need to be spread out.
    Again not advice I understand having 25g 25g 25g of protein on feed days has an effect on the vascular system. Is the new standard.
    This points to the type of protein intake I use on fasting days. I use non flavored whey protein as it is said in general to metabolize quicker for the the body to use. On fasting days I aim for 10g 10g 10g when planning my menu.
    On another note if what’s happening to you was happening to me. I would make sure to get a Flu shot. Reason is typically having the flu increases inflammation. There is a greater percentage of heart attacks occurring when having the flu. Avoiding 30 flu strains over ten years lowers to exposer to the inflamation caused by flu. Your 50% less likely over ten years to have heart attack. So wether it’s 5:2 or losing weight in any other way cholesterol lvl may raise when fat is released for energy. So there could be a combination of conditions to keep watch over. Inflamatory foods, flu inflammation, elevated blood pressure. So If it were me I would be more sedentary on fasting days, but eating anti inflammatory foods on feed day especially.
    Here’s a link to a list of the most anti inflammatory foods and their nutrition data.
    http://nutritiondata.self.com/foods-000992000000000000000.html
    Again I can’t be more clear about the fact that I can’t give any medical advice whatsoever. I’m not qualified at all. I do however have an opion that what is on my fork is just as important to consider as medication. Especially when were prone to health issues.
    I’ll make a huge guess and wild assumption. If I eat a fry up , of greasy greasy greasy ,bacon,sausage,burger,BBQ. Just as poor fat as possible, and flood my blood with fat. I may also influence the level of fat in my blood by eating lower fat protein such as whey protein.
    I go as far to boil my chicken breast in water and skim off the fat before I put it in my chicken soup when I have the flu.
    The biggest change I’ve made since watching The Truth About Exercise. Is to do better on my N.E.A.T, trying to also become healthy enough to accomplish H.I .T.T. So I can do it regularly. My experience trying this has made me more conscious about my meals , how to enjoy what’s good for me even more that what’s bad.
    Best wishes hope to see you around for five more decades.

  4. -> Continue reading
read more
Share on facebook

There are two types of compensation to look for in an ABG. If compensation occurs, it is full or partial. If there is no compensation, the ABG is called uncompensated. If there are both respiratory and metabolic primary problems, the ABG is known as mixed or combined. Uncompensated Here the pH is abnormal; it will be either an acidosis or an alkalosis. The pH will always point to the primary problems (acidosis/alkalosis). The nurse then needs to look at the pCO2 or HCO3. In an uncompensated problem, there will be a respiratory acidosis or alkalosis or a metabolic acidosis or alkalosis, but the value that would correct for this, the opposite organ value, will not change as there is no compensation for the problem. ---------- Biology tutoring on Chegg Tutors Learn about Biology terms like Uncompensated Partially Compensated on Chegg Tutors. Work with live, online Biology tutors like Niyati B. who can help you at any moment, whether at 2pm or 2am. Liked the video tutorial? Schedule lessons on-demand or schedule weekly tutoring in advance with tutors like Niyati B. Visit https://www.chegg.com/tutors/Biology-... ---------- About Niyati B., Biology tutor on Chegg Tutors: Kasturba Medical College, Manipal, India, Class of 2013 Medicine major Subjects tutored: Health and Medicine, PSAT (reading), PSAT (math), SAT (reading), Biology, Marathi, Medical Assistant, TOEFL, Basic Math, Hindi, English as a Second Language, SAT (math), and Medicine TEACHING EXPERIENCE I have taught concepts of basic math like solving linear equations to my young cousins in California ( grade 6 ) as well as basic human biology like circulatory system. I used to teach English to the children of the house hold helpers back in India and i find that this is what has helped me develop patience and not just that but also helped me brush up on my own knowledge of some things that I never thought I'd use after middle school. Einstein said if you can't explain it simply then you haven't understood it well enough and I completely agree. My goal: explain it simply, but also in a way that is hard to forget. EXTRACURRICULAR INTERESTS Well in a nutshell I'm a knowledge hungry newbie doctor ( graduated from a medical school in India ) , an avid reader , and I'm also a huge trivia nerd. I have a flair for all things literary ( debate , crosswords , word play you name it ) I absolutely love to read ( mostly fiction , some of my favorite authors like Khaled Hosseini are doctors by profession ) and I have written about 30 poems over the past 10 years. I enjoy listening to podcasts, my favorite one is called Good Job Brain which is a quiz and trivia podcast and I also have a particular fondness for learning about Greek and Roman mythology, and love spoken word poetry. I love to listen to music and sing ( albeit not too well ) and I collect fridge magnets from the places I've been. I have spent part of my childhood in the US, and then the rest in India and my life has been transcontinental for the most part which has given me the benefit of some amazing experiences. I also have an artsy side - sketching and painting are some ways I like to unwind, and listening to TED talks is always an option. Want to book a private lesson with Niyati B.? Message Niyati B. at https://www.chegg.com/tutors/online-t... ---------- Like what you see? Subscribe to Chegg's Youtube Channel: http://bit.ly/1PwMn3k ---------- Visit Chegg.com for purchasing or renting textbooks, getting homework help, finding an online tutor, applying for scholarships and internships, discovering colleges, and more! https://chegg.com ---------- Want more from Chegg? Follow Chegg on social media: http://instagram.com/chegg http://facebook.com/chegg http://twitter.com/chegg

Uncompensated, Partially Compensated, Or Combined Abg Problems

Arterial Blood Gas (ABG) analysis requires in-depth expertise. If the results are not understood right, or are wrongly interpreted, it can result in wrong diagnosis and end up in an inappropriate management of the patient. ABG analysis is carried out when the patient is dealing with the following conditions: • Breathing problems • Lung diseases (asthma, cystic fibrosis, COPD) • Heart failure • Kidney failure ABG reports help in answering the following questions: 1. Is there acidosis or alkalosis? 2. If acidosis is present, whether it is in an uncompensated state, partially compensated state, or in fully compensated state? 3. Whether acidosis is respiratory or metabolic? ABG reports provide the following descriptions: PaCO2 (partial pressure of dissolved CO2 in the blood) and PaO2 (partial pressure of dissolved O2 in the blood) describe the efficiency of exchange of gas in the alveolar level into the blood. Any change in these levels causes changes in the pH. HCO3 (bicarbonate in the blood) maintains the pH of the blood within normal range by compensatory mechanisms, which is either by retaining or increasing HCO3 excretion by the kidney. When PaCO2 increases, HCO3 decreases Continue reading >>

Share on facebook

Popular Questions

  1. mehdi84

    Is it normal to sweat WAY more on keto? Ketosis in 24 hours?!?

    Last week (first week) -- You can skip this if you want, but interesting for those who are interested
    Last week was my first week on Keto (Started Sunday). According to the ketosticks, and how I felt, it took until Thursday to get into keto.
    This is likely because my meals accidentally had more carbs then I thought, too much protein, and too little fat.
    Adding to this: I cheated. I had a 1.5 day carb-up, instead of doing what many people suggested, and sticking to Keto for 2 full weeks before adding carb-up days.
    Anyways Friday at lunch until Saturday at night was my carb-up. THOUGH, I admit the carb up was moderate (Grilled cheese sandwich, pizza, jalapeno poppers, and BK Whopper). LOL.
    Keto in 24 hours?!?
    This is my second week of keto. Except, I think i've been much stricter. Likely because:
    a) I've cut out more carbs (accidental carbs last week)
    b) Added more fat
    c) Cut out a big of protein, since I think I overdid it last week.
    Now here is the kicker. Sunday, the first day of the cycle, I did HIITs at night.
    The next morning, I check the ketostix, and it's positive.
    Then, that afternoon, my PreWO meal was 4tbsp of PB, and a Protein Shake.... WHOA... I'm hit with dizzyness soon after, and almost a slight "high".
    Ketosis in 24 hours? Is this normal or possible?
    TODAY, while I am having my coffee at roughly the same time... I feel "high"... or sorta "buzzed" like I could be drunk. I am drinking a ton of water as well.
    Sweating a lot of Keto?
    Yesterday, I sweat profusely during and after my lifting session.
    Today, during HIITs, the same thing... I'm sitting her drenched with sweat. I even had to take my shirt off, since even after drying myself off, my shirt got drenched after a few minutes.
    .
    .
    .
    I think it's working
    P.S. I hope this post is coherent. Big Brother is on, and don't want to miss anything. Go Jessie! (no homo)

  2. bigg_K

    Hey there,
    starting out Keto, with a 1.5 day cheat is not a good way to start. Infact, I'd call it almost a complete restart.
    Ketosis in 24 hours is completely normal, depending on your body, and what you do and eat, will determine how long it takes to get into ketosis.
    The sweating is normal too, I wore a white shirt to my workout today. And lets just say it look like an episode of Guy's Gone Wild (no homo), Wet Shirt Contest, I think I even caught the attention of some girls from dripping all over the place. (yes kinda gross) But I'm drinking close to 2 gallons of water also, so a lot of sweat is expected...And I like to destroy myself on legs day.
    Otherwise you're Coherent for the most part lol
    Stick to it, no more cheats, and lets see some good results.

  3. mehdi84

    Originally Posted by konradac
    Hey there,
    starting out Keto, with a 1.5 day cheat is not a good way to start. Infact, I'd call it almost a complete restart.
    Ketosis in 24 hours is completely normal, depending on your body, and what you do and eat, will determine how long it takes to get into ketosis.
    The sweating is normal too, I wore a white shirt to my workout today. And lets just say it look like an episode of Guy's Gone Wild (no homo), Wet Shirt Contest, I think I even caught the attention of some girls from dripping all over the place. (yes kinda gross) But I'm drinking close to 2 gallons of water also, so a lot of sweat is expected...And I like to destroy myself on legs day.
    Otherwise you're Coherent for the most part lol
    Stick to it, no more cheats, and lets see some good results.

    Really? I don't quite understand why it would be a restart. Could you elaborate a bit on that please?
    Should I skip my carb-up day this weekend, given my scenario? or should I be good to go?

  4. -> Continue reading
read more

No more pages to load

Related Articles

  • How Can Metabolic Acidosis Be Compensated?

    Content currently under development Acid-base disorders are a group of conditions characterized by changes in the concentration of hydrogen ions (H+) or bicarbonate (HCO3-), which lead to changes in the arterial blood pH. These conditions can be categorized as acidoses or alkaloses and have a respiratory or metabolic origin, depending on the cause of the imbalance. Diagnosis is made by arterial blood gas (ABG) interpretation. In the setting of me ...

    ketosis Apr 9, 2018
  • Mixed Respiratory And Metabolic Acidosis Abg

    Arterial Blood Gas (ABG) analysis requires in-depth expertise. If the results are not understood right, or are wrongly interpreted, it can result in wrong diagnosis and end up in an inappropriate management of the patient. ABG analysis is carried out when the patient is dealing with the following conditions: • Breathing problems • Lung diseases (asthma, cystic fibrosis, COPD) • Heart failure • Kidney failure ABG reports help in answering ...

    ketosis Apr 29, 2018
  • Partially Compensated Metabolic Acidosis

    (Video) Overview of Buffering and the Henderson-Hasselbalch Equation By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincents Ascension Health, Birmingham Metabolic alkalosis is primary increase in bicarbonate (HCO3) with or without compensatory increase in carbon dioxide partial pressure (Pco2); pH may be high or nearly normal. Common causes include prolonged vomiting, hypovolemia, diuretic use, and hypokalem ...

    ketosis Apr 1, 2018
  • Metabolic Acidosis Would Be Compensated By What Body System

    Respiratory Acidosis Definition Respiratory acidosis is a condition in which a build-up of carbon dioxide in the blood produces a shift in the body's pH balance and causes the body's system to become more acidic. This condition is brought about by a problem either involving the lungs and respiratory system or signals from the brain that control breathing. Description Respiratory acidosis is an acid imbalance in the body caused by a problem relate ...

    ketosis Jan 11, 2018
  • Compensated Metabolic Acidosis Abg

    This analyzer should not substitute for clinical context. Sodium and chloride are required for anion gap calculation. While the analyzer can often help with analysis, the history of the patient is critical for accurate interpretation. NOTE: Normal albumin levels are typically 4 g/dL in US units and 40 g/L in SI units. A venous blood gas often correlates well with arterial blood gas findings (except for PaO2) unless values are extremely abnormal, ...

    ketosis Apr 2, 2018
  • Partially Compensated Metabolic Acidosis Example

    Step 4: Identify the compensatory process (if one is present) In general, the primary process is followed by a compensatory process, as the body attempts to bring the pH back towards the normal range. If the patient has a primary respiratory acidosis (high PCO2 ) leading to acidemia: the compensatory process is a metabolic alkalosis (rise in the serum bicarbonate). If the patient has a primary respiratory alkalosis (low PCO2 ) leading to alkalemi ...

    ketosis Apr 1, 2018

More in ketosis