Copd Lactic Acidosis

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Acute Lactic Acidosis

Author: Bret A Nicks, MD, MHA; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Metabolic acidosis is defined as a state of decreased systemic pH resulting from either a primary increase in hydrogen ion (H+) or a reduction in bicarbonate (HCO3-) concentrations. In the acute state, respiratory compensation of acidosis occurs by hyperventilation resulting in a relative reduction in PaCO2. Chronically, renal compensation occurs by means of reabsorption of HCO3. [ 1 , 2 ] Acidosis arises from an increased production of acids, a loss of alkali, or a decreased renal excretion of acids. The underlying etiology of metabolic acidosis is classically categorized into those that cause an elevated anion gap (AG) (see the Anion Gap calculator) and those that do not. Lactic acidosis, identified by a state of acidosis and an elevated plasma lactate concentration is one type of anion gap metabolic acidosis and may result from numerous conditions. [ 2 , 3 , 4 ] It remains the most common cause of metabolic acidosis in hospitalized patients. The normal blood lactate concentration in unstressed patients is0.5-1 mmol/L. Patients with critical illness can be considered to have normal lactate concen Continue reading >>

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  1. metalmd06

    Does acute DKA cause hyperkalemia, or is the potassium normal or low due to osmotic diuresis? I get the acute affect of metabolic acidosis on potassium (K+ shifts from intracellular to extracellular compartments). According to MedEssentials, the initial response (<24 hours) is increased serum potassium. The chronic effect occuring within 24 hours is a compensatory increase in Aldosterone that normalizes or ultimatley decreases the serum K+. Then it says on another page that because of osmotic diuresis, there is K+ wasting with DKA. On top of that, I had a question about a diabetic patient in DKA with signs of hyperkalemia. Needless to say, I'm a bit confused. Any help is appreciated.

  2. FutureDoc4

    I remember this being a tricky point:
    1) DKA leads to a decreased TOTAL body K+ (due to diuresis) (increase urine flow, increase K+ loss)
    2) Like you said, during DKA, acidosis causes an exchange of H+/K+ leading to hyperkalemia.
    So, TOTAL body K+ is low, but the patient presents with hyperkalemia. Why is this important? Give, insulin, pushes the K+ back into the cells and can quickly precipitate hypokalemia and (which we all know is bad). Hope that is helpful.

  3. Cooolguy

    DKA-->Anion gap M. Acidosis-->K+ shift to extracellular component--> hyperkalemia-->symptoms and signs
    DKA--> increased osmoles-->Osmotic diuresis-->loss of K+ in urine-->decreased total body K+ (because more has been seeped from the cells)
    --dont confuse total body K+ with EC K+
    Note: osmotic diuresis also causes polyuria, ketonuria, glycosuria, and loss of Na+ in urine--> Hyponatremia
    DKA tx: Insulin (helps put K+ back into cells), and K+ (to replenish the low total potassium
    Hope it helps

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One of the many scans from the guys at UltrasoundPodcast.com. See this scan and many more on the free One Minute Ultrasound smartphone app available in the iTunes App Store and Android Market.

Correlation Of Levels Of Obstruction In Copd With Lactate And Six-minute Walk Testcorrelao Dos Graus De Obstruo Na Dpoc Com Lactato E Teste De Caminhada De Seis Minutos

Get rights and content Chronic obstructive pulmonary disease (COPD) is a leading cause of morbid-mortality world wide, leading not only to pulmonary damage but also to multisystemic impairment, with repercussions on skeletal muscles and the ability to undertake effort, as measured in the six-minute walk test (6-MWT). To correlate the level of obstruction in COPD with lactate concentration and heart rate (HR) at rest, and distance walked. To correlate distance walked with blood gas analysis and correlate desaturation in 6-MWT with post 6-MWT lactate concentration and heart rate. COPD patients underwent spirometry, blood gas analysis and 6-MWT to evaluate distance walked, heart rate, capillary lactate (CL) concentration pre and post 6MWT, and desaturation with 6-MWT. 91 patients with all levels of obstruction were evaluated. HR and CL increased significantly post 6-MWT. The decrease in peripheral saturation of haemoglobin to oxygen observed with 6-MWT was also significant. The distance walked was shorter the greater the obstruction. The correlation analysis was significantly positive between FEV1 and distance walked, negative between FEV1 and HR at rest and negative between distance Continue reading >>

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  1. Leila

    Source(s): Secret To Destroy Diabetes - http://DiabetesCure.raiwi.com/?mzVi

  2. Comment

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  3. BRUCE D

    Well, not necessarily. There are some situations, like when you're very sick or have an infections that can cause ketoacidosis. But generally, yes, it's the lack of insulin, as in type 1 diabetes, that causes it. Type 1's are generally in DKA of some level when diagnosed. After diagnosis DKA can happen when injections of insulin, insulin has gone bad, or not enough insulin is used. In the case of insulin pump users, the infusion sets that can be clogged and no insulin is delivered.

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Chronic Obstructive Pulmonary Disease (COPD) and Respiratory Acidosis Why is it related to respiratory acidosis? 1. Progression of the disease will make the patient breath harder (hypoventilation) which makes them hold on to carbon dioxide resulting to respiratory acidosis ----------------------------------------------------------------------------------------- What is ABG? https://www.youtube.com/watch?v=88fGs... ----------------------------------------------------------------------------------------- 1. Respiratory Acidosis and Chronic Obstruction Pulmonary Disorder (COPD) 1. What? 1. Is a breathing disorder that progresses over time. 2. Why is it related to respiratory acidosis? 1. Progression of the disease will make the patient breath harder (hypoventilation) which makes them hold on to carbon dioxide resulting to respiratory acidosis 3. Who is at risk? 1. Smokers 2. Toxic environment exposure 4. Signs and Symptoms 1. Barrel Chest 2. Fatigue 3. Confusion 4. Cyanotic 5. Wheezing and Crackles 6. Oxygen saturation normally in the 80s percentage 7. Cough 8. Sputum production 5. Intervention 1. Elevate the head of the bed 30 45 degrees 2. Pursed lip breathing 3. Tripod positioning 4. Oxygen as prescribed 5. Administer medication 6. Treatment 1. Stop smoking 2. Pneumonia vaccine 3. Yearly flu vaccine 4. Physical therapy 5. Oxygen therapy 6. Surgery 7. Medications 1. Short Acting Bronchodilators 1. B2 adrenergic agonist a) Albuterol i) Smooth muscle relaxation b) Theophylline (Short and Long acting) i) Adult Normal level 5 - 15 mcg/dL ii) Children 5 - 10 mcg/dL iii) More than 20 is toxic! iv) Treat emphysema and chronic bronchitis 2. Anticholinergic Bronchodilators 1. Atrovent a) Inhaler and nebulizer solution 3. Inhaled Corticosteroid 1. Used for moderate to severe 2. Not for long term use a) Combined Fluticasone/salmeterol (Advair) i) Fluticasone One. To stop chest tightness ii) Salmeterol (long acting bronchodilator) . To open up the airways Personal Item I used: These links will direct you to amazon at no cost to you. If you buy from my link, I will be getting few pennies worth. Thank you! YouTube plugin: https://www.tubebuddy.com/redhawk Saunders Book 7th Ed NCLEX-RN: http://amzn.to/2iG6YHS Saunders Drug Book 2017: http://amzn.to/2jXuZuZ Saunders Nursing Today 8th Ed: http://amzn.to/2jXpqNj blender bottle: http://amzn.to/2jFn3hP Weightlifting belt: http://amzn.to/2ippd4f shoes: http://amzn.to/2il8QKC Camera Setup Canon t6: http://amzn.to/2jFmogp waterproof vlogging camera: http://amzn.to/2jXpLPV vlogging tripod: http://amzn.to/2jwZcnF 5 Life saving nursing kit clinical items must have: https://youtu.be/6smxIZAcLQE Learn about blood pressure at http://abnormalbloodpressure.com/ Top 5 Books to Lower High Blood Pressure without Medication http://wp.me/P864rR-9H Top 5 Wrist Blood Pressure Monitor http://wp.me/P864rR-9e Top 3 Upper Arm Blood Pressure Monitor http://wp.me/P864rR-9q Top 5 Fitbit Wristband Fitness Tracker http://wp.me/P864rR-a2 Top 5 Weighing Scale http://wp.me/P864rR-aC come join me and become a member: https://www.goherbalife.com/jbegdamin step 1: click the link above step 2: register step 3: sign in step 4: choose your product of choice step 5: checkout step 6: let's do it together! #nursing #nursingschool #nursingstudents #studentmursejb #stundentnurse #murse Disclaimer: This video is for educational purposes only. If you are experiencing the same signs and symptoms, please do not diagnose yourself. Call your primary provider immediately. -~-~~-~~~-~~-~- #1 Best Selling Camera: "Canon EOS Rebel T6 Full Accessory Bundle | What Comes with it for Paying $469.95?" https://www.youtube.com/watch?v=MhSnU... -~-~~-~~~-~~-~-

Lactic Acid Levels In Patients With Chronic Obstructive Pulmonary Disease Accomplishing Unsupported Arm Exercises.

Lactic acid levels in patients with chronic obstructive pulmonary disease accomplishing unsupported arm exercises. de Souza GF, et al. Chron Respir Dis. 2010. Pulmonary Rehabilitation Center, Federal University of So Paulo, Unifesp, Brazil. Chron Respir Dis. 2010;7(2):75-82. doi: 10.1177/1479972310361833. Epub 2010 Mar 26. Patients with chronic obstructive pulmonary disease (COPD) may suffer dyspnea when performing unsupported arm exercises (UAE). However, some factors related to the tolerance of the upper limbs during these exercises are not well understood. Our investigation was to determine if an unsupported arm exercise test in patients with COPD accomplishing diagonal movements increases lactic acid levels; also, we assessed the metabolic, ventilatory and cardiovascular responses obtained from the unsupported arm exercise test. The study used results of maximal symptom limited tests with unsupported arms and legs performed on 16 patients with COPD. In order to do the test, some metabolic, respiratory and cardiovascular parameters such as oxygen uptake (VO(2)), carbon dioxide production (VCO(2)), respiratory rate (RR), pulmonary ventilation (VE), heart rate (HR) and blood pres Continue reading >>

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  1. Hsantos

    We all know that if you eat too many carbs, you can get kicked out of Ketosis. My question is this: Are there varying degrees of being kicked out of Ketosis? I know that once you're fat adapted, and you get kicked out, your body will burn through the glucose as energy and then you'll revert back to burning fat.

    So in that theory, if I just cheat "a little bit" say with one dessert, is it faster to get back into Ketosis than if I fall off and cheat a whole weekend? Cheat with one dessert or cheat throughout a whole weekend. Or does the amount of cheating not count and it takes the Body the same process to get back to fat burning?

  2. carolT

    Certainly the less you indulge the better, and not at all would be best. When ketogenesis is turned off, the liver will store glucose as glycogen. After your liver glycogen is refilled, the excess will be turned into fat and not utilized efficiently as long as your insulin levels remain elevated. The problem is, sometimes the blood glucose swings after the first little indulgence will trigger a cascade of cravings for more carbs.

  3. Chuck

    I have suffered through this. I can get back on track quickly, but it feels horrible! I lost almost 50 lbs before I cheated the first time.. I have not lost since! I have recommitted to strict keto and I am seeing both the inches and weight start to drop off again. I will be in Onderland in the next two weeks!

    Bottom line; DONT CHEAT! You are only cheating yourself!

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    Author: Bret A Nicks, MD, MHA; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Metabolic acidosis is defined as a state of decreased systemic pH resulting from either a primary increase in hydrogen ion (H+) or a reduction in bicarbonate (HCO3-) concentrations. In the acute state, respiratory compensation of acidosis occurs by hyperventilation resulting in a relative reduction in PaCO2. Chronically, renal compensation occurs by means of reab ...

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