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How Can Metabolic Acidosis Be Compensated?

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Paediatric Acid-base Disorders: A Case-based Review Of Procedures And Pitfalls

Paediatric acid-base disorders: A case-based review of procedures and pitfalls J Bryan Carmody , MD and Victoria F Norwood , MD Department of Pediatrics, Division of Pediatric Nephrology, University of Virginia, Charlottesville, Virginia, USA Correspondence: Dr J Bryan Carmody, Department of Pediatrics, Division of Pediatric Neprhology, University of Virginia, PO Box 800386, Charlottesville, Virginia 22903, USA. Telephone 434-924-2096, e-mail [email protected] , [email protected] Copyright 2013 Pulsus Group Inc. All rights reserved Acid-base disorders occur frequently in paediatric patients. Despite the perception that their analysis is complex and difficult, a straightforward set of rules is sufficient to interpret even the most complex disorders provided certain pitfalls are avoided. Using a case-based approach, the present article reviews the fundamental concepts of acid-base analysis and highlights common mistakes and oversights. Specific topics include the proper identification of the primary disorder; distinguishing compensatory changes from additional primary disorders; use of the albumin-corrected anion gap to generate a differential diagnosis for patients Continue reading >>

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  1. Horny

    Foreword: I don't want anything bad to happen to anybody on the GLL fat loss diet and I'm sure Chris doesn't either, but it DOES have its risks/bad sides and YOU need to know how to mitigate them. I've been tired from keto flu today but I need to get this long post out to inform you guys. Please read this whole post if you're on the fat loss plan and you're in ketosis or heading there with less than approx. 80g carbs per day.
    What happened to me:
    May 31th 2013 or day 14 of my fat loss journey, I woke up in the middle of the night at 3am feeling restless and soon experienced abnormally strong heart beats, heart palpitations and basically my heart revved up and started beating too fast. I was too panicked to count my pulse. I've had panic attacks before in 2012 so thought I had either a re-occuring panic attack, low blood sugar from my low-carb fat loss diet or some more serious shit.
    I fucking biked to the nearest hospital at 4am to get myself checked after I had a spoonful of honey and calmed down a bit. The nurse tested my blood pressure, pulse and blood sugar at my request. My blood sugar was normal, the nurse found nothing abnormal about me so she didn't even send me to a doctor. Luckily, I felt fine at that point and went home to sleep.
    The days before and after this I've experienced brain fog, feeling faint and lightheaded when standing up quickly, tingly sensation in my head during weighlifting, runny nose, phlegm in my throat, sore throat, irritability, muscular weakness, light cramping, tiredness waking up/during the day/afternoon/after a nap etc. All keto flu symptoms, which will go away in time, hopefully within the next few days. I'm not quitting my diet or anything, it's not that bad. I've lost enough fat+water in about 16 days that all my pants are sagging!!
    Here's another dieter's account from reddit - he's on a low-carb keto diet, which is what the GLL fat loss program is:
    "I woke up around 4am with shaky hands and pounding heart. I was shaking so badly that I could barely walk, and I was freaking out, being tired and surprised, and I was certain that I had to be dying or something. Then I remembered reading about keto and salt here on reddit, and I wobbled into the kitchen, dissolved half a teaspoon of salt in a glass of water, and drank it. Tasted like crap, but after 6-7 minutes, I felt completely fine again. I made sure to watch my salt intake after that."
    SOURCE: http://www.reddit.com/r/keto/comments/1b89uv/science_avoiding_keto_flu_explained/c94kunp
    If me and him and plenty of others with similar stories were INFORMED before they started dropping their carbs below 50g/day, these bad experienced would never have needed to happen!! If GLL had taken the reponsibility of informing us about this KETO FLU, I would've known to fucking look out for it and take more magnesium, potassium and sodium (salt)
    DO NOT GO ON THE GLL FAT LOSS DIET WITHOUT SUPPLEMENTING WITH 1 TSP/5 GRAMS OF SALT AND PLENTY OF WATER PER DAY WHEN EATING LESS THAN 50-80G CARBS PER DAY!!
    from: http://ketodietapp.com/Blog/post/2013/04/16/Keto-flu-and-Sufficient-Intake-of-Electrolytes
    "Here are signs of potassium deficiency (hypekalemia):
    hypertension
    cardiac arrhythmia
    muscular weakness and muscle cramps, weakness
    constipation
    depression and irritability
    heart palpitations
    skin problems
    respiratory depression, heart failure (severe deficiency)"
    Here's 3 more articles that are ESSENTIAL READING for all GLL fat loss warriors so you can understand how cutting carbs too fast expels a lot of toxins and bad gut bacteria from your stomach and causes flu-like symptoms and so you can maintain ketosis safely without having bad keto flu, low blood pressure, heart palpitations and possibly even worse shit sneak the fuck up on you!!
    https://sites.google.com/site/hillaryaj/recipes/keto/intro
    http://www.reddit.com/r/keto/wiki/faq
    http://www.reddit.com/r/keto/comments/1b89uv/science_avoiding_keto_flu_explained/
    AGAIN, DO NOT GO ON THE GLL FAT LOSS DIET WITHOUT SUPPLEMENTING WITH 1 TSP/5 GRAMS OF SALT AND PLENTY OF WATER PER DAY WHEN EATING LESS THAN 50-80G CARBS PER DAY!!
    TL:DR
    1.Eat 3-5g of salt per day. It can be from sea/table/kosher salt, salted nuts, broths, buillions, chicken soups etc. Or you can eg. take a full tablespoon of organic extra virgin olive oil + a little sea salt sprinkled on top with each meal. I supplement with a teaspoon of sea salt a day, no iodine.
    2.Supplement potassium 3g a day. Best food source is avodaco, 2nd nuts. 1 avocado has 1g of potassium. I'm currenctly little low and trying to find a supplement: I eat about 1.5 avocados a day and maybe 80g of nuts.
    3.supplement magnesium with at least 400mg a day. I use Country Life chelated magnesium pill with 250mg and then Life-Flo "pure magnesium oil" which is magnesium chloride bitrate taken from the zechstein seabed in the Netherlands. Got both from Iherb.
    CONSIDER YOURSELF WARNED. But keep calm and keto on.

  2. Dickie

    Re: WARNING: KETO FLU CAN/WILL HAPPEN TO YOU GLL FAT LOSS DIETERS!

    Yea, this diet is really only useful for guys who heven't yet developed alot of muscle mass. If All you care about is losing as much weight as quickty as you possibly can... then its gold. But for Anyone who has spend more than a year in the gym specifically trying to build muscle (bulking) then you need to be careful cause eating a combination of low carb + calory deficit will strip fat and ALSO destroy muscle mass very quickly.
    I leanred this the hard way. After my first stint on the GLL fat loss diet I lost 15 pounds in 2 months. I looked really lean and cut but also noticed my lifts were way down and my muscles had become flat looking. From what I can tell, Most people will agree that anything more than 4-6 pounds per month is goign to become muscle wasting. This is likely what had happened to me. BCAA's will help you a bit but I personally don't think its enough for anyone who is doing intense workouts... which you should be if you are trying to maintain any amount of muscle mass you need to continue lifting heavy throughout your cut phase otherwise your body will break down muscle for energy. It makes sense if you think about it logically. Your body is essentially starving on this diet. If you arent continuing to lift heavy and instead just doing cardio then your body will see that all that muscle isnt necessary and will break it down for energy. "use it or lose it"
    Now I use a modified version of the GLL diet. I eat 50-100g of (clean) carbs 1 hour before my workout. This gives me an energy boost and prevents muscle breakdown.

  3. PhilTheBeard

    Re: WARNING: KETO FLU CAN/WILL HAPPEN TO YOU GLL FAT LOSS DIETERS!

    So glad I didn't experience any of this being on this diet and still being on this diet.
    Good write up thou.

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Compensated Acidosis | Definition Of Compensated Acidosis By Medical Dictionary

Compensated acidosis | definition of compensated acidosis by Medical dictionary Also found in: Dictionary , Thesaurus , Encyclopedia . Related to compensated acidosis: acidotic 1. the accumulation of acid and hydrogen ions or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, resulting in a decrease in pH. 2. a pathologic condition resulting from this process, characterized by increase in hydrogen ion concentration (decrease in pH). The optimal acid-base balance is maintained by chemical buffers, biologic activities of the cells, and effective functioning of the lungs and kidneys. The opposite of acidosis is alkalosis. adj., adj acidotic. Acidosis usually occurs secondary to some underlying disease process; the two major types, distinguished according to cause, are metabolic acidosis and respiratory acidosis (see accompanying table). In mild cases the symptoms may be overlooked; in severe cases symptoms are more obvious and may include muscle twitching, involuntary movement, cardiac arrhythmias, disorientation, and coma. In general, treatment consists of intravenous or oral administration of sodium bicarbonate or sodium lactate solutions and cor Continue reading >>

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  1. Comment

    What Is Diabetic Ketoacidosis Symptoms - About.com About.com/Experts Find Related Content on What is diabetic ketoacidosis symptoms. Search Over 3 Million Articles on About.com Today!

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Abg: Respiratory Acidosis/metabolic Alkalosis

Home / ABA Keyword Categories / A / ABG: Respiratory acidosis/metabolic alkalosis ABG: Respiratory acidosis/metabolic alkalosis A combined respiratory acidosis / metabolic alkalosis will result in elevated PaCO2 and serum bicarbonate. Which process is the primary disorder (e.g. primary respiratory acidosis with metabolic compensation versus primary metabolic alkalosis with respiratory compensation) is dependent on the pH in an acidotic patient, the acidosis is primary (and the alkalosis is compensatory) and vice versa. Compensation behaves in accordance with the following rules: Metabolic Acidosis: As bicarbonate goes from 10 to 5, pCO2 will bottom out at 15. pCO2 = 1.5 x [HCO3-] + 8 (or pCO2 = 1.25 x [HCO3-]) Metabolic Alkalosis: compensation here is less because CO2 is driving force for respiration. pCO2 = 0.7 x [HCO3-] + 21 (or pCO2 = 0.75 x [HCO3-]) Acutely: [HCO3-] = 0.1 x pCO2 or pH = 0.008 x pCO2 Chronically: [HCO3-] = 0.4 x pCO2 or pH = 0.003 x pCO2 Respiratory Alkalosis: Metabolic compensation will automatically be retention of chloride (i.e., hyperchloremic, usually referred to as loss of bicarb although it is the strong ion difference that matters). If you have an anion Continue reading >>

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  1. SwitchingtoUbuntu

    I ask here because reading through the articles that mention it which I found on google is giving me cancer, even though it should be harder for me to get because keto (teehee).
    I guess I just don't know enough about Atkins to know what the difference is. Is there one? What makes Atkins different from Keto?

  2. EsotericKnowledge

    Keto is basically Atkins induction. But for the whole time. I started off using Atkins as a guide and kinda crafted my own thing based on my own body and self-experiments. Then I found r/keto. :)
    To put it simply: Atkins is generally a keto diet, but not all keto diets are Atkins.
    And Atkins himself would be pissed if he knew the stupid crap people are putting out in his name these days, all full of sugar alcohols, etc.

  3. simsalabimbam

    1) Atkins is a brand. Keto(sis) is a metabolic state.
    2) Atkins is low carb. Keto is no carb. (Or at least as close to no carb as is reasonably possible).
    3) The Atkins diet is designed for weight loss. The keto diet is designed for whole-body improvements (reduced blood pressure, better lipid panels, better insulin control etc.)
    4) The induction phase of Atkins lasts two weeks during which ketosis is possible. The keto diet encourages ketosis on a permanent basis.
    HTH

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