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How Does Chloride Cause Acidosis?

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Normal Saline Intoxication - Deranged Physiology

Uncontrolled pancreatic secretions as a cause of acidosis The overzealous administration of sodium chloride causes a normal anion gap metabolic acidosis by decreasing the strong ion difference. This is the archetypal normal anion gap acidosis. Previously discussed calculations suggest that every bag of saline increases the serum chloride by 3mmol/L. In Stewarts terms, normal saline has a strong ion difference of 0mmol/L (given how equal the concentrations of sodium and chloride are), and thus adding it to a body fluid will decrease the strong ion difference. The strong ion difference of Hartmanns, on the other hand, is 28mmol/L, and so it has a much gentler acidifying effect. This has been demonstrated experimentally in a cohort of 5 septic patients; and the theory is discussed in detail here . Change in strong ion difference following the infusion of normal saline The above graph is adopted from Lobo et al, who in 2003 infused a series of healthy volunteers with 2000ml of normal saline to study the difference between sodium chloride and Hartmanns solution. Now, enough saline-bashing. If we remain faithful to the interpretation of acid base disorders in terms of the strong ion dif Continue reading >>

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  1. FireFinder

    I am interested to learn more about running longer distances while VLC and using fat as fuel. Anyone have a guide they can suggest? Or any experience to share?

  2. upupandaway

    The Art and Science of Low Carbohydrate Performance by S Phinney and J Volek.
    I think Peter Attia does low carb running as well - eatingacademy.com

  3. chronyx

    I've got a copy of Ketogenic diets and physical performance by Stephen D Phinney as a PDF if you want it. Good stuff.
    Abstract
    Impaired physical performance is a common but not obligate result of a low carbohydrate diet.
    Lessons from traditional Inuit culture indicate that time for adaptation, optimized sodium and
    potassium nutriture, and constraint of protein to 15–25 % of daily energy expenditure allow
    unimpaired endurance performance despite nutritional ketosis.

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Whether due to bicarbonate loss or volume repletion with normal saline, the primary problems is in hyperchloremic metabolic acidosis hcl ammonium chloride loading, reabsorption proximal tubule reduced, part, because of hyperchloraemic acidosis, anion gap (in most cases). Administration of ns will decrease the plasma sid causing an acidosis this patient also had a normal anion gap hyperchloremic metabolic (hcma). Googleusercontent search. Normal anion gap (hyperchloremic) acidosis semantic scholar. Hyperchloremic metabolic acidosis is it clinically relevant? (pdf hyperchloremic in diabetes mellitus. Hyperchloremic acidosis wikipedia. Treatment of acute non anion gap metabolic acidosis ncbi nih. Aug 4, 2016 a normal ag acidosis is characterized by lowered bicarbonate concentration, which counterbalanced an equivalent increase in plasma chloride concentration. Acid base physiology 8. Hyperchloraemic metabolic acidosisdepartment of medicine. Mechanism of hyperchloremic metabolic acidosis. Hyperchloremic acidosis background, etiology, patient education emedicine. Respiratory acidosis alkalosis as with the hyperchloremic may result from chloride replacing lost bicarbonate. Although it can occur with disease of either the small or nov 5, 1984 normal anion gap (hyperchloremic) acidosiswalmsley and ghyperchloremic metabolic acidosis in which is jun 30, 2017 approach to adult causes hyperchloremic (normal gap) acidosis; Combined elevated official full text paper (pdf) existence has been recognized many areas for some was examined persistent. [1 ] quantify two phenomena that are important to anesthesiologists and other clinicians caring for hyperchloremic metabolic acidosis with a low serum k level is most commonly caused by diarrhea. Approach to the adult with metabolic acidosis uptodate. The most common nov 23, 2014 hyperchloremic metabolic acidosis is different. Extreme acidemia (ph 7. For this reason, it is also known as hyperchloremic metabolic acidosis a form of associated with normal anion gap, decrease in plasma bicarbonate concentration, and an increase chloride concentration (see gap for fuller explanation) common acid base disturbance critical illness, often mild (standard excess 10 meq l). Albumin corrected anion gap normal (5 15 meq l). Is correcting hyperchloremic acidosis beneficial? Emcrit. Hyperchloremic metabolic acidosis due to cholestyramine a case sid hyperchloremic openanesthesia. Anesthesiology hyperchloremic metabolic acidosis is a predictable consequence of pathophysiology, diagnosis and management. Hyperchloremia why and how science direct. There was no evidence of ingestion hydrochloric acid or its equivalentHyperchloremic acidosis wikipedia. The effect of acidemia on the serum potassium concentration depends we do not believe that transient perioperative hyperchloremic metabolic acidosis in this patient required presence ileal bladder augmentation issue anesthesiology, scheingraber et al. Hyperchloremic acidosis background, etiol

Is Correcting Hyperchloremic Acidosis Beneficial?

You are here: Home / PULMCrit / Is correcting hyperchloremic acidosis beneficial? Is correcting hyperchloremic acidosis beneficial? An elderly woman presents with renal failure due to severe dehydration from diarrhea. She has a hyperchloremic acidosis from diarrhea with a chloride of 115 mEq/L, bicarbonate of 15 mEq/L, and a normal anion gap. During her volume resuscitation, should isotonic bicarbonate be used to correct her hyperchloremic acidosis? Does correcting her hyperchloremic acidosis actually help her, or does this just make her numbers better? The use of bicarbonate for treatment of metabolic acidosis is controversial. However, this controversy centers primarily around use of bicarbonate for management of lactic acidosis or ketoacidosis.Treatment of these disorders requires reversing the underlying disease process, with bicarbonate offering little if any benefit.Hyperchloremic metabolic acidosis is different.Whether due to bicarbonate loss or volume repletion with normal saline, the primary problems is a bicarbonate deficiency.Treating this with bicarbonate is a logical and accepted approach: Giving bicarbonate to a patient with a true bicarbonate deficit is not controve Continue reading >>

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  1. beyondthesmile

    Does keto affect blood pressure?

    I was pleasantly surprised to find that my blood pressure has dropped (a good thing). This past summer my diastolic number was always 80ish, usually a bit higher than that. I checked my blood pressure a few times a few days ago and found that my BP has dropped to 107/74 (108/75 at one point). I don't think this is just from working out because I was working out in the summer and my BP didn't change much.
    The only thing I can think of is that since starting keto I eat less processed food, which are usually laden with sodium. But could this change make a difference in such a short time?
    Does keto itself (either being in ketosis, or eating a higher fat, low carb diet) affect blood pressure? I'm not complaining, just wondering what I can attribute this positive change to

  2. CanuckTank

    you betcha, mine dropped as well. Less fat, less blood pressure.

  3. DecemberDays86

    It's two things. Like you said, the low-sodium nature of keto helps reduce blood pressure. The other thing is that your body tends to hold onto less water when you have little to no carbohydrates to burn off. This further reduces the amount of water in your body and makes your BP drop.
    My BP is usually 120/70 and on keto it can get as low as 100/60 in the morning. Stay hydrated!

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Nephron Power: Consult Rounds: Why Does Infusion Of Normal Saline Cause Metabolic Acidosis?

Consult Rounds: Why does infusion of normal saline cause metabolic acidosis? Why does infusion of normal saline cause metabolic acidosis? This should be an easyanswer but when you review the literature, the literature is all over theplace( literally!!).Collection of responses I received when I asked few expertsin the field: 1. Thebicarbonate ions are diluted bythe isotonic fluid,and acidosis occursas a result. 2. The fall in serum bicarbonate is dueto the expansion of the extracellular fluid volume withlarge IV fluids 3. The "strong ion difference" (SID) helpsexplain this that in order to maintain electroneutrality. Since there is diluting fluid, water must dissociate, providing excess protons which leads to metabolic acidosis. - via the stewart method of acid base 4. Usually 60% of the filtered bicarbonate load isreabsorbed in euvolemia. When extracellular volume is low the proximaltubular absorption is increased, maybe to 80%,due to changes in oncoticpressure and hydrostatic pressure of peri tubular capillaries and glomerulus.This results in increased reabsorption in setting of volume depletion.When extracellular volume is increased then proximal tubular absorptionof bicarbonate Continue reading >>

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  1. [deleted]

    So I'm still pretty new to keto here and have a question that's been nagging at me for a bit. I've read up on how a ketogenic diet in general is better for weight loss than simply counting calories and I agree with this. But I figured the best of both worlds would be to eat a ketogenic diet while also counting calories. Now I'm reading lots of posts that seem to indicate that simply being on a ketogenic diet is enough. This is where I'm confused... I would love to stop counting calories because the foods with the highest fat content and lowest carb content also seem to have the most calories. So I'm constantly hungry... Can anyone offer up any advice?
    Here are my stats: 5'7" / 27 / F / 178.5 lbs. -> meaning on a traditional counting calories way of life I should eat an estimated 1504 calories a day to lose about two pounds a week.

  2. humbled

    Only for informational purposes. I discovered that I reduced my breakfast calories from ~500 (a bowl of cereal) to ~250 (cheese and roast beef), and yet could make it to 1:00pm without getting hungry instead of being hungry by 10:00 to 10:30. That amazed me.
    Just don't count calories, set up a "deficit," and starve yourself. Listen to your body.

  3. [deleted]

    Thanks - also roast beef and cheese sounds like a damn tasty breakfast :)

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