Metabolic Acidosis Bicarbonate

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Bicarbonate Therapy In Severe Metabolic Acidosis

Abstract The utility of bicarbonate administration to patients with severe metabolic acidosis remains controversial. Chronic bicarbonate replacement is obviously indicated for patients who continue to lose bicarbonate in the ambulatory setting, particularly patients with renal tubular acidosis syndromes or diarrhea. In patients with acute lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back to bicarbonate if the clinical situation improves. For these patients, therapy must be individualized. In general, bicarbonate should be given at an arterial blood pH of ≤7.0. The amount given should be what is calculated to bring the pH up to 7.2. The urge to give bicarbonate to a patient with severe acidemia is apt to be all but irresistible. Intervention should be restrained, however, unless the clinical situation clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy for patients with severe metabolic acidosis. Metabolic acidosis is an acid-base disorder characterized by a primary consumption of body buffers including a fall in blood bicarbonate concentration. There are many causes (Table 1), and there are multiple mechanisms that mi Continue reading >>

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Popular Questions

  1. milk

    Hello everyone,
    I am on week 2 day 5 of the ketogenic diet. I have been consuming high fat, moderate protein, and low carb. On average, my carbs have been 10-40g (the first few days around 30-40, and lately 10-20)
    I am 17 yo (about to be 18) female, and 5'5.5" with a start weight of 132lbs.
    Today I am about 129.5lbs, though my weight has been fluctuating.
    I thought I would have dropped water weight because of my low carbs, but I did not. I have been consuming 2-4L water a day on average.
    My average calories have been 1400-2300 calories, being closer to 2300 at the beginning and lessening towards this week when I was not seeing loss.
    I have not been doing any exercise, save walking up/down stairs in my house to do various things or walking around in the store for an hour or two.
    My problem now is that I checked my menstrual cycle calendar and saw that today is the day that I was supposed to end my period! I was very surprised. I am 6 days late. My last period was April 7-12. I usually have a 6-7 day period every 19 days.
    (I forgot to mention I couldn't be pregnant because I am a virgin.)
    I was supposed to start May 1. A few days ago I began to have the feeling that it was coming, so hopefully it will be here within a few days.
    My question is, could my lack of weight loss be due to my period? And could my period's lateness be due to ketosis? I saw that when fat is metabolized, estrogen is lost, and low-estrogen can result in missed or late periods. If I am losing estrogen, does that mean it is coming from body fat, or could it also be from metabolized dietary fat (does dietary fat contain estrogen?i have no idea)? If it is from body fat, does that mean I have lost weight, even though it is not showing?
    When I get my period, should I expect weight loss soon (the week) after? I suspect that I may experience a "whoosh" because this is my first time doing low-carb intentionally, though it may not be my first time in ketosis, as I have fasted before because of my Christian Faith, though it has never affected my period. My period has been regular for the last 5-6 years. Once I had two periods in a month because of stress, but that has been the only irregularity.
    Sorry for the overload of questions haha. I'm just confused about what's going on right now.
    Thanks for your help and may GOD Bless you with His Lovingkindness and mercy, and with the Love of His Son Jesus Christ forever!

  2. kaylakala

    I actally at first had the very heavy period problem. My Doctor who is a 10 year lc dieter himself said it was normal with a diet change for it to mess up your period.
    I missed mine this month and I've never missed while on the pill. So, I'm assuming it can go both ways. I of course since I'm married. LOL a newlywed at that. Took a pregnancy test and It was negative.
    Good luck!!

  3. milk

    I started my period later on the day I posted the OP. I can't tell yet if it's different than normal yet; usually it's heavy with cramping on the first day and slight cramps day 2. Yesterday I had cramps which was normal and today I didn't. I have a feeling it will be shorter than normal, but my TOM calendar calculator app says it will be longer than a week (whew) hope I'm right. sorry for slight grossness

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