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Metabolic Acidosis Treatment

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Treatment Of Acute Metabolic Acidosis: A Pathophysiologic Approach

Treatment of acute metabolic acidosis: a pathophysiologic approach Dr Jeffrey A. Kraut, MD is Chief of Dialysis at the Veterans Administration Greater Los Angeles Healthcare System, Professor of Medicine at UCLA David Geffen School of Medicine, and an investigator in the UCLA Membrane Biology Laboratory, USA. He is also the feature editor of the acid-base and electrolyte cases for the American Journal of Kidney Disease and Co-Director of the early course on Diagnosis and Treatment of AcidBase and Electrolyte Disorders for the American Society of Nephrology. His research interest is in the description of the factors that contribute to cellular dysfunction with acidbase disorders and development of rapid methods of diagnosis and targeted therapies. Dr Nicolaos E. Madias, MD is Chairman of the Department of Medicine at St Elizabeth's Medical Center in Boston and the Maurice S. Segal, MD Professor of Medicine at Tufts University School of Medicine, Boston, MA, USA. He has previously served as Chief of the Division of Nephrology at Tufts Medical Center. His research interests are focused on acidbase and electrolyte physiology and pathophysiology, and the pathophysiology of hypertensive Continue reading >>

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  1. Silky

    I became diabetic (Insulin Dependent) when I was just 10 and I'm now 19 (just turned yesterday actually) and in the past year I have been in hospital 5 TIMES!! with ketones, also had to be put in ICU on one occasion aswell, BIG SCARE! Thought I was going to die
    My diabeties is fairly well controlled but the thing that is worrying me is the fact I keep getting ketones, even though I control my sugars well. It's confusing for me, my doctor said it my of been caused from when I was younger (Between about 15 and 17) and neglected my diabeties and ate sweets and all that.
    Anyways... the thing that scares me the most is;
    1. I keep getting ketones.
    2. The way I have been told to get rid of them is quite dangerous.
    The reason for it being dangerous is because my doctor told me that I should inject insulin, untill the ketones are gone (unless my ketone level is at 3, then I should come into hospital), but the has caused my sugars to drop rapidly and I get shakey, blurred vision etc (you all know the signs)... I tried drinking sips on luzozade sport (my favorite drink), and it seemed to work, and I can successfully get rid of the ketones and also avoid going hypo... but tends to leave my bloods, a bit out of whack untill my next injection, and I tend to wee and drink a lot.
    Has anyone even had this problem? or is currently going through it?
    If so then please chat to me, it's driving me nuts!!

  2. Shelley

    Hiya Silky,
    Sorry l dont know much about T1 apart from what l've read in passing on this board.
    However have you tried just drinking lots of water to flush away ketones (if thats (poss)? - lt was just a thought, l dont really have a clue.
    l know water is good at keeping the kidney's flushed.
    l'm sure someone else will answer you soon, l saw a few of your posts and just thought l'd try.
    Welcome to the Diabetes Daily Forum.

  3. Silky

    thanks for the welcome Shelly.
    Yeah I tried drinking water, doesn't do that much in my opinion... mass' of insulin seems to be the only way and that is why I'm sooo scared! because I know how serious ketones is, the doctors once told me that if I didn't come in hospital when I did, then another hour and I'd be in a coma or worse... but thankfully I'm still here and alive and well.

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5.6 Metabolic Acidosis - Correction

The most important approach to managing a metabolic acidosis is to treat the underlying disorder. Then with supportive management, the body will correct the acid-base disorder. Accurate analysis & diagnosis is essential to ensure the correct treatment is used. Fortunately, in most cases this is not particularly difficult in principle. Remember though that a patient with a severe metabolic acidosis may be very seriously ill and even with optimal management the patient may not survive. The ECLS Approach to Management of Metabolic Acidosis 1. Emergency: Emergency management of immediately life-threatening conditions always has the highest priority. For example, intubation and ventilation for airway or ventilatory control; cardiopulmonary resuscitation; severe hyperkalaemia 2. Cause: Treat the underlying disorder as the primary therapeutic goal. Consequently, accurate diagnosis of the cause of the metabolic acidosis is very important. In some cases (e.g. methanol toxicity) there may be a substantial delay become the diagnosis can be confirmed so management must be based on suggestive evidence otherwise it will be too late. 3. Losses Replace losses (e.g. of fluids and electrolytes) whe Continue reading >>

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  1. nboylie

    I have searched rexall and shoppers drug mart and I can't seem to find them?

  2. quality_time

    I get mine at shoppers. I ask for them from the pharmacist as they keep them behind the counter. I've also gotten them from the pharmacy at the grocery store - same deal behind the counter. If they don't have them behind the counter it's on order. Typically with the diabetic stuff.

  3. rolodex9

    yep, Shoppers has them behind the pharmacists counter. In regards to how expensive they are, I combat that by cutting mine in half. They're still readable and instead of 50 you get 100 strips

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Treatment Of Metabolic Acidosis.

1. Curr Opin Crit Care. 2003 Aug;9(4):260-5. (1)Departemente d'Anesthesie Reanimation Est, Hopital Saint Roch-5, rue Pierre Devoluy, F-06006, Nice. [email protected] Metabolic acidosis is characterized by a decrease of the blood pH associated witha decrease in the bicarbonate concentration. This may be secondary to a decrease in the strong ion difference or to an increase in the weak acids concentration,mainly the inorganic phosphorus. From a conceptual point of view, two types ofnontoxic metabolic acidosis must be differentiated: the mineral metabolicacidosis that reveals the presence of an excess of nonmetabolizable anions, andthe organic metabolic acidosis that reveals an excess of metabolizable anions.Significance and consequences of these two types of acidosis are radicallydifferent. Mineral acidosis is not caused by a failure in the energy metabolicpathways, and its treatment is mainly symptomatic by correcting the blood pH(alkali therapy) or accelerating the elimination of excessive mineral anions(renal replacement therapy). On the other hand, organic acidosis gives evidencethat a severe underlying metabolic distress is in process. No reliable argumentexists to prove th Continue reading >>

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Popular Questions

  1. switch_it_to_wambo

    Which one would theoretically kick you into ketosis quicker: Fasting, or low carb/high fat dieting?
    Sorry if this has already been discussed here

  2. Renian

    Fasting, because absolutely nothing would be replacing your liver's glycogen stores. Moreover, it will force you to use them.

  3. gogge

    Your liver glycogen will be empty either way. The liver will be using gluconeogenesis to cover the lack of dietary glucose, so there won't be enough glucose around to meet the needs much less to get stored as liver glycogen.

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