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Metabolic Acidosis Treatment Guidelines Pdf

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Prolonged Resuscitation Of Metabolic Acidosis After Trauma Is Associated With More Complications

Prolonged resuscitation of metabolic acidosis after trauma is associated with more complications Optimal patterns for fluid management are controversial in the resuscitation of major trauma. Similarly, appropriate surgical timing is often unclear in orthopedic polytrauma. Early appropriate care (EAC) has recently been introduced as an objective model to determine readiness for surgery based on the resuscitation of metabolic acidosis. EAC is an objective treatment algorithm that recommends fracture fixation within 36h when either lactate <4.0mmol/L, pH 7.25, or base excess (BE) 5.5mmol/L. The aim of this study is to better characterize the relationship between post-operative complications and the time required for resuscitation of metabolic acidosis using EAC. At an adult level 1 trauma center, 332 patients with major trauma (Injury Severity Score (ISS) 16) were prospectively treated with EAC. The time from injury to EAC resuscitation was determined in all patients. Age, race, gender, ISS, American Society of Anesthesiologists score (ASA), body mass index (BMI), outside hospital transfer status, number of fractures, and the specific fractures were also reviewed. Complications in th Continue reading >>

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  1. Renfairewench

    Ketosis Tongue or Thrush?

    Seriously, as I sit and write this I am in tears. I simply am not physically nor mentally capable of handling one more issue, but here I am with one more thing that seemingly is going wrong. I'm at this point where I simply want to give up. And by give up I mean, stop feeding, stop drinking, stop taking my meds. I feel miserable all the time and I'm wishing that I never went and had a revision. I'll bet you don't hear that from many people, but I'm blunt and honest in that I'm sick of complications. I'm so depressed that even my all is bright and beautiful meds are not helping me at all. I had my operation on 8/10, I was back in the OR on 8/12. Then they discovered a leak. I've been NPO ever since. I was supposed to be released on 8/21, but my stomanch sprung a leak and my incision had to be opened up to allow for drainage. I was not released until 8/26. I came home for 3 days and was sent back to the hospital for an infected pic line and a DVT (Blood Clot) in my arm. I was in the hospital for that 4 or 5 days. Then I come home for another 4 days to have my husband discover that my open incision was spewing pus everywhere. Back to the hospital for another 5 days. I just got out Friday. I've been on antibiotics since 8/11 and have develoved a case of VRE thanks to being on Vancomycin and being in the hospital. Nothing to worry about really except that I could infect my family if I am not diligent about washing my hands, using alcohol hand cleaner and putting bleach in the tolie****er each time I pee or poo, oh and wiping down the seat with bleach wipes too.
    My water intake is limited by what I can push in my J tube. Since I have a leak and an active infection I have to limit my drinking to 4 to 8 oz. a day of water a day. I am allowed water or ice chips. Nothing more. No tea, no coffee, no crystal lite, nothing. I've been NPO since Aug. 10. I'm pretty goddamned tired of having nothing to eat. As for eating, I'm on 1400 CC of Osmolite a night delivered directly into my intestines via my stupid J tube.
    So today I have felt like I have fur on my tongue. I thought it was because I had not brushed my teeth. I took a look in the mirror and I am horrified at what I see. My entire tongue is covered in a white thick mucous like substance. Brushing my teeth and tongue did not make it go away either. It's still there. I looked up Thrush and it looks like if you have Thrush that there is significant pain involved, but I don't have any pain. I do feel like I have something stuck in the back of my throat though. I've heard other's talk about Ketosis tongue, but I'm not sure what that really is.
    I know that you are not doctors, but I was wondering what your advice is as to what this could be. I have an appointment with my doctor tomorrow to check my blood levels and to adjust my coumadin and will show him this, but I'd like to get a little advice on what you think this might be.

  2. Redhaired

    I had thrush and there was no pain. I tried the liquid stuff and the lozenges, they were nasty and made me sick to my stomach. Finally one day I was speaking with my hematologist and told him about it and I remember very clearly he said "oh we can do better than that". He gave me a prescription for diflucan and it was gone in something like two days!
    It sounds like you have a bad case of thrush.
    red

  3. Renfairewench

    Is it something you swish with? I'm currently on diflucan via IV. I am not allowed to swallow anything.

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Payperview: Metabolic Acidosis And Protein Catabolism: Mechanisms And Clinical Implications - Karger Publishers

I have read the Karger Terms and Conditions and agree. Metabolic acidosis increases protein degradation resulting in muscle wasting and a negative nitrogen balance. The branched-chain amino acids serve as useful markers of these changes and their catabolism is increased in acidosis, particularly for the spontaneous acidosis associated with renal failure. As a result, the neutral nitrogen balance is compromised and malnutrition results. Glucocorticoids mediate these changes through the recently discovered ATP-dependent ubiquitin-proteasome pathway. Therapy necessitates correction of the underlying acidosis either through adjustment of the alkalinity of the dialysate for the patient on dialysis or through dietary protein restriction and sodium bicarbonate supplements for the predialysis patient. Bright R: Reports of medical cases selected with a view to illustrating the symptoms and cure of diseases by a reference to morbid anatomy. London, Longman, Rees, Orme, Brown and Green, vol2, 1831. Lyon DM, Dunlop DM, Stewart CP: The alkaline treatment of chronic nephritis. Lancet 1931;2:10091113. Blom van Assendelf PM, Dorhout Mees EJ: Urea metabolism in patients with chronic renal failure: Continue reading >>

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  1. Voileen

    Ok not really . . . but I was told today by a VERY passionate Human Nutrition student. I've also read a few other studies that warn against long term dangers of eating Keto (longterm). I'd like to try to find some scientific evidence to back up that it is good (and to also reassure myself) . . . thoughts? Research? Articles?
    Here was what she sent me:
    I am in my last year as a BSc Human Nutrition and I have several things to say about the ketogenic diet, which I won't say in totality here because it will probably be a book.
    I'll summarize: Ketogenic diets are NOT okay for your body. Metabolically, ketogenic diets are a last resort once your body is expended of all its energy and begins to burn fat and protein instead of carbs as energy. As such, breakdown products are not easily metabolized by the body in the way that carbohydrate, your body's #1 fuel source, is. It's extremely unhealthy, creates toxic byproducts ("free radicals" if that means anything to you; it's hard on your liver) and actually ends up lowering more of your muscle mass than your fat mass in your body. You will lower your muscle mass as your body burns ketones (breakdown products of both fat and muscle tissue; primarily muscle as it is easily broken down wrt stored fat), thereby decreasing your resting metabolic rate and inducing false starvation, encouraging your body to burn MORE muscle (it's broken down more easily than fat) and starting a really bad circle. also your brain runs EXCLUSIVELY on glucose (a carb; a sugar) and inducing ketosis in your body reduces this fuel heavily. Carbohydrates are essential in every diet to fuel the brain: at least 120g per day for the average person. Pls don't deprive yourself of carbs, your brain needs them heart emoticon (also the rest of your body needs them, as they serve essential metabolic functions in terms of cellular regeneration, immune function and general maintenance pls take care of your body)

  2. FrigoCoder

    Metabolically, ketogenic diets are a last resort once your body is expended of all its energy
    That would be starvation.
    and begins to burn fat and protein instead of carbs as energy.
    Burning fat is kinda the point. Protein usage is actually less than when you suddenly run out of glycogen on a high carb diet. This is why keto is "muscle sparing" during diets. It's not that keto is magical, it's that the lack of the ability to burn fat efficiently means the body will try to derive glucose from protein when short on energy.
    As such, breakdown products are not easily metabolized by the body in the way that carbohydrate, your body's #1 fuel source,
    This is why we need an adaptation period where the body sets up the necessary metabolic machinery to metabolize fat and ketones efficiently. Besides, ethanol is the most readily metabolized, does it mean it is the #1 fuel source?
    It's extremely unhealthy,
    Hundreds of thousands, if not millions of people are on keto without major issues. The same can not be said for carbohydrate-rich diets.
    creates toxic byproducts ("free radicals" if that means anything to you;
    It actually produces less waste for the same amount of energy. It might produce more hydrogen peroxide according to a rat study, but endogenous antioxidant defenses are upregulated to deal with it. It helps against grey hair, which is caused by the loss of ability to deal with hydrogen peroxide. Hmmm now that I think about it, it might even work against vitiligo.
    it's hard on your liver)
    Glycogen storage and retrieval, de novo lipogenesis, carbohydrate-induced lipotoxicity and hyperglycemia, fatty liver are arguably much worse for your liver than ketogenesis.
    and actually ends up lowering more of your muscle mass than your fat mass in your body
    Not if you give it enough protein. I am actually able to gain strength and muscle on keto and StrongLifts as opposed to 2-3 years of high carb diet and overtraining.
    You will lower your muscle mass as your body burns ketones (breakdown products of both fat and muscle tissue; primarily muscle as it is easily broken down wrt stored fat),
    I do not think it is possible to convert amino acids into ketones. At least not without converting them to fat first, which I doubt happens to muscle protein.
    thereby decreasing your resting metabolic rate and inducing false starvation,
    Metabolic rate is downregulated only after prolonged fasting, and is not modified during keto. In fact, energy levels can increase. Keto resembles starvation much less than commonly thought. A full-fledged starvation response between hunts would not make any sense from an evolutionary point of view.
    encouraging your body to burn MORE muscle (it's broken down more easily than fat) and starting a really bad circle.
    Again, keto encourages fat usage over muscle breakdown.
    also your brain runs EXCLUSIVELY on glucose (a carb; a sugar)
    The brain has only a very small requirement of glucose that can not be substituted by ketones, somewhere around 20-30 grams. Moreover, this amount can be fully synthesized from protein, of which dietary protein is preferred by the body.
    and inducing ketosis in your body reduces this fuel heavily.
    Keto does not reduce the availability of glucose, it reduces the usage. Your serum glucose stays roughly the same, assuming it was normal in the first place. Tissues that rely on glucose continue to function in the same way. Diabetics and prediabetics often see the normalization of serum glucose, which is a good thing obviously.
    Carbohydrates are essential in every diet to fuel the brain:
    Dietary carbohydrates are non-essential. This is demonstrated by the continued existence of /r/zerocarb people.
    at least 120g per day for the average person.
    I actually consider 120 grams of carbohydrates the cutoff limit for low carb diets. Serum glucose and liver glycogen can only hold the equivalent of 120 grams of carbohydrates. If you eat less than that, you are guaranteed not to fill your liver glycogen, and your body has to look for other sources of energy. The average person should eat less than 120 grams of carbohydrates to maintain metabolic and general health.
    Pls don't deprive yourself of carbs, your brain needs them heart emoticon
    No it doesn't, middle finger emoticon.
    (also the rest of your body needs them, as they serve essential metabolic functions in terms of cellular regeneration, immune function and general maintenance pls take care of your body)
    Again, processes that require glucose continue to function normally.
    I am in my last year as a BSc Human Nutrition and I have several things to say about the ketogenic diet, which I won't say in totality here because it will probably be a book.
    Do a few years of research first before even considering a book, you are woefully inexperienced on the subject. I have a comp sci degree and still know more on the subject for fucks sake.

  3. Rawrcasm

    No it doesn't, middle finger emoticon.
    I felt gold was necessary for this line alone.

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Acid-base Balance And Metabolic Acidosis In Neonates

Your browser does not support the NLM PubReader view. Go to this page to see a list of supporting browsers. Acid-base Balance and Metabolic Acidosis in Neonates J Korean Soc Neonatol. 2010 Nov;17(2):155-160. J Korean Soc Neonatol. 2010 Nov;17(2):155-160. Korean. Published online November 30, 2010. Copyright 2010 by the Korean Society of Neonatology Acid-base Balance and Metabolic Acidosis in Neonates Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. Correspondence to Byong Sop Lee, M.D., Ph.D. Division of Neonatology, Department of Pediatrics, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3929, Fax: +82-2-3010-6978, Email: [email protected] Received October 25, 2010; Accepted November 18, 2010. This article has been cited by GoogleScholar. Metabolic acidosis is commonly encountered issues in the management of critically ill neonates and especially of preterm infants during early neonatal days. In extremely premature infants, low glomerular filtration rate and immaturity of renal tubules to produce new bicarbonate causes renal bicarbonate loss. Higher intake Continue reading >>

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Popular Questions

  1. shaffan33

    Does anyone else get heart palpitations, muscle twitches, random numbness ( a lot of times in my left temple), tiredness, when in Ketosis? I know you're supposed to go into ketosis atleast once a week, but these symptoms are making it hard. Anyone have any suggestions?

  2. enhancededdie

    I've been noticing I've been getting heart palpitations too, recently. However, it may be due to the mycotoxins that I've carelessly absorbed when eating food that I don't prepare. I take activated charcoal for that, but I still seem to get it sometimes. I've assumed this was due to mycotoxins, but come to think about it, ketosis may be something I should be aware of also, since this is something I haven't done before either. Hopefully other people have some insight into this.

  3. Meghan0825

    All of the above except the random numbness.. but I don't know if I'm in Ketosis... never tested... and I think I eat at least 100 carbs a day..

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