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Mixed Acidosis Treatment

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Respiratory acidosis #sign and symptoms of Respiratory acidosis Respiratory acidosis ABGs Analyse https://youtu.be/L5MWy1iHacI Plz share n subscribe my chanel is a condition that occurs when the lungs cant remove enough of the Suctioning https://youtu.be/hMJGkxvXTW0 carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic. Normally, the body is able to balance the ions that control acidity. This balance is measured on a pH scale from 0 to 14. Acidosis occurs when the pH of the blood falls below 7.35 (normal blood pH is between 7.35 and 7.45).Rinku Chaudhary NSG officer AMU ALIGARH https://www.facebook.com/rinkutch/ Respiratory acidosis is typically caused by an underlying disease or condition. This is also called respiratory failure or ventilatory failure. Suctioning https://youtu.be/hMJGkxvXTW0 Normally, the lungs take in oxygen and exhale CO2. Oxygen passes from the lungs into the blood. CO2 passes from the blood into the lungs. However, sometimes the lungs cant remove enough CO2. This may be due to a decrease in respiratory rate or decrease in air movement due to an underlying condition such as: asthma COPD pneumonia sleep apnea TYPES Forms of respiratory acidosis There are two forms of respiratory acidosis: acute and chronic. Acute respiratory acidosis occurs quickly. Its a medical emergency. Left untreated, symptoms will get progressively worse. It can become life-threatening. Chronic respiratory acidosis develops over time. It doesnt cause symptoms. Instead, the body adapts to the increased acidity. For example, the kidneys produce more bicarbonate to help maintain balance. Chronic respiratory acidosis may not cause symptoms. Developing another illness may cause chronic respiratory acidosis to worsen and become acute respiratory acidosis. SYMPTOMS Symptoms of respiratory acidosis Initial signs of acute respiratory acidosis include: headache anxiety blurred vision restlessness confusion Without treatment, other symptoms may occur. These include: https://www.healthline.com/health/res... sleepiness or fatigue lethargy delirium or confusion shortness of breath coma The chronic form of respiratory acidosis doesnt typically cause any noticeable symptoms. Signs are subtle and nonspecific and may include: memory loss sleep disturbances personality changes CAUSES Common causes of respiratory acidosis The lungs and the kidneys are the major organs that help regulate your bloods pH. The lungs remove acid by exhaling CO2, and the kidneys excrete acids through the urine. The kidneys also regulate your bloods concentration of bicarbonate (a base). Respiratory acidosis is usually caused by a lung disease or condition that affects normal breathing or impairs the lungs ability to remove CO2. Some common causes of the chronic form are: asthma chronic obstructive pulmonary disease (COPD) acute pulmonary edema severe obesity (which can interfere with expansion of the lungs) neuromuscular disorders (such as multiple sclerosis or muscular dystrophy) scoliosis Some common causes of the acute form are: lung disorders (COPD, emphysema, asthma, pneumonia) conditions that affect the rate of breathing muscle weakness that affects breathing or taking a deep breath obstructed airways (due to choking or other causes) sedative overdose cardiac arrest DIAGNOSIS How is respiratory acidosis diagnosed? The goal of diagnostic tests for respiratory acidosis is to look for any pH imbalance, to determine the severity of the imbalance, and to determine the condition causing the imbalance. Several tools can help doctors diagnose respiratory acidosis. Blood gas measurement Blood gas is a series of tests used to measure oxygen and CO2 in the blood. A healthcare provider will take a sample of blood from your artery. High levels of CO2 can indicate acidosis.

Respiratory Acidosis

Causes of respiratory acidosis include: Diseases of the lung tissue (such as pulmonary fibrosis, which causes scarring and thickening of the lungs) Diseases of the chest (such as scoliosis) Diseases affecting the nerves and muscles that signal the lungs to inflate or deflate Drugs that suppress breathing (including powerful pain medicines, such as narcotics, and "downers," such as benzodiazepines), often when combined with alcohol Severe obesity, which restricts how much the lungs can expand Obstructive sleep apnea Chronic respiratory acidosis occurs over a long time. This leads to a stable situation, because the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance. Acute respiratory acidosis is a condition in which carbon dioxide builds up very quickly, before the kidneys can return the body to a state of balance. Some people with chronic respiratory acidosis get acute respiratory acidosis because an illness makes their condition worse. Continue reading >>

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  1. Vega

    I was shopping at Fiesta today and they have a good selection of untypical meats. I thought I'd check and see if they had beef tongue. It was $8 a pound. I had bought all sorts of things lately like ribeye, brisket, boneless beef ribs, and chuck steaks for no more than $5 a pound. I was shocked that something like tongue would be so expensive.

  2. Chris_W

    I hope not; it will probably get too expensive.

    Tongue is a great LC/ZC protein. It's tender and has a nice texture and flavor.

  3. jmbundy

    It has been really popular here for a while, prime porterhouse is cheaper than tongue here.

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Metabolic Acidosis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find one of our health articles more useful. See also separate Lactic Acidosis and Arterial Blood Gases - Indications and Interpretations articles. Description Metabolic acidosis is defined as an arterial blood pH <7.35 with plasma bicarbonate <22 mmol/L. Respiratory compensation occurs normally immediately, unless there is respiratory pathology. Pure metabolic acidosis is a term used to describe when there is not another primary acid-base derangement - ie there is not a mixed acid-base disorder. Compensation may be partial (very early in time course, limited by other acid-base derangements, or the acidosis exceeds the maximum compensation possible) or full. The Winter formula can be helpful here - the formula allows calculation of the expected compensating pCO2: If the measured pCO2 is >expected pCO2 then additional respiratory acidosis may also be present. It is important to remember that metabolic acidosis is not a diagnosis; rather, it is a metabolic derangement that in Continue reading >>

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  1. Marie

    Hi I am sure I have read somewhere on here that nothing can be done about it but how do you all deal/cope with halitosisi please?
    I am not exaggerating when I say that people recoil or flinch when with me. I know it probably makes you laugh when I say that my daughter holds her nose, I could see the lady at the beauty counter whilst applying my lipstick flinching and holding back and my best friend admitted after duress that my breath smells foul!! ...I have cancelled my regular facials now also as that requires someone leaning over my face. I am soooooo embarrassed!!
    I spray breath spray but that makes no difference. I also drink a min of 2 litres of water throughout the day? Am I able to eat sugar free gum? Although tbh I'm not sure that'll make a lot of difference if it's coming from the gut??
    Please HELP!!
    [ed. note: Marie (2154136) last edited this post 2 years, 1 month ago.]

  2. Ellen

    If its ketosis breath, its more of a pear drops smell and it will pass. But halitosis can also be caused by excess protein. Make sure protein intake is moderate and wait.

  3. Marie

    If it was a pear drop smell Helen I don't think people would be running for the hills! Ha! Ha!
    It's been described as a 'sewage' smell....very embarrassing. I eat protein with my meals as described and required by the diet, definitely not in excess. Dental checks are up to date and normal. Surely someone else on here is or has suffered the same problem and if so has some useful tips to freshen the breath. Apart from wearing a mask over my mouth am not sure what I can do.
    In all seriousness I am getting quite anxious about it now tbh.

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

Approach To The Adult With Metabolic Acidosis

INTRODUCTION On a typical Western diet, approximately 15,000 mmol of carbon dioxide (which can generate carbonic acid as it combines with water) and 50 to 100 mEq of nonvolatile acid (mostly sulfuric acid derived from the metabolism of sulfur-containing amino acids) are produced each day. Acid-base balance is maintained by pulmonary and renal excretion of carbon dioxide and nonvolatile acid, respectively. Renal excretion of acid involves the combination of hydrogen ions with urinary titratable acids, particularly phosphate (HPO42- + H+ —> H2PO4-), and ammonia to form ammonium (NH3 + H+ —> NH4+) [1]. The latter is the primary adaptive response since ammonia production from the metabolism of glutamine can be appropriately increased in response to an acid load [2]. Acid-base balance is usually assessed in terms of the bicarbonate-carbon dioxide buffer system: Dissolved CO2 + H2O <—> H2CO3 <—> HCO3- + H+ The ratio between these reactants can be expressed by the Henderson-Hasselbalch equation. By convention, the pKa of 6.10 is used when the dominator is the concentration of dissolved CO2, and this is proportional to the pCO2 (the actual concentration of the acid H2CO3 is very lo Continue reading >>

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  1. NeuroGeneration

    tl;dr: I have high FBG (100-115) and postprandial for high sugar experiments (can get as high as 143), regardless of diet (it all started with keto, after which I progressed to VLC, paleo and now, 300+ g/day of mostly "clean" carbs), training or not training for 2 weeks, little sleep or a lot of sleep, etc. I am very lean, muscular and active, all of my blood markers are great (hba1c is borderline at 5.6), have no familial history, am not a high-risk ethnic group, and eat very "clean". Theories include potentially being unintentionally hypocaloric, physiological insulin resistance (but its been weeks), disruptive sleep, overtraining (though I believe I disproved this by taking 2 weeks off with the same #s), or something else altogether. Seeing endocrinologist who does not believe it is diabetes, but agrees it's odd. We're running labs next week. Until then, lab results are included in post below. ANY IDEA WHAT COULD BE GOING ON???
    Hi Guys,
    I've been searching for some answers on this issue for a while, and beyond picking up clues, haven't come to any solid answers. Any help is appreciated.
    My issue is high fasting blood glucose (100 - 115) and relatively high post prandial (as high as 143, typically below 140). Now, before you jump to the conclusion of diabetes (which even my new endocrinologist, who's beginning to run tests doesn't think it is), please read on.
    Throughout my life, I've had a high protein, high carb, low-fat (20-25%) diet, up until about 2.5 years ago. I read a Maffetone book and switched to low-carb, whole foods.
    At first I think I went too far, because I was beginning to show signs of depression. I upped the carbs by a bit (1/2 box of Kashi GoLean Crunch each night!) and I felt better. About 15 months ago, I experimented with keto for 6 months. I fell into chronic depression. My friend reminded me, "don't you remember being depressed the first time?", but I was determined. I suspect a lot of the depression was due to terrible sleep, which was constantly interrupted by very low-carb cortisol / catecholamine spikes. I switched to low-carb paleo. Better, but not enough.
    I bought a glucometer during my keto period to check if I was in ketosis. I was consistently above .7. One day I decided to check my FBG and saw that it was 110. This concerned me, but I then read about physiological insulin resistance (more on this below for those unfamiliar). I also seemed to have reactive hypoglycemia, because after experimenting with a few carbs, post prandial would sometimes drop into the 90's.
    While in paleo, consuming 100-150 g/day of carbs, I pulled out the glucometer again, to find that my FBG was still the same (100 - 115). This concerned me. I decided that since I had done well throughout my life with high carb/protein, low fat, I would go back to it. This was about 4 weeks ago. My FBG is still the same, I feel tired when I wake up (I still move a lot in my sleep, but I'm not nearly as conscious when I wake up as I was during low-carb/keto; definitely more restorative than keto). My post-prandial can slightly exceed 140.
    I'm a very active weight lifter and HIIT trainer. My stats below will tell you more about that – but the point is, I'm very much physically healthy, with plenty of muscle that's being depleted daily, theoretically thirsty to swallow up carbs. Also, I find it odd how my fasting & postprandial numbers are the same, regardless of how few or many carbs I ingest, the timing of my meals, whether I go a couple weeks without exercise or I train intensely for days...
    Here's what I already know / have learned:
    Low carb can cause "physiological insulin resistance." This is well-known and accepted among low-carbers. They treat it as low/no long-term risk, though I don't think anyone has proven that to be the case. I'd prefer to have my blood glucose below 90.
    I'm aware of the dawn phenomenon, but that doesn't seem to be the case for me, since I see high numbers at other times, too.
    I once suspected overtraining, but have ruled that out after going two weeks without training, with no changes to my numbers.
    I may currently be calorically restricted. Could this be an explanation? With keto & paleo I was probably eating about 3,000 cals/day. I've come to learn that my basal rate is 1,900, my training uses 600 - 1000, and I walk 5+ miles /day, so my lifestyle probably burns another 1,000. In other words, I should probably be consuming closer to 4,000 calories. The issue right now is that I do not have the appetite to consume 4,000 calories of whole foods, so this week I decided to add in some gluten-free granola & fruits to up my numbers to be closer to my daily expenditure (at least for now, while trying to figure this out).
    I've included some notable quotes related to low carb / high blood glucose at the bottom of this post. Please at least read the quotes before you comment.
    Stats (taken during paleo / moderate carb phase 5 months ago; may have been hypocaloric. I will have new stats in just over a week):
    Male, 29, 9% bf, 5'10 178lbs
    HbA1c = 5.6
    TSH: 1.82
    Free T3: 3.4
    Free T4: 1.2
    Test: 475
    Free Test: 66

    Note: Libido is moderate to low with occasional spikes
    ALT / SGPT, ALP, Billirubin, Albumin, Tot Prot, Globulin, A/G Ratio all good.
    AST / SGOT slightly high (44); could be from alcohol 2 days prior or exercise 1 day prior.
    Kidney health, bone health, blood health, vitamins & minerals all optimal levels.
    hs-CRP: .02
    LDL: 150
    HDL: 90
    Triglycerides: 76
    I'm not gaining weight / fat, other than a small amount from upping my cals and not training much over the past 2 weeks (maybe 1% increase in bf%; I've had 7-10% bf since I was a child, regardless of diet and activity levels).
    My resting heart rate averaged 56 this week.
    My HRV info for this week:

    AVNN: 1104
    SDNN: 94.7
    rMSSD: 67.5
    pNN50: 31.53
    LF: .301
    HF: .116
    Activity:

    Exercise 5-6 days/wk.
    HIIT 2 days
    weights 4 days
    Most workouts are 45 - 70 minutes
    I throw in some 5-6 mile cardio about 1x/wk
    I meditate daily and do not feel much anxiety / stress. Nearly all of my stress would be physiological.
    Diet & Sleep:

    2.5 years ago: Low-carb diet (not strict, but I'd estimate 150-200 g/day)
    1 year ago: I followed keto for 6 months; began blood glucose / ketone readings, noticed high levels of FBG. Believed it to be gluconeogenesis via physiological insulin resistance
    6 months ago: I switched to VLC / low carb (100-150g/day). Issue remained.
    1.5 months ago: I stopped experimenting with 2x weekly 16-18 hour fasts, after about 9 months
    1 month ago: I progressively added more carbs in.
    Poor sleep for past 18+ months. I fall asleep immediately, but toss and turn a lot (video). I get about 3 periods of 40-50 mins of no movement per night.
    When I'm low-carb, I consciously wake up, energized. When I'm higher carb, I wake up, though barely consciously. I fall back asleep more easily too, with carbs. I presume it's cortisol spurring gluconeogenesis?
    Theories:
    I considered overtraining. I took nearly 2 weeks off with no changes, and have therefor ruled this out.
    I considered low-carb, so I upped my carbs into the hundreds of grams (300-400 /day).

    Note, my mood is much improved after adding carbs back in, but blood glucose issues remain.
    I considered hypocaloric diet. Low carb paleo made me less hungry. Or, rather, not feeling the sensation of hunger as often (no more cravings for food). Over the past 2 weeks I've experimented and have found that I can eat more food than I thought, without feeling full. Being hypocaloric is a theory, leading to blood sugar regulation issues, but I haven't come across many papers on this.
    Poor sleep contributing to poor cortisol / blood sugar control, sparking a negative feedback loop?
    Stimulants. I removed them (coffee, tea) completely for a week with no effect.
    Thoughts:
    The fact that my numbers don't shift no matter what I do to my diet (add calories, remove calories, add carbs, add sugar, reduce training), my postrprandial never goes beyond 143 even when I have a "test" dessert fest and I never go below 80, I have no familial history, all other blood markers are great, I'm very fit, and these issues persist regardless of carb intake, makes me believe that it's not t1 or t2 diabetes.
    Maybe I'm still not getting enough calories and need to continue to up them? This will be hard with "clean" calories; I think it would require cereals or sugary foods for me to go any higher with my intake at this point.
    Some people on low carb forums state that it takes them 3+ weeks for their FBG to normalize after adding carbs back in (much longer than the 3 days for an OGTT that some quote). Maybe I take a little longer and should give it another week or two?
    Maybe I need to change my final meal timing / size / macronutrient composition, to prevent gluconeogenesis during my sleeping "fast"? Though, I have tried lots of honey (3 tbsp) / cottage cheese (2-3 servings) / nuts (small handful) just before bed with no effect.
    Maybe I'm totally off and it's something else altogether?
    QUOTES / RESOURCES
    "...asked about his gradual yet progressively rising fasting blood glucose (FBG) level over a 10 year period of paleolithic LC eating. Always eating less than 30g carbohydrate per day. Initially on LC his blood glucose was 83mg/dl but it has crept up, year by year, until now his FBG is up to 115mg/dl. Post prandial values are normal. He wanted to know if he was developing diabetes." http://high-fat-nutr...istance.html[1]
    "Still, a complaint that one sees a lot from people who have been doing glycogen-depleting exercise and intermittent fasting for a while is that their fasting blood glucose levels go up. This is particularly true for obese folks (after they lose body fat), as obesity tends to be associated with low GH levels, although it is not restricted to the obese. In fact, many people decide to stop what they were doing because they think that they are becoming insulin resistant and on their way to developing type 2 diabetes. And, surely enough, when they stop, their blood glucose levels go down." http://healthcorrela...ing.html?m=1[2]
    "Now I had something to tell my dad and others who'd been faithfully doing LC and became horrified, then scared, at fasting blood glucose measurements (which is primarily how the health community screens people for diabetes). I really didn't concern myself with it again—for all these last almost 7 years. OK, so long as post-prandial is fine (caveat: AFTER AN LC MEAL!), nothing to worry about; and combined with good HbA1c, and the fact that so far as we know, this condition will reverse in normal people after a few days of carbage, then just relax.
    ...That was until earlier this year when one of my collaborators, "Duck Dodgers," clued me into something. What if there are no populations on earth that we know of where you can observe the long-term effects of "physiological insulin resistance?""
    ..."then you would expect them to feature "physiological" insulin resistance—just like the thousands of LCers in various forums, my blog comments, and in my dad—right?" http://freetheanimal...hydrate.html[3]

  2. StevesPetRat

    Try thiamine.
    If you require more details, ask.

  3. xEva

    NeuroGeneration, I did the read your whole post, only skimmed it, but this is very common in people who were recently in ketosis due to fasting or a ketogenic diet. It's good that you monitor your BG, that's the best thing to quickly learn what works for you (and how a lot of popular books about diets a wrong or at least incomplete).
    First, it takes 2-3 weeks to adjust to living mostly on glucose (just as it takes a while to adapt to a ketosis). Second, paradoxically, increasing carbs --even simple carbs!-- at the last meal of the day, while at the same time eschewing fats, will get your BG in the normal range quickly. Also B5 and some other vitamins/supplements help, but not as fast as switching to higher carbs and low to no fats. You need to do this only for a while, a week or two, while you adjust. That was my experience.
    This has to do with an ancient adaptation to "ketosis of starvation", when glucose is deliberately ignored by the skeletal muscles as 'protein-sparing' strategy. High levels of fatty acids stimulate this adaptative response (and fatty acids remain high after ketosis due to simple metabolic enertia, that's why eschewing fats for a while helps).
    Also, you need to consider what diet is best for you long-term. You can be on any type of a diet if it is severely calory-restricted. But if your intake of calories is more or less normal, you have to choose either keto or carb. Remaining in this in-between land is no good, as it keeps your glucose levels chronically high and can lead to real insulin resistance.
    Edited by xEva, 13 February 2015 - 06:41 PM.

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