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Nejm Lactic Acidosis

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Causes Of Low Blood Pressure(Hypotension): In this video, we shared information about causes of low blood pressure(hypotension) - what causes blood pressure to drop - hypotension causes. Subscribe to our channel for more videos. Watch: (https://www.youtube.com/watch?v=ivQE7...) What Causes Low Blood Pressure? The cause of low blood pressure isn't always clear. It may be associated with the following: * Pregnancy * Hormonal problems such as an underactive thyroid (hypothyroidism), diabetes, or low blood sugar (hypoglycemia) * Some over-the-counter medications * Some prescription medicines such as for high blood pressure, depression or Parkinsons disease * Heart failure * Heart arrhythmias (abnormal heart rhythms) * Widening, or dilation, of the blood vessels * Heat exhaustion or heat stroke * Liver disease What Causes a Sudden Drop in Blood Pressure? Sudden drops in blood pressure can be life-threatening. Causes of this type of hypotension include: * Loss of blood from bleeding * Low body temperature * High body temperature * Heart muscle disease causing heart failure * Sepsis, a severe blood infection * Severe dehydration from vomiting, diarrhea, or fever * A reaction to medication

Hypotension, Tachycardia, Tachypnea, Lactic Acidosis: Causes & Diagnoses | Symptoma.com

The signs of MH include hypercarbia, muscle rigidity, fast-rising body temperature, tachycardia, myolysis, increased ETCO 2 , hyperkalemia, and acidosis. [ryanodex.com] Manifestations can include muscle rigidity, hyperthermia, tachycardia, tachypnea, rhabdomyolysis, and respiratory and metabolic acidosis. [msdmanuals.com] , cyanosis, hyperkalaemia, lactic acidosis, fever, and eventually (if untreated) death. [anaesthesia.mh.org.au] Later signs include complex arrhythmias, cyanosis, hypoxia, hypotension, electrolyte abnormalities, rhabdomyolysis and severe hyperthermia. [patient.info] Fever or hypothermia, leukocytosis or leukopenia, tachypnea, and tachycardia are the cardinal signs of the systemic response, that is often called the systemic inflammatory [accessmedicine.mhmedical.com] Components of SIRS include tachycardia, tachypnea, hyperthermia or hypothermia, and elevated white blood count. [medpagetoday.com] Sodium bicarbonate for the treatment of lactic acidosis. [enotes.tripod.com] Ketamine Drug of choice as it is relatively safe in hypotension and tachycardia. [emergencymedicinecases.com] Electrocardiography (ECG) often demonstrates sinus tachycardia. [symptoma.com] Diabeti Continue reading >>

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  1. doug684

    Ketosis can cause damage to kidneys and liver

    So I'm about to fire up a keto regiment (again, I always fall off the wagon after about 2 months). Just searching around as it seems the other two times I started it I tend to have diarrhea a lot. Anyway, came across this. Any truth to this?

    When protein is deflected in this manner, it releases nitrogen into the blood stream, placing a burden on the kidneys as they try to excrete excessive urinary water due to sodium loss. When fat is likewise deflected, the breakup releases fatty acids, or ketones, into the bloodstream, further burdening the kidneys. If ketosis continues for long periods of time, serious damage to the liver and kidneys can occur, which is why most low-carbohydrate, or ketogenic diets recommend only short-term use, typically 14 days.
    http://www.holisticonline.com/remedi...nd-ketosis.htm

  2. Eileen

    I don't know where to start.
    Okay, I'll start with the assumption that keto is high protein. No, it's not, it's moderate protein compared with standard BB diets. The dangers of protein to the kidneys would apply far more to a 40/40/20 diet than to a keto one. If they applied. But they don't. People with damaged kidneys can not tolerate high levels of protein. So some "experts" have extrapolated this to mean that high levels of protein can damage healthy kidneys. Except there has not been one single case of this ever, in the history of recorded medicine.
    Most keto diets do not recommend 14 days or less, that's the classic way to do it wrong. Most low carb diets recommend making it a lifestyle.
    And again, where is the evidence that ketones do any damage to liver or kidneys or any other organ? Not a single case. The closest to damage from a low carb diet comes from the odd nutcase who tries to combine keto with no liquid, which does put stress on the kidney (just like any other diet which does not include liquid) but because keto is slightly diuretic, you'll see the effects a little quicker.

  3. doug684

    Originally Posted by Eileen
    The closest to damage from a low carb diet comes from the odd nutcase who tries to combine keto with no liquid, which does put stress on the kidney (just like any other diet which does not include liquid) but because keto is slightly diuretic, you'll see the effects a little quicker.

    There are people who try that? I don't see how. Keto makes me thirsty and will often drink constantly as long as my glass of water is full.

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[nejm]nutrition In The Acute Phase Of Critical Illness

[NEJM]Nutrition in the Acute Phase of Critical Illness N Engl J Med 2014; 370:1227-1236 March 27, 2014 DOI: 10.1056/NEJMra1304623 Critically ill patients requiring vital organ support in the intensive care unit (ICU) commonly have anorexia and may be unable to feed volitionally by mouth for periods ranging from days to months. Unless such patients are provided with macronutrients in the form of enteral or parenteral nutrition, they accumulate an energy deficit that rapidly reaches proportions that contribute to lean-tissue wasting and that are associated with adverse outcomes.1 The catabolic response to acute critical illness is much more pronounced than that evoked by fasting in healthy persons, since the energy deficit in acutely ill patients is often superimposed on immobilization and pronounced inflammatory and endocrine stress responses. Severe skeletal-muscle wasting and weakness occurring during critical illness are associated with a prolonged need for mechanical ventilation and rehabilitation.2 In many studies, the degree of energy deficit accumulating in critically ill patients is strongly associated with the duration of stay in the ICU, which, in turn, is associated with Continue reading >>

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  1. walkerwally1

    Interpreting the ReliOn Ketone Test Strips

    I have been low carb, less than 25g/day, for the last week and was sure I was in ketosis but thought I would check with the ReliOn test strips from Walmart. My result was 40mg/dl on their chart which they call moderate. Everything I have read lists ketones as mmol and it is said ketosis is from 0.5 to 5.0 mmol. I thing 40mg/dl converts to about 2.2 mmol but I am not sure. If someone understands this better than me I would like to know if I am doing the conversion right.
    I am currently reading a book about Low Carb Living:
    The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable: Stephen D. Phinney, Jeff S. Volek: 9780983490708: Amazon.com: Books
    I think this is one of the best books I have found so far, not better than Dr. Bernstein's or Jenny Ruhl's, but a great compliment to the lchf WOE. It goes into great detail about the science of low carb and why it works and is more natural than our high carb diets. It is written to inform professionals and they invite you to give a copy to your Doctor. The link is to Amazon so you can get more info and see some of the reviews it has received. I have no connection to this book or authors other than being impressed.

  2. Steve3129

    Quote:

    Originally Posted by walkerwally1
    I have been low carb, less than 25g/day, for the last week and was sure I was in ketosis but thought I would check with the ReliOn test strips from Walmart. My result was 40mg/dl on their chart which they call moderate. Everything I have read lists ketones as mmol and it is said ketosis is from 0.5 to 5.0 mmol. I thing 40mg/dl converts to about 2.2 mmol but I am not sure. I use these strips as well, but the only thing they tell you is if you are spilling Ketones in the urine, excess Ketones at that. The color code really doesn't tell you more other than the darker the color, the more your kidneys are taking out of the blood.
    You have to get a special meter and strips to accurately measure blood Ketones, which is rather expensive and I'm not willing to buy. I'm satisfied to know that I'm producing Ketones by the excess production as indicated by the strip.

  3. MCS

    If your showing any color on the urine test strip your in ketosis.

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Biolab Medical Unit London Uk - Tests

Samples have to be separated and frozen immediately after collection D-lactate is produced from non-absorbed carbohydrates by colonic bacteria (which may also proliferate in the ileum). The absorption of large amounts of D-lactate can cause metabolic acidosis, altered mental status and a variety of other neurologic symptoms, in particular dysarthria and ataxia [2,3,4]. Its measurement is part of the differential diagnosis of chronic fatigue syndrome [5]. Although a temporal relationship has been described between elevations of plasma D-lactate and the accompanying encephalopathy, the exact neurological mechanisms remain undescribed [6]. Otherwise healthy children with gastroenteritis may also develop D-lactic acidosis. There are a number of other tests of gastro-intestinal function available from Biolab the gut fermentation test, the PEG profile (gut permeability), the measurement of plasma short-chain polypeptides and the lactulose breath hydrogen test. Each of these tests provides somewhat different information from the D-lactate test, which is specific for the presence of D-lactate-producing bacteria in the gut (probably Enterococcus and Streptococcus spp. [5]). Unaffected subj Continue reading >>

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  1. holymolysoly

    I am on day 21 and my husband has remarked on several occasions that my breath is absolutely horrific and offensive. After some searching in this forum and online, it seems the most likely culprits are ketosis and acetone breath from the over-consumption of protein? I dont think either of these are possible culprits, but over the last few days, I have increased my starchy veggie consumption to two per day and my husband said it hasn't helped. I am a nursing mamma to an almost 2 year old, so I figured I could use the extra starchy veggie because he still nurses 4 to 6 times in a 24 hour period. I follow the meal template fairly strictly so I don't think I am lacking or overdoing it in terms of protein or plant based starches/carbs. I feel great and want to continue with a very slow reintroduction of just a few things but my husband said he can barely tolerate the next 9 days and he is looking forward to me eating "normally" and my bad breath issue resolving ASAP. Any suggestions ? I really would like to make this way of eating a lifestyle and the breath issue is the only impediment for me.

  2. ladyshanny

    On July 25, 2016 at 10:12 PM, holymolysoly said:



    I am on day 21 and my husband has remarked on several occasions that my breath is absolutely horrific and offensive. After some searching in this forum and online, it seems the most likely culprits are ketosis and acetone breath from the over-consumption of protein? I dont think either of these are possible culprits, but over the last few days, I have increased my starchy veggie consumption to two per day and my husband said it hasn't helped. I am a nursing mamma to an almost 2 year old, so I figured I could use the extra starchy veggie because he still nurses 4 to 6 times in a 24 hour period. I follow the meal template fairly strictly so I don't think I am lacking or overdoing it in terms of protein or plant based starches/carbs. I feel great and want to continue with a very slow reintroduction of just a few things but my husband said he can barely tolerate the next 9 days and he is looking forward to me eating "normally" and my bad breath issue resolving ASAP. Any suggestions ? I really would like to make this way of eating a lifestyle and the breath issue is the only impediment for me.
    Hi,
    The most common culprits is ketosis but could also be from dehydration causing dry mouth which allows bacteria to breed.
    If would be most helpful if you would outline your last few days of food including portion sizes, specific vegetables/fat types and quantities, fluids, exercise etc. We can take a look and see if anything stands out.

  3. holymolysoly

    Thanks so much for the response. I generally walk between 5-7 miles a day and sleep is disrupted with several night time wake-ups since my son does not sleep through the night yet.
    Here's what my days have looked like:
    M1 - 3 scrambled eggs cooked in ghee
    1/3 of a 6 inch in diameter acorn squash drizzled with some EVOO
    1 trader joe's bag of organic spinach, steamed to yield about a cup
    1/2 cup coconut milk in coffee
    M2 - 3 turkey meatballs (each a bit smaller than a tennis ball),
    1 cup home made complaint marinara
    2 cups green beans (steamed)
    2 tbsp ghee mixed into marinara after cooking
    M3 - 1 and a half boneless skinless chicken thighs cooked into a curry with
    1 cup broccoli, 1/2 cup red peppers
    Served atop cauli rice with 1-2 tbsp of ghee mixed in after cooking
    Yesterday
    M1 - Fritatta made with 2 eggs, 1/4 cup ground chicken, asparagus, zucchini, onions, spinach
    roasted potatoes with herbs
    1/2 cup coconut milk with coffee
    M2 - Buffalo chicken spaghetti squash bake (PaleoOMG recipe)
    Mixed greens with tomato and cucumber, EVOO and balsamic
    M3 - ground turkey with 2 cups of veggies (same as in morning fritatta) with 1-2 tbsp of ghee mixed in after cooking
    I practice good oral hygeine and brush and floss twice a day. I have been carrying around mouth wash and using that several times a day as well. I can't tell that my breath smells bad. Also, I never had this issue before W30, and do not have any underlying medical conditions that could be causing this. My husband mentioned bad breath to me the last time I did a W30 in October of 2013, but he doesn't recall it being as severe as it is now. About a week ago, I ate squash or potato at every meal for 2 or 3 days and my husband said it wasn't as rancid but that he could still smell it.

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