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Respiratory And Metabolic Acidosis And Alkalosis

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Abg: Respiratory Acidosis/metabolic Alkalosis

Home / ABA Keyword Categories / A / ABG: Respiratory acidosis/metabolic alkalosis ABG: Respiratory acidosis/metabolic alkalosis A combined respiratory acidosis / metabolic alkalosis will result in elevated PaCO2 and serum bicarbonate. Which process is the primary disorder (e.g. primary respiratory acidosis with metabolic compensation versus primary metabolic alkalosis with respiratory compensation) is dependent on the pH in an acidotic patient, the acidosis is primary (and the alkalosis is compensatory) and vice versa. Compensation behaves in accordance with the following rules: Metabolic Acidosis: As bicarbonate goes from 10 to 5, pCO2 will bottom out at 15. pCO2 = 1.5 x [HCO3-] + 8 (or pCO2 = 1.25 x [HCO3-]) Metabolic Alkalosis: compensation here is less because CO2 is driving force for respiration. pCO2 = 0.7 x [HCO3-] + 21 (or pCO2 = 0.75 x [HCO3-]) Acutely: [HCO3-] = 0.1 x pCO2 or pH = 0.008 x pCO2 Chronically: [HCO3-] = 0.4 x pCO2 or pH = 0.003 x pCO2 Respiratory Alkalosis: Metabolic compensation will automatically be retention of chloride (i.e., hyperchloremic, usually referred to as loss of bicarb although it is the strong ion difference that matters). If you have an anion Continue reading >>

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  1. fhinix

    I have been following a ketogenic diet for the last 6 weeks. I even bought a ketone meter and my ketones measure 3.0 mmol on a fairly regular basis so I know that I am producing adequate ketones, but I am totally exhausted. I am on the verge of giving up. My macros are 83% fat, 3% carbs, and 14% protein. I am eating only moderate levels of protein, and my carbs are around 15 grams or below. I am having no fruit and no nuts. My carbs are only salad vegetables like kale, lettuce, spinach, or chives. Protein is mostly meat, eggs, and some cheese. Fat is coming from coconut oil, and ghee. I also am taking a teaspoon of salt twice a day to make sure that my sodium levels are adequate. I am not eating enough protein to disrupt ketosis as my ketone meter clearly indicates. My energy levels are extremely low, and I do not have increased mental clarity. Please help. I have been super strict and it does not appear to be working. I track my food daily in an online food log and I am very specific.
    Am I just one of those people that does not function well on a ketogenic diet? Any suggestions?

  2. Reka

    You are one of the SEVERAL people who don't function well on this.
    Just check out these threads:
    http://forum.bulletproofexec.com/index.php?/topic/12376-too-much-if-and-extensive-fatigue/
    http://forum.bulletproofexec.com/index.php?/topic/10904-anyone-getting-adrenal-fatigue-with-prolonged-intermittant-ketosis/?hl=adrenal
    http://forum.bulletproofexec.com/index.php?/topic/9436-what-the-fgetting-frustratedplease-criticize/page-3?
    http://forum.bulletproofexec.com/index.php?/topic/12563-coconut-water-and-bananas-to-the-rescue/
    http://forum.bulletproofexec.com/index.php?/topic/12417-adrenal-fatigue/page-2#entry97182
    Unless you have a condition to which constant keto is the solution I advise you to refeed with carbs, as mentioned in all these threads. 150-200 grams of net carbs 1-2 times a week.

  3. DMan

    After long term ketosis start reintroducing carbs slowly! I might make you feel sick if you start eating lots of carbs all of a sudden...

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Metabolic Acidosis Or Respiratory Alkalosis? Evaluation Of A Low Plasmabicarbonate Using The Urine Anion Gap.

1. Am J Kidney Dis. 2017 Sep;70(3):440-444. doi: 10.1053/j.ajkd.2017.04.017. Epub2017 Jun 7. Metabolic Acidosis or Respiratory Alkalosis? Evaluation of a Low PlasmaBicarbonate Using the Urine Anion Gap. Batlle D(1), Chin-Theodorou J(2), Tucker BM(3). (1)Division of Nephrology & Hypertension, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: [email protected] (2)Division of Nephrology & Hypertension, Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL. (3)Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT. Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is afinding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratoryalkalosis and mixed metabolic acidosis and chronic respiratory alkalosis.Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy.Proper diagnosis of the cause of hypobicarbonatemia requires integration of thelaboratory values, arterial blood gas, and clinical history. Th Continue reading >>

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  1. K.Smith

    Why are ketones and aldehydes two different categories? To me it seems like aldehydes should be a subset of ketones. Since the general formula for ketones is CnH2n+1COCmH2m+1 and for aldehydes it is CnH2n+1COH which is just the formula for ketones but with m=0.
    I am not looking for an opinion, but rather an explanation behind the reasons to have two different groups. Are there any inherent differences between them in how they react with other compounds or how they are produced?

  2. gannex

    Ketones are to aldehydes as ethers are to alcohols. You could extend this to water. Is water formalcohol? Once you begin to explore the periodic table deeply enough, you will see that there is no distinctions really exist. Only trends. The same is true of organic structure. Organic chemistry is a continuum and the groups we create are constructs -- but they are not arbitrary. Especially in organic chemistry, we group things into these categories because they help us to make assumptions based on consistent trends in reactivity. Ketones and aldehydes have significantly different chemistry. There is only a minor difference between the chemistry of acetone and butanone, but there is a pretty big difference between the chemistry of acetone and acetaldehyde.
    To make a long story short, aldehydes are categorized differently because their chemistry varies significantly enough that different sorts of reagents are needed for the same types of reactions.
    Aldehydes are much more electrophilic. This is because they don't have the electron donating effect of an alkyl group. Aldehydes have much more acidic alpha-protons. Aldehydes are also more easily oxidized. Aldehydes pose problems different problems in synthesis. For Their non-acidic proton, for example can be hard to remove for substitution.
    An interesting example of a useful tool for dealing with aldehyde protons is dithiane chemistry. You can use a dithiane protecting group to make the aldehyde proton acidic, substitute it, then put the oxygen back on in a deprotection step.

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Acid-base Disorders - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincents Ascension Health, Birmingham Acid-base disorders are pathologic changes in carbon dioxide partial pressure (Pco2) or serum bicarbonate (HCO3) that typically produce abnormal arterial pH values. Acidosis refers to physiologic processes that cause acid accumulation or alkali loss. Alkalosis refers to physiologic processes that cause alkali accumulation or acid loss. Actual changes in pH depend on the degree of physiologic compensation and whether multiple processes are present. Primary acid-base disturbances are defined as metabolic or respiratory based on clinical context and whether the primary change in pH is due to an alteration in serum HCO3 or in Pco2. Metabolic acidosis is serum HCO3< 24 mEq/L. Causes are Metabolic alkalosis is serum HCO3> 24 mEq/L. Causes are Respiratory acidosis is Pco2> 40 mm Hg (hypercapnia). Cause is Decrease in minute ventilation (hypoventilation) Respiratory alkalosis is Pco2< 40 mm Hg (hypocapnia). Cause is Increase in minute ventilation (hyperventilation) Compensatory mechanisms begin to correct t Continue reading >>

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  1. Raviv

    I'd take it with a grain of salt.
    Yes, exercising too much can raise your cortisol and cause your body to cling to its fat stores for dear life.
    But I'm not sure I'd say 10,000 steps a day would be considered excessive. It's really close to what someone who is is naturally active would do.
    So they have the right theory - "chronic cardio" stalls weight loss - but I don't think it applies in this situation.
    *******
    FitBit One
    "You should really wear a helmet."
    5K 9/2015 - 36:59.57
    *******

  2. HeatherRayne

    Thank you for your reply!
    That sparks another question for me. I have to walk on the treadmill at least 90 mins at 3-3.5mph (this is just where my endurance is at this point...was MUCH lower only a couple of months ago) in order to get to 10k...this includes daily activities around the house/grocery store, etc. I know I get frustrated because I am not where I was before surgery or where most people I know are...but this seems like A LOT of walking for a mere 10k. It seems in the past week or so it has gotten to where I have to work harder for the same amount of steps. I don't get it. Nothing has changed.

  3. HeatherRayne

    As an example - yesterday I went grocery shopping and to physical therapy. Also did several loads of laundry (up and down a flight of stairs). This was on top of 105 mins on the treadmill. I only logged 10,380 steps. Very frustrating.

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