Severe Acidosis

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Bicarbonate Therapy In Severe Metabolic Acidosis

Abstract The utility of bicarbonate administration to patients with severe metabolic acidosis remains controversial. Chronic bicarbonate replacement is obviously indicated for patients who continue to lose bicarbonate in the ambulatory setting, particularly patients with renal tubular acidosis syndromes or diarrhea. In patients with acute lactic acidosis and ketoacidosis, lactate and ketone bodies can be converted back to bicarbonate if the clinical situation improves. For these patients, therapy must be individualized. In general, bicarbonate should be given at an arterial blood pH of ≤7.0. The amount given should be what is calculated to bring the pH up to 7.2. The urge to give bicarbonate to a patient with severe acidemia is apt to be all but irresistible. Intervention should be restrained, however, unless the clinical situation clearly suggests benefit. Here we discuss the pros and cons of bicarbonate therapy for patients with severe metabolic acidosis. Metabolic acidosis is an acid-base disorder characterized by a primary consumption of body buffers including a fall in blood bicarbonate concentration. There are many causes (Table 1), and there are multiple mechanisms that mi Continue reading >>

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    So she is 18 weeks and wanting to set her macros right without risking the baby. She increased her carbs to 50 per day. Is this correct? About where should she be?
    149lbs 25y/o

  2. jargarita

    I would definitely consult with her doctor. If she's doing it to lose weight, it really is not recommended to lose weight while pregnant.

  3. DevilishDreamer

    More than it being not recommended trying to lose weight, it is advised against. I'm currently pregnant and overweight, I was sent to the dietician with strict instructions that I not gain nor try to lose weight. I dropped several pounds in my first trimester, like many women do, because I simply couldn't eat or keep food down, but since then I've been doing well.

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In this video I discuss what is stress, why is stress bad, and what causes stress. I also cover how stress is bad, how to deal with stress, and stress management. Transcript What is stress? Whats up dudes, and whats up ladies, Bryan here and in this video we are going to look at stress. What is it, what causes it, and what can we do about it? So, Lets roll. Stress hormones Stress is your body's way of reacting to any kind of demand or threat. When the body feels stress, your hypothalamus, a tiny region in your brain, signals your adrenal glands, located atop your kidneys, to release a surge of hormones, which include adrenaline and cortisol, into the bloodstream. As these hormones are released, the liver is triggered to produce more blood sugar, which gives you an energy kick, breathing becomes more rapid, and heart beat and blood pressure rise. If the stress is caused by physical danger, these chemicals can be beneficial, as they give you more energy and strength, and also speed up your reaction time and enhance your focus. But, if the stress is caused by something emotional, it can be harmful, because there is no outlet for this extra energy and strength. Once the source of the stress has passed, hormone levels return to normal as do heart rate and blood pressure, and other systems also return to normal. Recent stress statistics show the top 7 causes of stress in the US to be job pressure, relationships, money, health related, poor nutrition, media overload, and sleep issues. All of these are of the emotional kind, not the physical danger kind that can be beneficial. 77% of people REGULARLY experience PHYSICAL symptoms caused by stress, 54% of people say stress has caused them to fight with people close to them, and 30% of people say they are always or often under stress at work…wow! So, how does all of this stress effect our bodies? Long term activation of the stress-response system can cause major problems including… • Anxiety • Depression • Digestive problems • Headaches • Heart disease • Sleep problems • Weight gain • Memory and concentration impairment It is vital to learn how to deal with stressors in your life. Some things you can do to manage stress include… Getting regular exercise, which can act as a distraction and also causes the release of endorphins that boost your mood. Eat a healthy diet that includes fruits and vegetables which provide vitamins, minerals and antioxidants that can help maintain proper bodily functions. Make consistent time in your schedule for relaxation and fun, such as going to a yoga class, listening to music, take a walk or work in your garden. Build relationships and friendships with people who have more positive attitudes. Cut down on caffeine, sugar, energy drinks, and alcohol. The effects of these are only short term. Make sure you get enough good quality sleep. If all else fails, seek professional help. Bottom line. As you can see by the statistics, stress is a huge problem in society. A big part of being healthy is being happy. If stress is a big problem in your life, do something about it now, don’t let it erode your health. Other sources... http://www.medicalnewstoday.com/artic... http://www.webmd.com/balance/stress-m... http://www.statisticbrain.com/stress-...

Severe Acidosis Caused By Starvation And Stress.

Severe acidosis caused by starvation and stress. Department of Pediatrics, Children's Hospital of Wisconsin, Milwauke, WI, USA. A 1-year-old boy had severe anoxic brain injury owing to a cardiorespiratory arrest. He had an initial metabolic acidosis, but this largely resolved by hospital day 2. He then had a persistent, profound metabolic acidosis. Evaluation on hospital day 6 found that the patient had ketonemia, ketonuria, and a normal serum glucose level; he had received no intravenous dextrose during his hospitalization. The dextrose-free fluids were given initially to protect his brain from the deleterious effects of hyperglycemia after brain injury. Continuation beyond 24 hours was inadvertent. The initiation of dextrose-containing intravenous fluids produced a rapid resolution of his metabolic acidosis. Starvation usually produces a mild metabolic acidosis, but when combined with physiologic stress, starvation may cause a severe metabolic acidosis. Among the few reports of severe starvation ketoacidosis, our case is unique because the patient was monitored closely in an intensive care unit, allowing us to describe the time course of the acidosis in detail. Continue reading >>

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

Metabolic Acidosis In Emergency Medicinetreatment & Management

Metabolic Acidosis in Emergency MedicineTreatment & Management Author: Antonia Quinn, DO; Chief Editor: Romesh Khardori, MD, PhD, FACP more... The initial therapeutic goal for patients with severe acidemia is to raise the systemic pH above 7.1-7.2, a level at which dysrhythmias become less likely and cardiac contractility and responsiveness to catecholamines will be restored. Metabolic acidosis can be reversed by treating the underlying condition or by replacing the bicarbonate. The decision to give bicarbonate should be based upon the pathophysiology of the specific acidosis, the clinical state of the patient, and the degree of acidosis. [ 10 ] Treating the underlying conditions in high AG states usually is sufficient in reversing the acidosis. Treatment with bicarbonate is unnecessary, except in extreme cases of acidosis when the pH is less than 7.1-7.2. For all cases of diabetic ketoacidosis, the role of bicarbonate is controversial, regardless of the pH or bicarbonate level. In hyperchloremic acidosis, the central problem is with the reabsorption or regeneration of bicarbonate. In these conditions, therapy with bicarbonate makes physiologic sense and is prudent in patients wit Continue reading >>

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  1. littleT

    I've read how people get a metal taste in their mouth when they are in ketosis, but does anyone ever get a sweet taste? I've had kind of a sweet taste and have been sooo thirsty. I've been drinking so much water; I can't get enough. But, I haven't got to the point where I'm not hungry. Could it be ketosis?

  2. AmyLowCarbs

    i always got a sweet taste in ketosis. but not a real sweet, and artificial sweet taste! i thought it was an artificial sweetener aftertaste until my mom told me it's the ketones. i bought some ketostix and she was right!
    congrats, little T! drink water.

  3. IdreamofLean

    YOu can have sweet breath in ketosis.
    Thirst is also an indication that your body is burning fat. It needs water to flush it all out!! Also, as you burn stored body fat your cells may store water in the space formerly occupied by fat. this will whoosh off when the whoosh fairy comes your way!

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