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Sodium Bicarbonate Acidosis

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Bala Venkatesh (University of Queensland, Australia) busting lactate myths at #SGANZICS on 22 April 2017. Mark your calendar for SGANZICS 17-21 May 2018!

Sodium Bicarbonate In The Critically Ill Patient With Metabolic Acidosis

Sodium bicarbonate in the critically Ill patient with metabolic acidosis Uso de bicarbonato de sdio na acidose metablica do paciente gravemente enfermo Lactic acidosis is an acid-base imbalance frequently found in critically ill patients. It is associated with a poor prognosis. Despite the substantial body of evidence that critical levels of acidemia have several adverse effects on cell function, the use of sodium bicarbonate to treat lactic acidosis in critically ill patients remains highly controversial. This article aimed at: 1) analyzing the main differences between hyperchloremic and organic acidoses, with high anion gap; 2) comparing the risks associated with critical levels of acidemia with those associated with the use of sodium bicarbonate; 3) critically analyzing the literature evidence about the use of sodium bicarbonate for the treatment of lactic acidosis in critically ill patients, with an emphasis on randomized control trials in human beings; and 4) providing a rationale for the judicious use of sodium bicarbonate in that situation. Descriptors: lactic acidosis, diabetic ketoacidosis, sodium bicarbonate, septic shock. A acidose ltica um distrbio do equilbrio cido-ba Continue reading >>

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  1. CyprusRoots

    Hi all, I'm 5 days into my keto journey and just got a little bit impatient and decided to take a ketones reading using the stick method. The reading was in the purple (very excited) and the reading was +15 (1.5) mg/dl(mmol/L). I haven't a clue what that means? Could someone give me an explanation? Thanks.

  2. Azuriaz

    Sounds like the number is milligrams per deciliter? I never pay attention to that, I just go with the shade of purple. The times I've gone several months straight in ketosis, the tendency is for the sticks to go into the light/moderate range as long as I stay well-hydrated. From what I understand that is normal. I have yet to see the sticks show not in ketosis at all unless I've eaten something that I knew would put me out. Really they're a very rough guide, I'm just too broke to go around spending five bucks on blood test strips!

  3. KnitOrMiss

    You should be able to download a chart online by brand. My general understanding is that the darker the color, the more ketones being dumped as waste. That means you are making a ton, but not yet efficient at using all of what you make (adapted). It's a good first step stage. That being said, as you adapt, you will "waste" less, and those results will become unreliable at best.

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Access the mini course here: http://defeatkidneydisease.com/FreeMi... Hi, my name is David. A friend of mine was diagnosed with Stage 3 Chronic Kidney Disease (CKD) recently. He was shocked - he had not felt that bad and was there for a routine check-up. He was told that there were 5 CKD stages and that all he could do is try and slow the descent down to Stage 5 - Kidney failure. I am guessing if you are watching this video then you or a loved one has had a similar experience. My personal experience with Western medicine is that it can be very useful, life saving for many. But it can take a rather narrow view to what is possible. So for my friends sake, I went out to find the truth for myself. I learned about the CKD stages which I tell you about in the video. But in the course of my searches I came across Duncan, a second generation naturopath who was leading the world in the natural healing of kidneys. He has many patients who have reversed their Kidney disease, moving from Stage 3 to Stage 2 as an example. Knowing how severe the lower CKD stages are I asked Duncan if he would put together a course I could provide people like you and me who are looking to heal kidney disease. He agreed, and you can access that course via http://defeatkidneydisease.com/FreeMi... Feel free to subscribe to this channel as well as I will be aiming to post small videos from time to time on various topics relating to kidney disease.

Metabolic Acidosis And Kidney Disease: Does Bicarbonate Therapy Slow The Progression Of Ckd?

Metabolic acidosis and kidney disease: does bicarbonate therapy slow the progression of CKD? Correspondence and offprint requests to: Csaba P. Kovesdy; E-mail: [email protected] Search for other works by this author on: Nephrology Dialysis Transplantation, Volume 27, Issue 8, 1 August 2012, Pages 30563062, Csaba P. Kovesdy; Metabolic acidosis and kidney disease: does bicarbonate therapy slow the progression of CKD?, Nephrology Dialysis Transplantation, Volume 27, Issue 8, 1 August 2012, Pages 30563062, Metabolic acidosis is a common complication associated with progressive loss of kidney function. The diminishing ability of the kidneys to maintain acidbase homeostasis results in acid accumulation, leading to various complications such as impairment in nutritional status, worsened uremic bone disease and an association with increased mortality. In addition to these adverse effects which are related to acid retention, metabolic acidosis may also cause kidney damage, possibly through the stimulation of adaptive mechanisms aimed at maintaining acidbase homeostasis in the face of decreasing kidney function. Recent clinical trials have suggested that correction or prevention of metab Continue reading >>

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  1. Rakesh Parikh

    Ketosis

    Diabetes

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    Why does ketosis cause impairment of glucose uptake by brain in diabetes patients?




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    Because by the time ketosis sets in body is exhausted of glucose reserve.

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

8.7 Use Of Bicarbonate In Metabolic Acidosis

8.7 Use of Bicarbonate in Metabolic Acidosis Metabolic acidosis causes adverse metabolic effects (see Section 5.4 ). In particular the adverse effects on the cardiovascular system may cause serious clinical problems. Bicarbonate is an anion and cannot be given alone. Its therapeutic use is as a solution of sodium bicarbonate. An 8.4% solution is a molar solution (ie it contains 1mmol of HCO3- per ml) and is the concentration clinically available in Australia. This solution is very hypertonic (osmolality is 2,000 mOsm/kg). The main goal of alkali therapy is to counteract the extracellular acidaemia with the aim of reversing or avoiding the adverse clinical effects of the acidosis (esp the adverse cardiovascular effects). Other reasons for use of bicarbonate in some cases of acidosis are: to promote alkaline diuresis (eg to hasten salicylate excretion) 8.7.2 Undesirable effects of bicarbonate administration In general, the severity of these effects are related to the amount of bicarbonate used. These undesirable effects include: 8.7.3 Important points about bicarbonate 1. Ventilation must be adequate to eliminate the CO2 produced from bicarbonate Bicarbonate decreases H+ by reacting Continue reading >>

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  1. jasonb135

    Been doing keto for almost a year, on and off. So finally decided to try the ketostix, (CVS store brand "Ketone Care Test Strips"). Cut out all carbs as possible with the exception of my fiber supplement in the last 2 days, at 14 carbs for 2050 calories. My results were almost Moderate 40. So just to see if they're a gimmick, I did a mild carb up last night with a bowl of menudo with lemon and geen onions, a bowl of cereal and 1%, a quesadilla, and one package of Handisnacks. I know it was a dirty carb up! so did the test this morning and got a negative result. I started back on keto this morning with 3 eggs scrambled with 15g heavy whipping cream, 1 farmer john wiener, 28g marbled jack cheese, 23g of whey = 33% Pro, 2% Carbs, 65% Fat. Waited about 2 hours, tested again, now I'm on Trace 5. So I think these things work. Going to do an hour on the stationary bike now, see if I can rid my body with the rest of the glycogen and produce more ketones. I think its a cool tool to use.

  2. jasonb135

    Just finished the stationary bike for an hour, while maintaining an average HR at about 155, burned 840 calories. Tested at Small 15, I'll try it again tonight a few hours after dinner, hopefully I'll be at Moderate 40 again.

  3. llidisky

    just so you know from what I understand, as long as their is a trace showing, you are in ketosis. You could be at the mod-large output, but well hydrated with water throughout the day and it will delute you urine so that you are only showing a trace to small. They are great to see if there are ketones or not in your pee, but as far as tracking how much, dude if you are showing ketones, you will be fine, don't waste the strips until after the carb up. also, cut all the strips in half if you haven't already. same results, double the quanitity so you get 100% more for the buck .

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