Sodium Bicarbonate Acidosis

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Review Article Sodium Bicarbonate Therapy In Patients With Metabolic Acidosis

Correspondence should be addressed to Mar Received July ; Revised September ; Accepted September ; Published October a M. Adeva-Andany et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is Metabolic acidosis occurs when a relative accumulation of plasma anions in excess of cations reduces plasma pH. Replacement of sodium bicarbonate to patients with sodium bicarbonate loss due to diarrhea or renal proximal tubular acidosis is useful, but there is no denite evidence that sodium bicarbonate administration to patients with acute metabolic acidosis, including diabetic ketoacidosis, lactic acidosis, septic shock, intraoperative metabolic acidosis, or cardiac arrest, is benecial regarding clinical outcomes or mortality rate. Patients with advanced chronic kidney disease usually show metabolic acidosis due to increased unmeasured anions and hyperchloremia. It has been suggested that metabolic acidosis might have a negative impact on progression of kidney dysfunction and that sodium bicarbonate administration might attenuate this eect, but f Continue reading >>

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  1. dietcherry


    This serious complication, the result of acid buildup in the blood, can lead to coma or even death.
    If you have type 1 diabetes, one of the serious complications you may face is a condition known as ketoacidosis. In diabetic ketoacidosis, acids called ketones build up in your blood and could eventually lead to diabetic coma or death.
    But by vigilantly controlling your diabetes and watching for early signs of ketoacidosis, you can help prevent it from happening to you.
    What Is Diabetic Ketoacidosis?
    "When blood sugars get elevated and there is not enough insulin, your fat cells start to break down their storage sites of energy, which are called ketones," says Jay Cohen, MD, medical director of the Endocrine Clinic and clinical assistant professor in the department of family medicine at the University of Tennessee. Ketones are acidic, and that acid builds up in your blood.
    Diabetic ketoacidosis is found more often in younger people than older people, and more often in women than in men. At least 20 percent of people learn they have diabetes after seeking medical care for complaints that turn out to be symptoms of ketoacidosis.
    Common Causes of Diabetic Ketoacidosis
    The three common causes of ketoacidosis are:
    Not enough insulin. This can happen if you don’t inject enough insulin or if your insulin needs increase in response to an illness such as a cold or the flu. Blood glucose can’t be used for energy without enough insulin to help in the process, so the body breaks down fat for energy and high ketone levels result.
    "Elevated blood sugars could be due to an infection or any other physical or emotional stress — good or bad," says Dr. Cohen. Unexpected increases in your blood glucose levels can increase your insulin needs. "You may have a certain amount of insulin that you usually use, but if you have an infection, you may need more insulin to help your body to improve blood sugars," Cohen explains.
    Not enough food intake. If you don’t eat enough, your body has to break down fat for energy, producing high ketone levels. This is particularly common in people who are sick and don't feel like eating.
    Low blood glucose levels. This situation can force your body to break down fat to use as energy, resulting in ketone production.
    Diabetic Ketoacidosis Symptoms
    Symptoms of ketoacidosis usually progress relatively slowly. But since diabetic ketoacidosis can be a life-threatening condition, it is important to seek medical help immediately if you experience any of its symptoms. These include:
    Excessive thirst
    Dry mouth
    Frequent urination
    Elevated blood glucose levels
    Elevated ketones in the urine
    Persistent fatigue
    Skin that is dry or flushed
    Nausea or vomiting
    Pain in your abdomen
    Shortness of breath
    A fruity smell to your breath (the result of elevated ketone levels)
    Inability to concentrate
    Confused state
    Preventing Diabetic Ketoacidosis
    Ask your endocrinologist how you can reduce your risk of developing diabetic ketoacidosis. It is often a good idea to use a home dipstick test to check for ketones in your urine when your blood glucose levels are high (over 240 milligrams per deciliter) and when you have an infection.
    Diabetes education also helps. One study found that hospital stays for ketoacidosis were reduced among a group of people who attended diabetes education classes.
    Managing Diabetic Ketoacidosis
    If think you may have ketoacidosis, it is essential to contact your doctor or get to the emergency room immediately.
    "If we can catch it early, with medicine and IV fluids, we can stop the diabetic ketoacidosis from progressing to severe dehydration," says Cohen. "Diabetic ketoacidosis, if severe and not treated aggressively, has about a 5 percent death rate, so you really want to get a handle on it rapidly."
    Remember that regularly monitoring your blood glucose levels, performing urine ketone tests as recommended, and recognizing symptoms that might indicate your ketone levels are high is the best approach to reducing your risk of diabetic ketoacidosis.
    From Everyday Health

  2. Gem93

    I recently had a friend that got DKA she only had ketones for a day and was bring violently sick she couldn't test for ketones as her strips were left at her uni campus and went home to visit her family for the weekend her mum was just about to leave to go get the strips when she said I don't feel well take me to hospital betime she got to hospital ( which is a 10 min drive from where she lives) her vains had short down and the only vain left was the one to her heart they had to cut her throat open to put in an insulin drip immediately and was put in intensive care her family was told she might not make it and that was from having ketone symptoms for just a few hours / day at the most .. This has woken me up to life alot Snd made me realise what can happen if you don't look after yourself

  3. dietcherry

    OMG Can you get her to join here so we may talk to her?

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What is renal tubular acidosis (RTA)? RTA is a type of metabolic acidosis caused by the kidneys failure to properly acidify the urine. Find more videos at http://osms.it/more. Study better with Osmosis Prime. Retain more of what youre learning, gain a deeper understanding of key concepts, and feel more prepared for your courses and exams. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways and more when you follow us on social: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Thank you to our Patreon supporters: Sumant Nanduri Omar Berrios Alex Wright Sabrina Wong Suzanne Peek Arfan Azam Mingli Fng Osmosis's Vision: Empowering the worlds caregivers with the best learning experience possible.

Metabolic Acidosis Treatment & Management: Approach Considerations, Type 1 Renal Tubular Acidosis, Type 2 Renal Tubular Acidosis

Metabolic AcidosisTreatment & Management Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN more... Treatment of acute metabolic acidosis by alkali therapy is usually indicated to raise and maintain the plasma pH to greater than 7.20. In the following two circumstances this is particularly important. When the serum pH is below 7.20, a continued fall in the serum HCO3- level may result in a significant drop in pH. This is especially true when the PCO2 is close to the lower limit of compensation, which in an otherwise healthy young individual is approximately 15 mm Hg. With increasing age and other complicating illnesses, the limit of compensation is likely to be less. A further small drop in HCO3- at this point thus is not matched by a corresponding fall in PaCO2, and rapid decompensation can occur. For example, in a patient with metabolic acidosis with a serum HCO3- level of 9 mEq/L and a maximally compensated PCO2 of 20 mm Hg, a drop in the serum HCO3- level to 7 mEq/L results in a change in pH from 7.28 to 7.16. A second situation in which HCO3- correction should be considered is in well-compensated metabolic acidosis with impending respira Continue reading >>

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    Thanks for the link to Thermogenex. Checking it out now!
    Started 9/27/13 to release myself from my 'FAT' cocoon ~ Restarting 9/1/17 my journey!!!!
    SW 254.4 lbs 9/1/17 CW 250 lbs 10/4/17 GW 145 -135 lbs by 9/1/18
    I use this KETO Calculator to figure my min/max amounts http://www.mydreamshape.com/keto-calculato
    Carbs 18-24 g; (5%)
    Fat 129-174 g; (80%)
    Protein 55-73 g; (15%)
    calories 1456-1956
    as of 2/6/17 (recalculate at 10-20 lb loss)
    Suggested Reading "KETO CLARITY" by Jimmy Moore & Dr. Eric C. Westman

    current weight: 249.8







    I had surgery induced menopause and the hot flashes were unbelievable. It is embarrassing when your co-workers think you are dying because your face is so red. They sat a fan in front of me to help. Lol.
    I have to agree with the low carb recommendation for hot flashes. Atkin's induction helped but if I cheated and ate ANYTHING with sugar or ate too many carbs the hot flashes were back within an hour! The low carb also helped with migraines too.
    Feel free to stop by for a visit & "like" my Facebook pages!
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    current weight: 168.0







    I had quite a bit of hot flashes when I used to eat high carbohydrate. Rarely a warm flash now. The cold thermogenesis is slowly getting used to cold pack on upper back, back of neck, colder showers, sleeping without being covered and dunking face in ice water. Ray Cronice teaches this stuff. hypothermics.com/home/
    "The body as physical form is an incredible misperception of your true nature." Tolle www.eckharttolle.com
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    current weight: -8.4 under






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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 To Treat Severe Acidosis In The Critically Ill ((bicar-icu))

Design: randomized multiple center clinical trial, open label Arms: intravenous 4.2% Sodium Bicarbonate vs no additional treatment Inclusion: age of 18 yo or above, critically ill patient with a SOFA score of 4 or above, lactatemia of 2mmol/l or above, with pH of 7.20 or below and PaCO2 of 45mmHg or below and bicarbonatemia of 20mmol/l or below Exclusion: single respiratory disorder (PaCO2 > 50 mmHg, Bicarbonatemia equal or higher than (PaCO2-40)/10 + 24 ; acute diarrhea, ileostomy or biliary drainage ; stage IV kidney failure or chronic dialysis ; tubular acidosis, ketoacidosis, high anion gap acids poisoning (PEG, aspirin, methanol) ; PaCO2 equal to 45mmHg or above and spontaneous breathing, pregnancy, protected patients, moribund patient (life expectancy of 48h or below) Randomization: website randomization with stratification on age, presence of sepsis at inclusion, renal failure Intervention: experimental arm: intravenous 4.2% Sodium Bicarbonate 125 to 250ml in 30min up to 1000ml/24h. The target is a plasma pH of 7.30 or above. An interim statistical analysis is planned when 200 patients will be included Evolution of the organ failure scores [TimeFrame:Day 0 to Day 28] use of Continue reading >>

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  1. nomzbacon

    Hi ladies,
    DH and I have had no luck getting pregnant in the 5 years we have been married - the last year has involved my obgyn, Chlomid, basal temps, charts, calendars, etc. Finally when she referred me to a fertility specialist we decided if it wasn't meant to be, it just wasn't meant to be (i couldnt wrap my head around the cost) and I started on keto in October last year. Fast forward a few months, lately my breasts have been sore, I've woken up with awful nausea the past week or so and have absolutely no appetite - the very THOUGHT of food is turning my stomach.
    Picked up an early pregnancy test today (I was skeptical since my period is usually incredibly irregular so I wasn't even sure if this is a good time to be testing) and .... it was positive. o_O Long story short, what are the odds that a keto based diet may cause a false positive on a pregnancy test? I picked up a two-pack and am going to test again in a few days but my head is just spinning right now.
    Thanks so much for your help <3
    UPDATE: Thank you all SO much for your responses and lovely words of encouragement! I took a second test this morning that came up positive as well... so I called my obgyn and am scheduled to meet with her on Thursday morning. Needless to say I don't think keto is on the cards for me right now :( the very thought of bacon or any kind of meat is turning my stomach and it is all I can do to keep saltine crackers and ginger ale down.
    I just noticed that my flair did not transfer over from /r/keto - pre-keto my HW was 238.4lbs ... as of yesterday I was 196.8... so while I am still a long ways from a "healthy" weight range, maybe that was enough to resolve my infertility issues? I am hoping and praying so... :) Again, thank you all, your responses warmed my heart and reminded me yet again why I love this community! I will post an update on Thursday after my appointment.
    2ND UPDATE 01/10/12 - IT'S OFFICIAL!!!! :) Posted a full update for you ladies here! <3

  2. Jilleh-bean

    Um... You're probably pregnant. False positive are very, very uncommon.
    More than likely, your weight loss sparked it. I have no idea what size you are, but women who are very overweight can have trouble getting pregnant.
    Run to a local lab and get a blood test.

  3. eyisila

    My husband and I also tried for 5 years to get pregnant. We now have 2 little girls and both pregnancies happened when I started losing weight.
    Get to the doctor and congrats! :)

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