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Sodium Bicarbonate Intracellular Acidosis

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069 - pH and Buffers In this video Paul Andersen explains how buffer solutions maintain pH in a solution. A buffer solution is made up of a weak acid and its conjugate base. As strong acids or bases are added the pH remains stable. A good buffer solution has a pKa value equivalent to the pH and equal amounts of the weak acid and the conjugate base. Do you speak another language? Help me translate my videos: http://www.bozemanscience.com/transla... Music Attribution Title: String Theory Artist: Herman Jolly http://sunsetvalley.bandcamp.com/trac... All of the images are licensed under creative commons and public domain licensing: AzaToth. Myoglobin 3D Structure, February 5, 2008. self made based on PDB entry. http://commons.wikimedia.org/wiki/Fil.... File:Arginine.png, n.d. http://commons.wikimedia.org/wiki/Fil.... File:Aspartic Acid.png, n.d. http://commons.wikimedia.org/wiki/Fil.... "File:Blausen 0761 RedBloodCells.png." Wikipedia, the Free Encyclopedia. Accessed February 5, 2014. http://en.wikipedia.org/wiki/File:Bla.... "File:Bromothymol Blue Colors.jpg." Wikipedia, the Free Encyclopedia. Accessed February 15, 2014. http://en.wikipedia.org/wiki/File:Bro.... File:Glutamine2.png, n

Buffers

Metabolic acidosis: Assessment and Treatment Acidosis is a frequent problem in critically-ill neonates. Buffers, such as sodium bicarbonate, are often used to treat metabolic acidosis. However, evidence to support the use or efficacy of this therapy is lacking. The etiology of a low pH must be understood to treat infants appropriately. Respiratory acidosis (increased CO2 on a blood gas and normal or near normal serum bicarbonate concentration) can only be treated by improving ventilation. Buffers will not help in this case, and may make the situation worse because infusion of NaHCO3 results in the immediate formation of CO2. For every mole of proton neutralized by bicarbonate, an equimolar amount of CO2 is produced. The futility of using NaHCO3 in a situation where ventilation is inadequate can be appreciated by the Henderson-Hesselbalch equation: pH - pK1 + log [HCO3-]/[CO2] (pK1 = 6.1) When ventilation is impaired, use of NaHCO3 will move the pH toward the pK of the equation, which is 6.1. In order to achieve a pH of 7.4, the molar ratio of HCO3 to CO2 must be 20:1. Thus, correction of acidosis depends on the removal of CO2. CO2 elimination depends on minute ventilation and pulm Continue reading >>

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  1. cappinA

    Body ache from Keto.

    Just wondering, I asked this question elsewhere, but no one has answered it. I'm about 5 days into my Keto diet and my body has a constant ache. It's like I've been working out, but it's been a week since I could get to the gym so I decided I'd adjust to the new diet. I'm consuming around 1600 calories a day. I weigh 262, I'm 6'3-6'4. If someone could give me some advice it would be great.

  2. pperry

    I'm not sure about a constant ache but I've had considerable doms recently, might just be my new program though

  3. BlackHeart.au

    yeah i had that when i tried keto, personally i hate that diet. I'd rather something i can stick to... example : going out for dinner, limited options etc is just not for me.

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An overview of the use of IV fluids during resuscitation of patients in shock, including comparison of crystalloid vs. colloid, and NS vs. LR (and other balanced solutions).

Use Of 1.27% And 1.4% Sodium Bicarbonate As Initial Fluid Therapy In Acute Resuscitation | Bja: British Journal Of Anaesthesia | Oxford Academic

Adequate restoration of intravascular volume remains an important goal in the management of both surgical, medical and intensive care patients. Interest is now focusing on organ perfusion and function, as keyparameters by which adequate fluid replacement can be assessed. There has long been a debate over which is the ideal intravenous fluid for volume replacement, and controversy still exists in the literature as to whether colloid or crystalloid is most beneficial. 0.9% saline is the mainstay for volume depleted patients especially in the accident and emergency setting, although it is associated with potentially detrimental physiological effects. Many studies have shown that volume replacement with 0.9% saline can result in hyperchloremic acidosis1 2 3 thus exacerbating the existing acidosis due to tissue and organ hypo-perfusion. Although, Brill et al showed this base deficit to beassociated with a lower mortality compared to other causes of acidosis,4 concern is still voiced over the clinical significance of hyperchloremic acidosis. As chloride ions are present for electrochemical balance of the cations present and not specifically required, this problem could potentially be av Continue reading >>

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  1. 3 answers

    What is diabetic ketoacidosis?

    Diabetic ketoacidosis (DKA is the abbreviation) is a life-threatening complication of diabetes mellitus. (It affects predominantly type 1 diabetics, but can also affect SOME type 2 diabetics.)
    It occurs due to there being a distinct lack of insulin present within the bloodstream. Insulin, which is a hormone produced by the beta cells (islets of Langerhans) of the pancreas, is needed to 'move' sugar (glucose) from the bloodsteam into the body's cells, where it is used to create energy.
    When there's a lack of insulin present, the body's cells believe that the sufferer is going through a period of starvation so they deliberately break down fat and muscle tissues in an attempt to stay alive. The side-effect of this is that ketone bodies are produced. (It's ketones that produce the smell that some people who are in diabetic ketoacidosis, or very near to going into diabetic ketoacidosis, have on their breath ... it's a smell like pear drops or acetone (nail varnish remover).)
    Diabetic ketoacidosis is very damaging to the body's organs, blood vessels, and nerves. In high concentrations, ketone levels make the blood acidic, which accounts for some of the damage that is caused. It would require the sufferer to be admitted to hospital for emergency medical care.
    If the sufferer is not found in time, the s/he MAY lapse into a comatose state, or even die.

  2. Comment

    http://www.phlaunt.com/diabetes will answer this question and a lot more!

  3. Rick B

    Google it.

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Sodium Bicarbonate - An Overview | Sciencedirect Topics

Jamie McElrath Schwartz, ... Donald H. Shaffner, in Smith's Anesthesia for Infants and Children (Eighth Edition) , 2011 Sodium bicarbonate causes an acid-base reaction in which bicarbonate combines with hydrogen ion to form water and carbon dioxide, resulting in an elevated blood pH: Because sodium bicarbonate generates CO2, adequate alveolar ventilation must be present before its administration. As respiratory failure is the leading cause of cardiac arrest in children, caution should be taken before sodium bicarbonate administration in the face of preexisting respiratory acidosis. Sodium bicarbonate use during CPR is one of the most controversial issues in the literature related to cardiac arrest. This stems from lack of evidence of benefit during CPR in animals and humans, as well as the potential adverse effects associated with sodium bicarbonate administration. Literature on sodium bicarbonate use in CPR dates back to the 1960s, but there are little data demonstrating a beneficial impact on human survival (Levy, 1998). In animal models of resuscitation from cardiac arrest, sodium bicarbonate has been associated with increased survival in few studies and with no difference in s Continue reading >>

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  1. TheCommuter

    You can post this question on this site's Nursing Student Assistance Forums and perhaps get an answer. One of our frequent users, Daytonite, loves to give detailed answers to these types of questions.
    http://allnurses.com/forums/f205/

  2. ICRN2008

    Here is the formula for anion gap:
    Agap = Na + K - Cl -CO2
    I would think that the doctor would be monitoring the glucose level (not the agap) to determine when to stop the insulin drip. Anyone else have an idea?

  3. P_RN

    One of our wonderful members Mark Hammerschmidt has a great FREE MICU site:
    http://www.icufaqs.org/
    Check section 4.2
    It's all acidosis/alkalosis

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