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What Does Hyperchloremic Metabolic Acidosis Mean?

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Hyperchloremic Acidosis

Normal albumin-corrected anion gap acidosis Hyperchloremic acidosis is a common acid-base disturbance in critical illness, often mild (standard base excess >-10 mEq/L). Definitions of hyperchloremic acidosis vary. The best are not based on chloride concentrations, but on the presence of metabolic acidosis plus the absence of significant concentrations of lactate or other unmeasured anions. 2. standard base excess less than -3 mEq/L or bicarbonate less than 22 mmol/L, 3. Albumin corrected anion gap normal (5-15 mEq/L). A normal strong ion gap is an alternative indicator of the absence of unmeasured anions, although rarely used clinically and offering little advantage over the albumin corrected anion gap. The degree of respiratory compensation is relevant. It is appropriate if PaCO2 approximates the two numbers after arterial pH decimal point (e.g. pH=7.25, PaCO2=25 mm Hg; this rule applies to any primary metabolic acidosis down to a pH of 7.1). Acidosis is severe if standard base excess is less than -10 mEq/L, or pH is less than 7.3, or bicarbonate is less than 15 mmol/L. Common causes in critical illness are large volume saline administration, large volume colloid infusions (e.g. Continue reading >>

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  1. FaintIlluzion

    I know on Keto you want to have more fat then protein, but how will too much protein occasionally effect weight loss? Will it kick me off track of loosing weight? What are the negatives of getting more protein then fats in a day?

  2. thadass

    Ratios don't matter; you have no need to compare the macro-nutrients. Evaluate each macro individually.
    There is no harm at all in having more protein than fat, but there is a possible risk from having WAY too much protein. Having even a little more protein than you really need is also simply a waste of protein.
    Enter your info in the keto calculator in the side bar and:
    Stay under your net carb limit (<20g is best)
    Meet your protein goal every day
    Eat fats to satiate hunger and fill out your caloric intake (do not have too high of a caloric deficit. 20% is best for most).

  3. dernnn

    Just curious, why can't you have too high of a deficit? The keto calculator puts me at 1700 for 20% deficit, and I find it a struggle to get to about 1200 calories. (On keto for a week FWIW)

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Whether due to bicarbonate loss or volume repletion with normal saline, the primary problems is in hyperchloremic metabolic acidosis hcl ammonium chloride loading, reabsorption proximal tubule reduced, part, because of hyperchloraemic acidosis, anion gap (in most cases). Administration of ns will decrease the plasma sid causing an acidosis this patient also had a normal anion gap hyperchloremic metabolic (hcma). Googleusercontent search. Normal anion gap (hyperchloremic) acidosis semantic scholar. Hyperchloremic metabolic acidosis is it clinically relevant? (pdf hyperchloremic in diabetes mellitus. Hyperchloremic acidosis wikipedia. Treatment of acute non anion gap metabolic acidosis ncbi nih. Aug 4, 2016 a normal ag acidosis is characterized by lowered bicarbonate concentration, which counterbalanced an equivalent increase in plasma chloride concentration. Acid base physiology 8. Hyperchloraemic metabolic acidosisdepartment of medicine. Mechanism of hyperchloremic metabolic acidosis. Hyperchloremic acidosis background, etiology, patient education emedicine. Respiratory acidosis alkalosis as with the hyperchloremic may result from chloride replacing lost bicarbonate. Although it ca

Hyperchloremic Acidosis

Author: Sai-Ching Jim Yeung, MD, PhD, FACP; Chief Editor: Romesh Khardori, MD, PhD, FACP more... This article covers the pathophysiology and causes of hyperchloremic metabolic acidoses , in particular the renal tubular acidoses (RTAs). [ 1 , 2 ] It also addresses approaches to the diagnosis and management of these disorders. A low plasma bicarbonate (HCO3-) concentration represents, by definition, metabolic acidosis, which may be primary or secondary to a respiratory alkalosis. Loss of bicarbonate stores through diarrhea or renal tubular wasting leads to a metabolic acidosis state characterized by increased plasma chloride concentration and decreased plasma bicarbonate concentration. Primary metabolic acidoses that occur as a result of a marked increase in endogenous acid production (eg, lactic or keto acids) or progressive accumulation of endogenous acids when excretion is impaired by renal insufficiency are characterized by decreased plasma bicarbonate concentration and increased anion gap without hyperchloremia. The initial differentiation of metabolic acidosis should involve a determination of the anion gap (AG). This is usually defined as AG = (Na+) - [(HCO3- + Cl-)], in whic Continue reading >>

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  1. Courtney Schumacher

    Ketoacidosis

    Comas

    Medical Treatments

    Medical Conditions and Diseases


    Neuroscience

    Medicine and Healthcare



    Why does Ketoacidosis cause coma? How is it treated?




    1 Answer







    I’m assuming that you do know that ketoacidosis does not have to mean that you have high blood sugar. It means that you have a high level of ketones in your blood, which are usually by-products of your body trying to break down fatty acids for fuel it’s not getting from your food intake.
    It is usually treated with fluids, electrolytes, and insulin. It is much more common in those with type 1 diabetes then type 2, but it can still occur.

    You can look up more specific information on diabetes at the Mayo Clinic site.

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The varied secretagogues such as vasoactive intestinal peptide (vip), which is associated with neoplasms of the pancreas or sympathetic chain (chapter 201), cause large losses hco 3 in stool, a resulting hypokalemic, hyperchloremic metabolic acidosis. We report two cases of hyperchloremic metabolic acidosis in children posted for colorectal surgery following tgi with summary'these words have been the doctrine medicine since its inception. Also known as non anion gap metabolic acidosis normal albumin corrected strong ion related conditions 'dilutional' or 'infusion related' post diabetic ketoacidosis renal tubular (rta) 29 jun 2006 two thirds of patients in the isotonic saline group but none balanced fluid developed hyperchloremic [3]. Respiratory acidosis alkalosis as with the henderson hasselbalch equation. Treatment of these disorders requires reversing the underlying disease process, with bicarbonate offering little if any benefit. Hyperchloraemic metabolic acidosis. Treatment of acute non anion gap metabolic acidosis. The colloid crystalloid debate continues to evolve this method of evaluating acid base disorders was developed help determine the mechanism disorder rather than s

Causes And Effects Of Hyperchloremic Acidosis

Causes and effects of hyperchloremic acidosis 1Institute of Child Health, University of Liverpool, Eaton Road, Liverpool L12 2AP, UK This article has been cited by other articles in PMC. Gunnerson and colleagues [ 1 ] found in their retrospective study that critically ill patients with lactate acidosis had a higher mortality compared to patients with hyperchloremic acidosis, whose mortality was not significantly different from patients with no acidosis. Because of its iatrogenic etiology the authors commented that it is reassuring that hyperchloremic acidosis is not associated with an increased mortality. Previous randomized controlled trials have, however, generated concerns regarding the adverse effects of hyperchloremic acidosis associated with rapid isotonic saline administration. Rapid isotonic saline infusion predictably results in hyperchloremic acidosis [ 2 ]. The acidosis is due to a reduction in the strong anion gap by an excessive rise in plasma chloride as well as excessive renal bicarbonate elimination. In a randomized controlled trial with a mixed group of patients undergoing major surgery, isotonic saline infusion was compared to Hartmann's solution with 6% hetastar Continue reading >>

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  1. tdseest

    As a future resource for new people, please list your favorite podcasts, with their associated Websites here.
    [I made this a wiki, so anyone who can see the little green pencil icon at the top can edit this post. -carolt]
    Keto-centric podcasts:
    2 Keto Dudes
    65 - rss
    1
    Keto Woman Podcast
    2
    Keto Talk
    37 (Jimmy Moore and Doc Nally Dr. Will Cole) - rss
    2
    Livin’ La Vida Low Carb
    15 - rss
    1
    Low Carb Conversations
    30
    The Keto Evangelist
    41 (Brian Williamson) - rss
    3
    The Ketogenic Athlete
    22 (Brian Williamson, Danny Vega) - rss
    1
    Ketovangelist Kitchen
    17 (Brian Williamson, Carrie Brown) - rss
    Low Carb Keto Living
    35 - rss
    Primal Endurance
    15 - rss
    2
    Fat Burning Man - rss
    5
    Endurance planet
    4 - rss
    Vinnie Tortorich America’s Angriest Trainer
    7 - rss
    Hobbitcast - Ketogenic Fireside Chats (Ben McDonald)
    36 - rss
    3
    Break Nutrition - (Raphael Sirtoli)
    5 - rss
    1
    Leanne Vogel : Keto Diet
    13 - rss
    Keto For Women
    35 (Shawn Mynar) - rss
    1
    Keto for Normies
    15 - rss
    Podcasts related to keto lifestyle:
    Nourish Balance Thrive
    6 (Christopher Kelley) - rss
    The Obesity Code Podcast
    1
    The Quantified Body
    7 - rss
    Ben Greenfield Fitness
    1 - rss
    The Daily Lipid
    20 (Chris Masterjohn PhD) - rss
    The Fat Emperor
    44 (Ivor Cummins) - rss
    3
    Fasting Talk
    38 (Jimmy Moore, Jason Fung, Megan Ramos) - rss
    1
    Metabolic Optimization
    33 (Dominic D’Agostino, Travis Christofferson) - rss
    2
    Dana’s Low Carb for Life
    15 (Dana Carpender)
    Headbangers Kitchen
    5
    Podcasts featuring keto guests:

    The Tim Ferriss Show:
    Dom D’Agostino - Part 1
    16
    Dom D’Agostino - Part 2
    6
    Dom D’Agostino - Disease prevention, cancer and living longer
    4
    Peter Attia - Life-Extension, Drinking Jet Fuel, Ultra-Endurance, Human Foie Gras, and More
    4 (2 episodes)
    Bulletproof Radio
    14 (Dave Asprey) - rss
    The Joe Rogan Experience
    57 - rss
    7
    The Low Carb Leader
    5 (Dan Perryman)
    Jeff Volek on STEM Talk
    6

  2. richard

    there is one I like has a dude with a on it

  3. jfricke

    It's ok I guess.

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