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Why Is Bicarb Low In Dka

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What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness. A person's breath may develop a specific smell. Onset of symptoms is usually rapid. In some cases people may not realize they previously had diabetes. DKA happens most often in those with type 1 diabetes, but can also occur in those with other types of diabetes under certain circumstances. Triggers may include infection, not taking insulin correctly, stroke, and certain medications such as steroids. DKA results from a shortage of insulin; in response the body switches to burning fatty acids which produces acidic ketone bodies. DKA is typically diagnosed when testing finds high b

* Diabetic Ketoacidosis

* Diabetic Ketoacidosis #155767 malak - 01/24/07 22:35 Diabetic Ketoacidosis In children under 10 years of age, diabetic ketoacidosis causes 70% of diabetes-related deaths. Diabetic ketoacidosis is defined by the triad of hyperglycemia, acidosis, and ketosis. Clinical Presentation Diabetes is newly diagnosed in 20% of cases of diabetic ketoacidosis. The remainder of cases occur in known diabetics in whom ketosis develops because of a precipitating factor, such as infection or noncompliance with insulin. Symptoms of DKA include polyuria, polydipsia, fatigue, nausea, and vomiting, developing over 1 to 2 days. Abdominal pain is prominent in 25%. Physical Exam Patients are typically flushed, tachycardic, and tachypneic. Kussmaul's respiration, with deep breathing and air hunger, occurs when the serum pH is between 7.0 and 7.24. A fruity odor on the breath indicates the presence of acetone, a by-product of diabetic ketoacidosis. Fever is seldom present even though infection is common. Hypothermia and hypotension may also occur. Eighty percent of patients with diabetic ketoacidosis have altered mental status. Most are awake but confused; 10% are comatose. Laboratory Findings Serum glucos Continue reading >>

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  1. flowerlady

    Since in DKA we have acidosis why there is decrease in HCO3 bicarbonate
    and why there is hyperkalemia if there is osmotic diuresis?

  2. step_enhancer

    usually when there is acidosis H+ goes into the cell and K+ comes out of the cell resulting in the hyperkalemia but intracellular hypokalemia.
    H+/K+ pump is present on the surface of the cells.
    pts with diabetic ketoacidosis have intracellular hypokalemia ,so they r given glucose,insulin and K+ to normalize their intracellular K+ to prevent arrhythmias.

  3. tiger73jo

    In DKA there is gain of fixed acids (ketone bodies ) causes excess (H+) ,
    and since there should be an equilibrium in the reaction (CO2) <--> (H+)+(HCO3-) then the reaction should shift to the left forming more CO2 (which result in hyperventilation ) and less HCO3
    for the hyperkalemia part i totally agree with step enhancer.

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What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies, formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and ß-hydroxybutyrate. Ketoacidosis is a pathological metabolic state marked by extreme and uncontrolled ketosis. In ketoacidosis, the body fails to adequately regulate ketone production causing such a severe accumulation of keto acids that the pH of the blood is substantially decreased. In extreme cases ketoacidosis can be fatal. Ketoacidosis is most common in untreated type 1 diabetes mellitus, when the liver breaks down fat and proteins in response to a perceived need for respiratory substrate. Prolonged alcoholism may lead to alcoholic ketoacidosis. Ketoacidosis can be smelled on a person's breath. This is due to acetone, a direct by-product of the sp

Bicarbonate Therapy In Severe Diabetic Ketoacidosis

Twenty-one adult patients with severe diabetic ketoacidosis entered a randomized prospective protocol in which variable doses of sodium bicarbonate, based on initial arterial pH (6.9 to 7.14), were administered to 10 patients (treatment group) and were withheld from 11 patients (control group). During treatment, there were no significant differences in the rate of decline of glucose or ketone levels or in the rate of increase in pH or bicarbonate levels in the blood or cerebrospinal fluid in either group. Similarly, there were no significant differences in the time required for the plasma glucose level to reach 250 mg/dL, blood pH to reach 7.3, or bicarbonate level to reach 15 meq/L. We conclude that in severe diabetic ketoacidosis (arterial pH 6.9 to 7.14), the administration of bicarbonate does not affect recovery outcome variables as compared with those in a control group. Continue reading >>

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  1. Knicks

    In DKA, the patient is acidotic, right? So why would the body decrease bicarbonate (a base)? Wouldn't you want to keep the bicarbonate high so as to neutralize the acid?
    Too tired to think straight at the moment.

  2. generic

    The HCO3 derangement is not a compensation--it is the primary problem.
    DKA patients have a metabolic acidosis, I think it's mostly caused by the formation of tons and tons of ketone bodies (acidic). These are formed because despite high circulating levels of glucose, the cells can't use the glucose without insulin-->turn to ketone formation instead.
    The metabolic acidosis may cause respiratory compensation, which would give Kussmaul breathing, for example.

  3. treva

    Knicks said: ↑
    In DKA, the patient is acidotic, right? So why would the body decrease bicarbonate (a base)? Wouldn't you want to keep the bicarbonate high so as to neutralize the acid?
    Too tired to think straight at the moment. Remember the kidney takes days to compensate for acidodic state by producing more bicarb. Acutely, the bicarb is used to buffer the extra acid, so it drops.
    This also explains why DKA pts have increased RR:
    CO2 + H20 <--> H2CO3 <--> HCO3- + H+
    If you blow off extra CO2 (ie by upping RR) you shift the above equation to the left, and promote the formation of H2CO3 via CA, helping to mop up the H+.

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1L saline bag with 1 1/2 tablespoons bicarb, given via jugular to calf 5 days old, flat and unresponsive, scours dehydration. Not responsive. 100mls into treatments we have response.

Result Why Bicarb Low In Dka :

Diabetic Ketoacidosis (DKA) Explained Clearly - Diabetes Complications Understand Diabetic Ketoacidosis (DKA) with this clear explanation from Dr. Seheult of This is video 1 of 2 on diabetic ketoacidosis (pathophysiology and signs of... View More Bicarbonate Buffer System and pH Imbalances An explanation of how the bicarbonate buffer system function into respiratory and metabolic pH imbalances-- Created using PowToon -- Free sign up at . Make your own... View More What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning What is DIABETIC KETOACIDOSIS? What does DIABETIC KETOACIDOSIS mean? DIABETIC KETOACIDOSIS meaning - DIABETIC KETOACIDOSIS definition - DIABETIC KETOACIDOSIS explanation. Source: Wikipedia.org... View More What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning, definition & explanation What is KETOACIDOSIS? What does KETOACIDOSIS mean? KETOACIDOSIS meaning - KETOACIDOSIS definition - KETOACIDOSIS explanation. Source: Wikipedia.org article, adapted under View More Diabetic Ketoacidosis (DKA) Diabetic Ketoacidosis (DKA) Instructional Tutorial Video CanadaQBank.com QBanks for AMC Exams, MCCEE, MCCQE & USMLE URL Continue reading >>

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Popular Questions

  1. Knicks

    In DKA, the patient is acidotic, right? So why would the body decrease bicarbonate (a base)? Wouldn't you want to keep the bicarbonate high so as to neutralize the acid?
    Too tired to think straight at the moment.

  2. generic

    The HCO3 derangement is not a compensation--it is the primary problem.
    DKA patients have a metabolic acidosis, I think it's mostly caused by the formation of tons and tons of ketone bodies (acidic). These are formed because despite high circulating levels of glucose, the cells can't use the glucose without insulin-->turn to ketone formation instead.
    The metabolic acidosis may cause respiratory compensation, which would give Kussmaul breathing, for example.

  3. treva

    Knicks said: ↑
    In DKA, the patient is acidotic, right? So why would the body decrease bicarbonate (a base)? Wouldn't you want to keep the bicarbonate high so as to neutralize the acid?
    Too tired to think straight at the moment. Remember the kidney takes days to compensate for acidodic state by producing more bicarb. Acutely, the bicarb is used to buffer the extra acid, so it drops.
    This also explains why DKA pts have increased RR:
    CO2 + H20 <--> H2CO3 <--> HCO3- + H+
    If you blow off extra CO2 (ie by upping RR) you shift the above equation to the left, and promote the formation of H2CO3 via CA, helping to mop up the H+.

  4. -> Continue reading
read more

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