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Acid base ketoacidosis

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https://www.readbyqxmd.com/read/28761186/blood-lactate-concentration-in-diabetic-dogs
#1
Poliana Claus, André M Gimenes, Jacqueline R Castro, Matheus M Mantovani, Khadine K Kanayama, Denise M N Simões, Denise S Schwartz
Human diabetic patients may have increased lactate levels compared to non-diabetics. Despite the use of lactate levels in critical care assessment, information is lacking for diabetic dogs. Therefore, this prospective cross-sectional clinical study aimed to determine lactate concentrations in 75 diabetic dogs [25 newly diagnosed non-ketotic diabetics, 25 under insulin treatment, and 25 in diabetic ketoacidosis (DKA)], compared to 25 non-diabetic dogs. Lactate levels (mmol/L) were not different among groups (P = 0...
August 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28748724/acid-base-and-electrolyte-disorders-associated-with-the-use-of-antidiabetic-drugs
#2
Theodosios Filippatos, Eleftheria Tzavella, Christos Rizos, Moses Elisaf, George Liamis
The use of antidiabetic drugs is expected to substantially increase since diabetes mellitus incidence rises. Currently used antidiabetic drugs have a positive safety profile, but they are associated with certain acid-base and electrolyte abnormalities. The aim of the review is to present the current data regarding the antidiabetic drugs-associated acid-base and electrolyte abnormalities. Areas covered: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been linked with the scarce, but serious, complication of euglycemic diabetic ketoacidosis, as well as with an increase in serum potassium, magnesium and phosphorus levels...
August 4, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28742636/the-influence-of-chloride-for-the-interpretation-of-plasma-bicarbonate-during-the-treatment-of-diabetic-ketoacidosis
#3
Juan Pablo Ferreira, Magali Hamui, Milagros Torrents, Romina Carrano, Mabel Ferraro, Ismael Toledo
INTRODUCTION: Hyperchloremic metabolic acidosis can occur in diabetic ketoacidosis (DKA) and may affect the acid-base interpretation during treatment. OBJECTIVES: This study aims to describe the prevalence of hyperchloremia during the treatment of DKA and its effect on the interpretation of bicarbonate value. METHODS: A cross-sectional study, including all cases of DKA in patients aged 1 to 18 years old admitted from 2010 to 2015, was performed...
July 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28458895/case-of-diabetic-ketoacidosis-as-an-initial-presentation-of-cushing-s-syndrome
#4
Runa Acharya, Udaya M Kabadi
SUMMARY: Diabetic ketoacidosis (DKA) is commonly encountered in clinical practice. The current case is a unique and rare presentation of DKA as the initial manifestation of Cushing's disease secondary to ACTH-secreting pituitary adenoma. Appropriate management as elaborated in the article led to total remission of diabetes as well as the Cushing's disease. LEARNING POINTS: DKA is a serious and potentially life-threatening metabolic complication of diabetes mellitus...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28129999/long-term-risk-of-stroke-in-type-2-diabetes-patients-with-diabetic-ketoacidosis-a-population-based-propensity-score-matched-longitudinal-follow-up-study
#5
Y-L Chen, S-F Weng, C-Y Yang, J-J Wang, K-J Tien
AIM: To investigate the long-term risk of stroke in type 2 diabetes (T2D) patients with previous episodes of diabetic ketoacidosis (DKA). METHODS: This retrospective nationwide population-based cohort study was conducted using Taiwan's National Health Insurance database. Claims data from 2000 to 2002 were extracted for 3572 T2D patients with DKA and 7144 controls matched for age, gender, diabetes complications severity index, frequency of clinical visits and baseline comorbidities...
January 24, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28070957/controlled-trial-of-hartmann-s-solution-versus-0-9-saline-for-diabetic-ketoacidosis
#6
Michael Yung, Georgia Letton, Steve Keeley
AIM: We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS). METHODS: We conducted a double-blind, randomised controlled trial comparing HS to NS as the initial intravenous fluid in children with DKA. Patients were stratified by severity (pH < 7.1) and known or new diabetes...
January 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27913012/hyperglycemic-high-anion-gap-metabolic-acidosis-in-patients-receiving-sglt-2-inhibitors-for-diabetes-management
#7
Juliette Sandifer Kum-Nji, Aidar R Gosmanov, Helmut Steinberg, Samuel Dagogo-Jack
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a class of antidiabetic medications that improve glycemic control via inhibiting the reabsorption of filtered glucose and are approved for use in type 2 diabetes (T2DM). These drugs have recently been associated with euglycemic diabetic ketoacidosis (DKA). An increasing number of cases of SGLT-2i-associated DKA have occurred in patients with T2DM. Herein, we describe five episodes of hyperglycemic DKA in four type 2 diabetes patients receiving SGLT-2i therapy...
March 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27777693/comparison-of-end-tidal-carbon-dioxide-and-arterial-blood-bicarbonate-levels-in-patients-with-metabolic-acidosis-referred-to-emergency-medicine
#8
Ali Taghizadieh, Mahboub Pouraghaei, Payman Moharamzadeh, Alireza Ala, Farzad Rahmani, Karim Basiri Sofiani
Introduction: The routine and gold standard method to diagnose of acid - base disturbance is arterial blood gas (ABG) sampling. Capnography could be used to measure the end-tidal carbon dioxide (ETCO2) levels and ETco2 has a close correlation with the PaCo2. The aim of this study was comparison the ETco2 and arterial blood bicarbonate levels in patients with metabolic acidosis. Methods: In a descriptive-analytical study that performed in Emergency Department of Emam Reza Medical Research and Training Hospital of Tabriz on patients with metabolic acidosis, ETco2 level and blood bicarbonate levels in 262 patients were evaluated...
2016: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#9
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27747968/perioperative-intravenous-fluid-therapy-in-children-guidelines-from-the-association-of-the-scientific-medical-societies-in-germany
#10
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27599629/approach-to-the-treatment-of-diabetic-ketoacidosis
#11
Kamel S Kamel, Martin Schreiber, Ana P C P Carlotti, Mitchell L Halperin
Diabetic ketoacidosis (DKA), a common cause of severe metabolic acidosis, remains a life-threatening condition due to complications of both the disease and its treatment. This Acid-Base and Electrolyte Teaching Case discusses DKA management, emphasizing complications of treatment. Because cerebral edema is the most common cause of mortality and morbidity, especially in children with DKA, we emphasize its pathophysiology and implications for therapy. The risk for cerebral edema may be minimized by avoiding a bolus of insulin, excessive saline resuscitation, and a decrease in effective plasma osmolality early in treatment...
December 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27373929/metformin-inhibits-branched-chain-amino-acid-bcaa-derived-ketoacidosis-and-promotes-metabolic-homeostasis-in-msud
#12
Davis S Sonnet, Monique N O'Leary, Mark A Gutierrez, Steven M Nguyen, Samiha Mateen, Yuehmei Hsu, Kylie P Mitchell, Antonio J Lopez, Jerry Vockley, Brian K Kennedy, Arvind Ramanathan
Maple Syrup Urine Disease (MSUD) is an inherited disorder caused by the dysfunction in the branched chain keto-acid dehydrogenase (BCKDH) enzyme. This leads to buildup of branched-chain keto-acids (BCKA) and branched-chain amino acids (BCAA) in body fluids (e.g. keto-isocaproic acid from the BCAA leucine), leading to numerous clinical features including a less understood skeletal muscle dysfunction in patients. KIC is an inhibitor of mitochondrial function at disease relevant concentrations. A murine model of intermediate MSUD (iMSUD) shows significant skeletal muscle dysfunction as by judged decreased muscle fiber diameter...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27074163/hypochloremia-in-cats-prevalence-and-associated-diseases
#13
Florian K Zeugswetter, Maximilian Pagitz, Mona Sarah Friedrich
OBJECTIVE: To describe the prevalence and possible causes of hypochloremia in the local hospital cat population. MATERIAL AND METHODS: Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes...
August 17, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/27050945/acidosis-induced-hypochloremic-alkalosis-in-diabetic-ketoacidosis-confirmed-by-the-modified-base-excess-method
#14
Keigo Yasuda, Makoto Hayashi, Masanori Murayama, Noriyoshi Yamakita
CONTEXT AND OBJECTIVE: Diabetic ketoacidosis (DKA) is associated with a metabolic alkalosis, which is thought to be due to vomiting. However, alkalosis can occur in DKA without vomiting. We retrospectively reviewed the acid-base disturbances in DKA admissions without vomiting. PARTICIPANTS AND METHODS: We included admissions of the patients with blood glucose and beta-hydroxybutyrate (βOHB) levels > 250 mg/dL and > 1.0 mmol/L, respectively. Admissions without vomiting were classified into a group with a βOHB > 3...
June 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27002274/unpeeling-the-evidence-for-the-banana-bag-evidence-based-recommendations-for-the-management-of-alcohol-associated-vitamin-and-electrolyte-deficiencies-in-the-icu
#15
REVIEW
Alexander H Flannery, David A Adkins, Aaron M Cook
OBJECTIVE: Patients with a chronic alcohol use disorder presenting to the ICU may be deficient in important vitamins and electrolytes and are often prescribed a "banana bag" as a reflexive standard of therapy. The difficulty of diagnosing Wernicke's encephalopathy in the critical care setting is reviewed. Furthermore, whether the contents and doses of micronutrients and electrolytes in standard banana bags meet the needs of critically ill patients with an alcohol use disorder is assessed based on available evidence...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26733088/pyruvate-dehydrogenase-activity-is-decreased-in-emergency-department-patients-with-diabetic-ketoacidosis
#16
Lars W Andersen, Katherine M Berg, Sophia Montissol, Christopher Sulmonte, Julia Balkema, Michael N Cocchi, Richard E Wolfe, Ashok Balasubramanyam, Xiaowen Liu, Michael W Donnino
OBJECTIVES: The pyruvate dehydrogenase complex (PDH) is an essential enzyme in aerobic metabolism. Ketones are known to inhibit PDH activity, but the extent of this inhibition is unknown in patients with diabetic ketoacidosis (DKA). METHODS: We enrolled adult patients presenting to the emergency department in hyperglycemic crisis. Patients were classified as DKA or hyperglycemia without ketoacidosis based on laboratory criteria. Healthy controls were also enrolled...
June 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/26390536/euglycemic-diabetic-ketoacidosis-due-to-gastroparesis-a-local-experience
#17
Ronillo Legaspi, Philipp Narciso
Euglycemic Diabetic Ketoacidosis is an uncommon occurrence. It is caused by an interaction of existing and worsening acidosis due to nausea and vomiting by a precipitating illness. In this case, a Type I Diabetic patient initially presented with Diabetic Ketoacidosis (DKA) that eventually evolved into Euglycemic Ketoacidosis brought about by continuous nausea and vomiting. The case presented the complexity involved with Type I Diabetes in regards to glucose and energy metabolism and highlights the need for vigilance in monitoring acid/base balance in all diabetic patients who are ill and present with normal blood glucose level...
September 2015: Journal of the Arkansas Medical Society
https://www.readbyqxmd.com/read/26351828/impact-of-preoperative-fasting-times-on-blood-glucose-concentration-ketone-bodies-and-acid-base-balance-in-children-younger-than-36-months-a-prospective-observational-study
#18
Nils Dennhardt, Christiane Beck, Dirk Huber, Katja Nickel, Björn Sander, Lars-Henrik Witt, Dietmar Boethig, Robert Sümpelmann
BACKGROUND: In contrast to preoperative fasting guidelines in paediatric anaesthesia, actual fasting times are often too long. OBJECTIVE: The objective of this study was to evaluate the effect of preoperative fasting on glucose concentration, ketone bodies and acid-base balance in children. DESIGN: A prospective, noninterventional, clinical observational study. SETTING: A single-centre trial, study period from June 2014 to November 2014...
December 2015: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26246634/effect-of-maternal-ketoacidosis-on-the-ovine-fetus
#19
Diego E Gomez, Shikha Kuthiala, Hai L Liu, Daniel L Durosier, Mingju Cao, Patrick Burns, André Desrochers, Gilles Fecteau, Martin G Frasch
Ketoacidosis during pregnancy carries significant risk of intrauterine fetal demise, but little is known about the impact of ketoacids on the ovine fetus. We report a case series of maternal ketoacidosis in ewes. Maternal ketoacidosis may result in biochemical and acid-base fetal abnormalities associated with changes in feto-placental unit perfusion.
August 2015: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/26029609/congenital-broncho-oesophageal-fistula-an-unusual-cause-of-persistent-pneumonia-in-a-young-adult
#20
Savvidou Savvoula, Pasoglou Vasiliki, Karatzidou Kyparisia, Antoniou Christina, Mallias Ioannis, Kalampakas Athanasios
A 19-year-old female with a 3-day history of high temperature, productive cough and dyspnoea was admitted due to diabetic ketoacidosis and pneumonia of the right lower lobe. Antibiotics (amoxicillin-clavulanic acid), insulin, fluids and electrolytes were administered, as appropriate. The patient was doing well (normal temperature, normal glucose levels, normal acid-base balance) until the sixth day of hospitalization, when she reported bouts of cough when swallowing liquids. Barium oesophagography revealed the presence of a broncho-oesophageal fistula (BOF)...
2013: Respiratory Medicine Case Reports
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