Podcast 559: Metabolic Acidosis

Podcast 559: Metabolic Acidosis

Contributor: Dylan Luyten, MD

Educational Pearls

  • Acidosis can be caused by a respiratory, metabolic, or mixed source
  • A respiratory acidosis will have a low serum pH and elevated bicarbonate if it's chronic, but most importantly end tidal CO2 or arterial CO2 will be high.
  • With a metabolic acidosis we expect to see a low serum pH and low serum bicarbonate.
  • Once it's determined a patient is in a metabolic acidosis, we need to determine if it's an elevated anion gap or normal anion gap acidosis. Anion gap is calculated by subtracting the serum anions from the cations, or serum sodium minus the serum chloride and CO2 (Na-(Cl+CO2)). A normal gap is 6-10, gaps over 10 have an elevated anion gap acidosis.
  • The causes of an elevated anion gap acidosis can be remembered with MUDPILES mnemonic (Methanol, Uremia (renal failure), Diabetes/DKA, Paraldehyde, Isoniazid, Lactate, Ethanol/Ethylene glycol, salicylates/aspirin).
  • So when you suspect an elevated gap acidosis you need to evaluate for all causes, so you need to get an venous or arterial blood gas along with lactate, salicylate, and Tylenol levels.

References

  1. Vanmassenhove J. Lameire N. Approach to the patient presenting with metabolic acidosis. Acta Clin Belg. 2019 Feb;74(1):21-27. doi: 10.1080/17843286.2018.1547245. Epub 2018 Nov 24.
  2. Burger MK, Schaller DJ. Physiology, Acidosis, Metabolic. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482146/

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD

Jaksot(1147)

UnfilterED #9: Dr. Steven Bradley

UnfilterED #9: Dr. Steven Bradley

Dr. Steven Bradley is an active duty U.S. Naval officer practicing as a Staff Anesthesiologist in Virginia where also resides on the Medical Ethics Committee for his hospital. He serves as the Anesthe...

8 Heinä 202039min

Podcast 576: Status Epilepticus Drugs

Podcast 576: Status Epilepticus Drugs

Author: Charlene Gnisci Melton, PharmD Educational Pearls: Status Epilepticus is defined as continuous seizure activity for >5 minutes, or 2 or more seizures without full return to consciousness betw...

7 Heinä 20205min

Podcast 575:  Light on the Sedation

Podcast 575: Light on the Sedation

Contributor: Aaron Lessen, MD Educational Pearls: Studies have shown that patients who are under deeper sedation in the ICU have worse outcomes. Recent study compared lighter vs heavier sedation of p...

6 Heinä 20202min

Epidemic Meets Pandemic #4: The Patient Perspective

Epidemic Meets Pandemic #4: The Patient Perspective

This limited series will investigate how the nation's opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm reductionist, an addiction me...

6 Heinä 202047min

Epidemic Meets Pandemic #3: The Law Enforcement Perspective

Epidemic Meets Pandemic #3: The Law Enforcement Perspective

This limited series will investigate how the nation's opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm reductionist, an addiction me...

1 Heinä 20201h 2min

Epidemic Meets Pandemic #2: The Addiction Medicine Perspective

Epidemic Meets Pandemic #2: The Addiction Medicine Perspective

This limited series will investigate how the nation's opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm reductionist, an addiction me...

30 Kesä 202029min

Epidemic Meets Pandemic #1: The Harm Reductionist Perspective

Epidemic Meets Pandemic #1: The Harm Reductionist Perspective

This limited series will investigate how the nation's opioid epidemic has been impacted by the COVID-19 pandemic. Over the course of this series, we will hear from a harm reductionist, an addiction me...

29 Kesä 202041min

UnfilterED Clips: A Toxicologist's Perspective on COVID-19, Biological Warfare and the Need for Disaster Preparedness

UnfilterED Clips: A Toxicologist's Perspective on COVID-19, Biological Warfare and the Need for Disaster Preparedness

Taken from 'UnfilterED #8: Dr. Christopher Hoyte'. "This current sars-coV-2 / COVID-19 situation should really be a wake-up call for not just a pandemic, but for a biological attack...One of the thing...

27 Kesä 202011min

Suosittua kategoriassa Tiede

rss-poliisin-mieli
rss-mita-tulisi-tietaa
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi