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Bicarbonate


Presentation

  • A 50-year-old male ingested 13.6 grams of amitriptyline and presented in cardiopulmonary arrest. After initial resuscitation, the patient developed a Brugada electrocardiographic pattern.[ncbi.nlm.nih.gov]
  • Evaluation should begin with assessment of whether an acute and potentially reversible cause of metabolic alkalosis is present. If not, management should be directed at treating malnutrition.[ncbi.nlm.nih.gov]
  • CASE PRESENTATION: A 48-year-old man ingested approximately 6.4 g of acebutolol with ethanol (blood ethanol 61 mmol/L). There were no other coingestants identified.[ncbi.nlm.nih.gov]
  • METHODS: The present short review reports early findings as well as recent insights into the role of CFTR for bicarbonate transport and its defects in CF.[ncbi.nlm.nih.gov]
  • We described the relationship between bicarbonate and adverse outcomes in children presenting to the emergency department (ED).[ncbi.nlm.nih.gov]
Pallor
  • The child's cardiac monitor revealed a wide-complex tachycardia with left bundle branch morphology, with associated pallor and poor capillary refill. Sodium bicarbonate was administered intravenously due to suspected flecainide toxicity.[ncbi.nlm.nih.gov]
Lip Numbness
  • Lip numbness was a requisite for all the patients. Success was determined as no or mild pain on the basis of Heft-Parker visual analog scale recordings upon access cavity preparation or initial instrumentation.[ncbi.nlm.nih.gov]
Muscle Twitch
  • Symptoms of Alkalosis • Confusion(can progress to stupor or coma) • Hand tremor • Light-headedness • Muscle twitching • Nausea, vomiting • Numbness or tingling in the face or extremities • Prolonged muscle spasms (tetany) Tell your doctor if you have:[drsircus.com]
Chvostek Sign
  • Because metabolic alkalosis decreases ionized calcium concentration, signs of hypocalcemia (eg, tetany, Chvostek sign, Trousseau sign), change in mental status, or seizures may be present.[drsircus.com]
Seizure
  • A self-limiting generalized seizure was witnessed 16 hours after ingestion. At this time the bicarbonate infusion had been ceased and the QRS interval was not prolonged.[ncbi.nlm.nih.gov]
  • Midazolam was administered with seizure resolution. Examination revealed 4-mm reactive pupils; nystagmus; warm, dry, flushed skin; and altered mental status.[ncbi.nlm.nih.gov]
  • Bupropion may cause seizures and conduction delays similar to tricyclic antidepressants in the overdose setting by an unknown mechanism.[ncbi.nlm.nih.gov]
  • The patient was found at home by his parents with witnessed "seizure-like"activity 2 hours after reportedly chewing and swallowing 168 yew seeds.[ncbi.nlm.nih.gov]
  • We report three cases involving four episodes of extreme MA with an arterial pH value greater than 7.60, serum bicarbonate concentration greater than 55 mmol/L, and stupor or seizure.[ncbi.nlm.nih.gov]
Neglect
  • For a long time, research concentrated on abnormal Cl - and Na transport, but neglected bicarbonate as a crucial factor in CF.[ncbi.nlm.nih.gov]
Generalized Seizure
  • A self-limiting generalized seizure was witnessed 16 hours after ingestion. At this time the bicarbonate infusion had been ceased and the QRS interval was not prolonged.[ncbi.nlm.nih.gov]

Workup

Bicarbonate Increased
  • RESULTS: The success rate after the buccal infiltration of sodium bicarbonate was 78%, whereas without the buccal infiltration of sodium bicarbonate it was 44% (P CONCLUSIONS: A buccal infiltration of 0.7 mL 8.4% sodium bicarbonate increased the success[ncbi.nlm.nih.gov]
  • Each 1 mEq/L of bicarbonate increase was associated with a 13% higher risk of incident heart failure (hazards ratio 1.13, 95% CI 1.01-2.11). Among diuretic users, higher bicarbonate was not associated with CVD.[ncbi.nlm.nih.gov]

Treatment

  • Our results show that this new treatment modality-which is inexpensive, easy to use, and has a low side-effect profile is effective in this chronic patient group.[ncbi.nlm.nih.gov]
  • Our actions to deal with these symptoms focused on reducing the bicarbonate gain during the first phase of the dialysis treatment.[ncbi.nlm.nih.gov]
  • The independent variable was treatment group, and confounders included sociodemographic data, neutrophil count, chemotherapy drug and dose received.[ncbi.nlm.nih.gov]
  • RESULTS: Thirteen patients in the placebo group and 15 patients in the treatment group completed the 104 weeks of follow-up with a comparable dropout rate (placebo group: 35% vs treatment group: 25%).[ncbi.nlm.nih.gov]
  • Abstract Bicarbonate dialysis is the treatment modality of choice for correction of metabolic acidosis in chronic renal failure. However, improper selection of dialysate concentrate can result in life-threatening human errors.[ncbi.nlm.nih.gov]

Prognosis

  • Spontaneous rupture of the stomach is an uncommon condition with a usually poor prognosis. The rupture occurs as a result of a closed loop obstruction with increased pressure against the stomach wall.[ncbi.nlm.nih.gov]

Epidemiology

  • Author information 1 Division of Nephrology, Department of Medicine, and matthew.abramowitz@einstein.yu.edu. 2 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York matthew.abramowitz@einstein.yu.edu.[ncbi.nlm.nih.gov]
  • Abstract Background: High dietary acid load relates to increased risk of type 2 diabetes in epidemiological studies. We aimed to investigate whether buffering a high acid load meal with an alkalizing treatment changes glucose metabolism post meal.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • A case of stomach rupture occurring after hyperdistention of the stomach following ingestion of sodium bicarbonate is described and the pathophysiological mechanism is discussed.[ncbi.nlm.nih.gov]
  • To understand the pathophysiology of the syndrome, we expressed wild-type (WT) NBCe1 and S427L-NBCe1 in Xenopus oocytes. Function was evaluated by measuring intracellular pH (HCO3- transport) and membrane currents using microelectrodes.[ncbi.nlm.nih.gov]
  • Useful For Suggests clinical disorders or settings where the test may be helpful Diagnosis and treatment of acid-base imbalance in respiratory and metabolic systems Clinical Information Discusses physiology, pathophysiology, and general clinical aspects[mayomedicallaboratories.com]

Prevention

  • There is no high quality randomised evidence regarding prevention of EVAR related AKI. METHODS: A novel AKI prevention strategy for EVAR was devised, based on best evidence and an expert consensus group.[ncbi.nlm.nih.gov]
  • BACKGROUND: The efficacy of combining use of N-acetylcysteine (NAC) and sodium bicarbonate (SOB) in the prevention of contrast-induced nephropathy (CIN) after cardiac catheterization and percutaneous coronary intervention (PCI) is unclear.[ncbi.nlm.nih.gov]
  • Abstract We describe the successful use of hydration with sodium bicarbonate and N-acetylcholine to prevent contrast-induced nephrophathy in a patient with a kidney transplant undergoing endovascular native renal artery aneurysm exclusion.[ncbi.nlm.nih.gov]
  • These results suggest possible efficacy of pretreatment with sodium bicarbonate as a preventive measure in patients with exercise-induced anaphylaxis.[ncbi.nlm.nih.gov]
  • We also prevented further MA with the use of a proton pump inhibitor.[ncbi.nlm.nih.gov]

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