#tweetorial ๐งต on Why we should not give Bicarbonate in patients of #DKA ...
Let's dive into the depth of #Physiology and #Biochemistry
We all Know Diabetes is a state of Insulin deficiency +/- resistance
#Medtwitter #NEETPG
@Paramomycin @BhvikaZ @karthik2k2 @DoctorLFC
Let's dive into the depth of #Physiology and #Biochemistry
We all Know Diabetes is a state of Insulin deficiency +/- resistance
#Medtwitter #NEETPG
@Paramomycin @BhvikaZ @karthik2k2 @DoctorLFC
So what happens in DKA, there is extreme deficiency of Insulin results in abundance of Sugar (glucose) in blood but Decreased Glucose intracellularly
Results in Increased lipolysis and ketosis production results in decreased Hco3 levels and High H+ levels
Note : H+ is raised
Results in Increased lipolysis and ketosis production results in decreased Hco3 levels and High H+ levels
Note : H+ is raised
On the other side there is Intracellular depletion of Glucose.....
the only source of energy for RBCs is Glycolysis.... Intracellular hypoglycemia results in decreased Glycolysis
Note: 2,3 DPG is a byproduct of Glycolysis
the only source of energy for RBCs is Glycolysis.... Intracellular hypoglycemia results in decreased Glycolysis
Note: 2,3 DPG is a byproduct of Glycolysis
Now let's look into the Physiology of Oxygen supply To the cells through RBCs
Oxygenated Hemoglobin get's deoxygenated in Tissue after dissociation of Oxygen from HB
This dissociation depends on various factors Which are explained by "Bohr Effect"
Oxygenated Hemoglobin get's deoxygenated in Tissue after dissociation of Oxygen from HB
This dissociation depends on various factors Which are explained by "Bohr Effect"
Now Look Back into what happens in DKA patient as I mentioned in above tweets
They will have more H+ ions and low 2,3DPG results in maintaining Hb oxygen dissociation curve in equilibrium
What will happen if you infuse Hco3 and correct acidosis
There will be reduced H+ ions
They will have more H+ ions and low 2,3DPG results in maintaining Hb oxygen dissociation curve in equilibrium
What will happen if you infuse Hco3 and correct acidosis
There will be reduced H+ ions
This results in shifting of the Hb oxygen dissociation curve towards left results in increased oxygen affinity to RBCs, leads to tissue (Intracellular) Hypoxia
This is detrimental to the patient
#NephTwitter #Endotwitter #ApexPathshala
@kidney_boy @hswapnil @divyaa24
This is detrimental to the patient
#NephTwitter #Endotwitter #ApexPathshala
@kidney_boy @hswapnil @divyaa24
Loading suggestions...