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Lactate levels in dka

Avichai Weissbach, Noy Zur, Eytan Kaplan, Gili Kadmon, Yulia Gendler, Elhanan Nahum
OBJECTIVES: Acute kidney injury in the critically ill pediatric population is associated with worse outcome. The aim of this study was to assess the prevalence, associated clinical variables, and outcomes of acute kidney injury in children admitted to the PICU with diabetic ketoacidosis. DESIGN: Retrospective cohort. SETTING: PICU of a tertiary, university affiliated, pediatric medical center. PATIENTS: All children less than age 18 years with a primary diagnosis of diabetic ketoacidosis admitted to the PICU between November 2004 and October 2017...
January 2019: Pediatric Critical Care Medicine
Obeid Shafi, Virendra Kumar
INTRODUCTION: The optimal fluid therapy in children with DKA is a matter of debate, especially if we take into account its association with cerebral edema, the most important complication. Hypertonic Saline Solution is used in the treatment of cerebral edema, and also has been used for volume resuscitation in children with shock. AIM OF STUDY: To compare the effects of 3% saline and 0.9% saline solutions on changes in vital parameters, sodium and chloride levels, lactate and pH; time needed for the correction of hyperglycemia; time needed for the control of ketoacidosis and incidence of cerebral edema...
2018: Pediatric Endocrinology, Diabetes, and Metabolism
Yu-Mou Chou, Chen-June Seak, Zhong Ning Leonard Goh, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chih-Chuan Lin
RATIONALE: Diabetic ketoacidosis is a serious and potentially life-threatening acute complication of diabetes mellitus (DM). Euglycemic diabetic ketoacidosis (eDKA) is however challenging to identify in the emergency department (ED) due to absence of marked hyperglycemia, often leading to delayed diagnosis and treatment. eDKA has been recently found to be associated with sodium-glucose cotransporter 2 (SGLT2) inhibitors, one of the newest classes of antidiabetics, though there are very limited reports implicating dapagliflozin as the offending agent in ED patients...
June 2018: Medicine (Baltimore)
Chia Yeow, Frederick Wilson, Edward Walter, Javed Sultan
Euglycaemic diabetic ketoacidosis is a term describing features of diabetic ketoacidosis but with normoglycaemia. We present a case of a perioperative diagnosis of euglycaemic ketoacidosis in a patient not known to be diabetic, and the subsequent management of the patient. A 65-year-old lady was scheduled for re-exploration of a giant paraoesophageal hernia, which had been initially repaired over six weeks previously. She developed dysphagia soon after the initial surgery and had low caloric intake. Arterial blood gases performed intraoperatively revealed metabolic acidosis with a normal lactate level...
February 2016: Journal of the Intensive Care Society
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
Jong-Min Kim, Jun-Seop Shin, Byoung-Hoon Min, Hyun-Je Kim, Jung-Sik Kim, Il-Hee Yoon, Won-Young Jeong, Ga-Eul Lee, Min-Sun Kim, Ju-Eun Kim, Sang-Man Jin, Chung-Gyu Park
BACKGROUND: Diabetes mellitus (DM) model using streptozotocin (STZ) which induces chemical ablation of β cell in the pancreas has been widely used for various research purposes in non-human primates. However, STZ has been known to have a variety of adverse effects such as nephrotoxicity, hepatotoxicity, and even mortality. The purpose of this study is to report DM induction by STZ, toxicity associated with STZ and procedure and complication of exogenous insulin treatment for DM management in rhesus monkeys (Macaca mulatta) that are expected to be transplanted with porcine islets within 2 months...
November 2016: Xenotransplantation
Yutaro Ihara, Kazuoki Hizawa, Kouhei Fujita, Yuichi Matsuno, Tsutomu Sakuma, Motohiro Esaki, Mitsuo Iida
Acute esophageal mucosal lesions (AEMLs) are categorized into black esophagitis (type B) and non-black esophagitis (type NB) on endoscopy. To clarify the distinct pathophysiology, we compared the clinical features and hematological findings at onset among 17 patients with type B esophagitis and 6 patients with type NB esophagitis. In type B esophagitis, time to endoscopy after onset was significantly shorter, and blood levels of lactate, urea nitrogen, creatinine, and glucose were higher than in type NB esophagitis...
April 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Elizabeth Osei, Susanne Fonville, Adrienne A M Zandbergen, Paul J A M Brouwers, Laus J M M Mulder, Hester F Lingsma, Diederik W J Dippel, Peter J Koudstaal, Heleen M den Hertog
BACKGROUND: Impaired glucose tolerance is present in one third of patients with a TIA or ischemic stroke and is associated with a two-fold risk of recurrent stroke. Metformin improves glucose tolerance, but often leads to side effects. The aim of this study is to explore the feasibility, safety, and effects on glucose metabolism of metformin and sitagliptin in patients with TIA or minor ischemic stroke and impaired glucose tolerance. We will also assess whether a slow increase in metformin dose and better support and information on this treatment will reduce the incidence of side effects in these patients...
2015: Trials
Terhi Keltanen, Antti Sajantila, Tiina Valonen, Teija Partanen, Katarina Lindroos
Glycated hemoglobin (HbA1c) is used for diagnosis of diabetes and evaluation of the glycemic control of diabetics in clinical medicine. It is also a useful biomarker for analyzing postmortem samples, since it is relatively stable and correlates well with clinical samples. We wanted to evaluate the information provided by HbA1c analysis of postmortem blood samples using a HPLC based, fully automated analyzer. Autopsy data from 55 cases, in which glucose, lactate, ketone bodies, and HbA1c were analyzed as a part of cause of death investigation, were selected for the study...
March 2015: Forensic Science, Medicine, and Pathology
Suhendro Suwarto, Bambang Sutrisna, Sarwono Waspadji, Herdiman T Pohan
AIM: to determine the role of serum lactate and diabetic ketoacidosis (DKA) severity as predictors for five-days mortality in DKA patients. METHODS: a prospective cohort study was conducted in DKA patients admitted to emergency department (ED) at Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during 2007-2008 periods. Predictors for 5 days mortality in DKA patients in this study including serum lactate and DKA severity (plasma glucose, arterial blood pH, serum bicarbonate, osmolality, anion gap, and alteration in sensorium) at admission...
January 2014: Acta Medica Indonesiana
Jeroen J M A Hendrikx, Jurjen S Lagas, Ratana Daling, Jan Hendrik Hooijberg, Jan H M Schellens, Jos H Beijnen, Desiderius P M Brandjes, Alwin D R Huitema
An intoxication with drugs, ethanol or cleaning solvents may cause a complex clinical scenario if multiple agents have been ingested simultaneously. The situation can become even more complex in patients with (multiple) co-morbidities. A 59-year-old man with type 2 diabetes mellitus (without treatment two weeks before the intoxication) intentionally ingested a substantial amount of ethanol along with ~750 mL of laminate floor cleaner containing citric acid. The patient was admitted with severe metabolic acidosis (both ketoacidosis and lactic acidosis, with serum lactate levels of 22 mM)...
November 2014: Basic & Clinical Pharmacology & Toxicology
Terhi Keltanen, Antti Sajantila, Jukka U Palo, Teija Partanen, Tiina Valonen, Katarina Lindroos
Diabetes and alcohol abuse may cause severe metabolic disturbances that can be fatal. These may be difficult to diagnose in autopsies based solely on macroscopical and histological findings. In such cases, metabolic markers, such as postmortem glucose and ketone levels, can provide supporting information. Glucose or combined glucose and lactate, the Traub value, is often used to indicate hyperglycemia. The use of the Traub value, however, has been questioned by some, because the lactate levels are known to elevate in postmortem samples also due to other reasons than glycolysis of glucose molecules...
November 2013: International Journal of Legal Medicine
Lars W Andersen, Julie Mackenhauer, Jonathan C Roberts, Katherine M Berg, Michael N Cocchi, Michael W Donnino
Lactate levels are commonly evaluated in acutely ill patients. Although most often used in the context of evaluating shock, lactate levels can be elevated for many reasons. While tissue hypoperfusion may be the most common cause of elevation, many other etiologies or contributing factors exist. Clinicians need to be aware of the many potential causes of lactate level elevation as the clinical and prognostic importance of an elevated lactate level varies widely by disease state. Moreover, specific therapy may need to be tailored to the underlying cause of elevation...
October 2013: Mayo Clinic Proceedings
Ari Moskowitz, Amanda Graver, Tyler Giberson, Katherine Berg, Xiaowen Liu, Amy Uber, Shiva Gautam, Michael W Donnino
PURPOSE: Thiamine functions as an important cofactor in aerobic metabolism and thiamine deficiency can contribute to lactic acidosis. Although increased rates of thiamine deficiency have been described in diabetic outpatients, this phenomenon has not been studied in relation to diabetic ketoacidosis (DKA). In the present study, we hypothesize that thiamine deficiency is associated with elevated lactate in patients with DKA. MATERIALS AND METHODS: This was a prospective observational study of patients presenting to a tertiary care center with DKA...
February 2014: Journal of Critical Care
Horacio Márquez-González, Jesús Pámanes-González, Horacio Márquez-Flores, Alonso Gómez-Negrete, Mireya C Muñoz-Ramírez, Antonio Rafael Villa-Romero
Gasometry is the measurement of dissolved gases in the blood, by measuring pH, carbon dioxide pressure (pCO(2)), serum bicarbonate (HCO(3-)), and lactate and serum electrolytes: sodium, potassium and chlorine you can make a diagnosis, etiology and treatment in the critically ill patient. The aim is to provide five steps for the interpretation of blood gases by: 1. The definition of acidemia or acidosis, or alkalemia or alkalosis. 2. Defining the metabolic component or respiratory. 3. To determine the anion gap; levels above 15 ± 2 determine other likely causes of excess anions (methanol, uremia, diabetic ketoacidosis, paraldehyde, ionized, lactic acidosis, ethylene glycol and salicylates...
July 2012: Revista Médica del Instituto Mexicano del Seguro Social
Cristian Palmiere, Frank Sporkert, Paul Vaucher, Dominique Werner, Daniel Bardy, François Rey, Christelle Lardi, Christophe Brunel, Marc Augsburger, Patrice Mangin
According to the hypothesis of Traub, also known as the 'formula of Traub', postmortem values of glucose and lactate found in the cerebrospinal fluid or vitreous humor are considered indicators of antemortem blood glucose levels. However, because the lactate concentration increases in the vitreous and cerebrospinal fluid after death, some authors postulated that using the sum value to estimate antemortem blood glucose levels could lead to an overestimation of the cases of glucose metabolic disorders with fatal outcomes, such as diabetic ketoacidosis...
May 2012: International Journal of Legal Medicine
D G Van Zyl, P Rheeder, E Delport
OBJECTIVE: To determine if Ringer's lactate is superior to 0.9% sodium chloride solution for resolution of acidosis in the management of diabetic ketoacidosis (DKA). DESIGN: Parallel double blind randomized controlled trial. METHODS: Patients presenting with DKA at Kalafong and Steve Biko Academic hospitals were recruited for inclusion in this study if they were >18 years of age, had a venous pH >6.9 and ≤7.2, a blood glucose of >13 mmol/l and had urine ketones of ≥2+...
April 2012: QJM: Monthly Journal of the Association of Physicians
Jianxin Lu, Gordon A Zello, Edward Randell, Khosrow Adeli, John Krahn, Qing H Meng
BACKGROUND: A high anion gap in diabetic ketoacidosis (DKA) suggests that some unmeasured anions must contribute to the generation of the anion gap. We investigated the contribution of D-lactate to the anion gap in DKA. METHODS: Diabetic patients with and without DKA and high anion gap were recruited. Plasma D-lactate was quantified by HPLC. Plasma methylglyoxal was assayed by liquid chromatography-tandem mass spectrometry. RESULTS: The plasma fasting glucose, β-hydroxybutyrate, and blood HbA1c levels were highly elevated in DKA...
January 30, 2011: Clinica Chimica Acta; International Journal of Clinical Chemistry
V N Titov, L F Dmitriev, V A Krylin, V A Dmitriev
In philogenesis, due to the failure to store a great deal of carbohydrates in vivo as glycogen, all animal species began synthesizing from glucose palminitic fatty acid and depositing it as triglycerides. During biological dysfunction of exotrophy (long starvation, early postnatality, hibernation), cells also accomplish a reverse synthesis of glucose from fatty acids under aerobic conditions. Under physiological conditions, acetyl-CoA that is converted to malate and pyruvate in the glyoxalate cycle is a substrate of glyconeogenesis...
March 2010: Klinicheskaia Laboratornaia Diagnostika
Roger W Byard, Chong Zhou
The Armanni-Ebstein phenomenon, which is found in the kidneys in diabetic ketoacidosis, has also been proposed as an independent diagnostic postmortem marker for hypothermia. A case is reported to demonstrate the possibility of a more complex inter-related etiology in certain instances. A 44-year-old man with a past history of hospital admission for hypothermia, alcoholism and insulin dependent diabetes mellitus was found dead at his home address. At autopsy there were prominent superficial erosive gastritis (Wischnewsky spots) in keeping with terminal hypothermia...
December 2010: Forensic Science, Medicine, and Pathology
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