Uncovering the basis of a severe degree of acidemia in a patient with diabetic ketoacidosis by M. Gowrishankar, A.P.C.P. Carlotti, C. St George-Hyslop,

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Presentation transcript:

Uncovering the basis of a severe degree of acidemia in a patient with diabetic ketoacidosis by M. Gowrishankar, A.P.C.P. Carlotti, C. St George-Hyslop, D. Bohn, K.S. Kamel, M.R. Davids, and M.L. Halperin QJM Volume 100(11): October 30, 2007 © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Overview of the biochemistry and physiology of ketoacidosis. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Uncoupling of oxidative phosphorylation and hepatic ketogenesis. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Balance for H+ and β-HB− when ketoacids are accumulating. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Indirect loss of NaHCO3. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Buffering of H+ in the brain in a patient with a contracted ‘effective’ arterial blood volume. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please

Time course for the rise in the PHCO3 in this patient. M. Gowrishankar et al. QJM 2007;100: © The Author Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please