Chapter Nineteen: Metabolic Acidosis, part 2

About this episode

The episode discusses metabolic acidosis, its clinical implications, and related research findings.

References Chapter 19, Part 12 Metabolic acidosis  June 14, 2023 References Chapter 19, Part 2 Roger mentioned MELAS syndrome MELAS syndrome: Clinical manifestations, pathogenesis, and treatment options Josh mentioned this blog on lactate- Understanding lactate in sepsis & Using it to our advantage We discussed the Warburg effect The Warburg Effect: How Does it Benefit Cancer Cells? - PMC and here’s a case from skeleton key- Skeleton Key Group Case #28: Mysterious Acidosis in Cancer - Renal Fellow Network Otto Warburg won the Nobel Prize in Physiology and Medicine in 1931 for describing how animal tumors produce large quantities of lactic acid ( Wikipedia ) Joel calls it the Lactate saline reflex, but the accepted term of art is Lacto-Bolo reflex The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis Buffer agents do not reverse intramyocardial acidosis during cardiac resuscitation. Josh mentioned this article the BICAR-ICU Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial - The Lancet Roger shared 3 quotes to make the point that…

Topics covered

• metabolic acidosis
• MELAS syndrome
• lactate
• Warburg effect
• bicarbonate therapy
• sepsis

Keywords

• metabolic acidosis
• MELAS syndrome
• lactate
• Warburg effect
• bicarbonate therapy
• sepsis
• clinical manifestations
• treatment options

Mentioned in this episode

Organizations: Skeleton Key Group, Renal Fellow Network, The Lancet, Annals of Internal Medicine

Books & works: Understanding lactate in sepsis & Using it to our advantage, The Warburg Effect: How Does it Benefit Cancer Cells? - PMC, BICAR-ICU Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial - The Lancet, Lactic Acidosis and Bicarbonate Therapy | Annals of Internal Medicine, Wikipedia

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• Chapter Twenty: Respiratory Acidosis · June 3, 2026 · 1h 45m
• Chapter Twenty One: Respiratory Alkalosis · March 24, 2026 · 1h 7m
• Chapter Nineteen: Metabolic Acidosis, part 3 · February 22, 2026 · 1h 58m
• Chapter Eighteen: Metabolic Alkalosis, part 2 · July 22, 2025 · 1h 40m
• Chapter Nineteen: Metabolic Acidosis, The Show, part 1 · June 2, 2025 · 1h 45m
• Chapter Eighteen: Metabolic Alkalosis, part 1 · March 23, 2025 · 1h 6m