#103 Fluids: 5 Pearls Segment
Core IM | Internal Medicine Podcast
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The Knock on Normal Sailing
The knock on normal sailing has been this idea that im giving too much of it can create hyper chloremic metabolic acidosis. But basically the way to think about it is that an excess of chloride creates a state a non gat metabolic acidosis and obviously, any state of acidosi is not good for an ailing patient. If you think about a septic patient whose kidney is already at risk, that really high chloride basically tricks kidney into dropping its own g f r. And ina vulnerable kidney, that could be enough to push it into ac so one of the mechanisms that is called tub glamalar feedback. Whenever you have increasing levels of chloride, it then turns to the
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