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Biochemistry of Buffering Capacity and Ingestion of Buffers In Exercise and Athletic Performance
Published in Peter M. Tiidus, Rebecca E. K. MacPherson, Paul J. LeBlanc, Andrea R. Josse, The Routledge Handbook on Biochemistry of Exercise, 2020
Bryan Saunders, Guilherme G. Artioli, Eimear Dolan, Rebecca L. Jones, Joseph Matthews, Craig Sale
Normal resting blood bicarbonate concentrations range between 23 and 27 mmol·L−1 (67). Sodium bicarbonate is a buffering agent capable of inducing alkalosis via increases in blood pH and bicarbonate (21, 60). This aids in the maintenance of muscle acid–base balance during exercise, increasing the efflux of H+ from the contracting muscle (59), forming carbonic acid, and allowing further buffering by the respiratory system (Figure 22.3). Sodium bicarbonate is another supplement included as one of the five sport supplements that have sufficient evidence to support their use by the International Olympic Committee (68).
Clinical Aspects of Acid–Base Control
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Acidosis describes the abnormal condition or process that tends to decrease blood pH if there are no secondary changes in the response to the primary disease. The primary process is called respiratory if the changes are in or metabolic if the changes are due to fixed or non-volatile acids that lead to a decrease in .
Micronutrient Supplementation and Ergogenesis — Metabolic Intermediates
Published in Luke Bucci, Nutrients as Ergogenic Aids for Sports and Exercise, 2020
Although excessive alkalosis theoretically has negative effects,354 and performance with blood pH greater than 7.5 reportedly caused decreases in performance,403 it appears that a mildly elevated blood pH of 7.4 to 7.5 at start of exercise is associated with increased anaerobic performance. Tolerance to lactate via increases in body-buffering capacity,354,382,384,405 sparing of muscle glycogenolysis and creatine phosphate,363,381 greater efflux of H+ and lactate from muscle cells,382,405 and possibly increased utilization of lactate as a fuel354 are thought to contribute to the beneficial ergogenic effects of alkaline loading.
The role of sodium-glucose co-transporter 2 protein inhibitors in heart failure: more than an antidiabetic drug?
Published in Expert Opinion on Pharmacotherapy, 2022
Sugeevan Savarimuthu, Amer Harky
Diabetic ketoacidosis (DKA) can be a rare and life-threatening side effect of SGLT2 inhibitor use with the atypical presentation of euglycaemic ketoacidosis, which can occur in 70% of cases. SGLT2 inhibitors can act to reduce plasma insulin concentration, increase plasma glucagon concentration, and increase in free fatty acid which promotes ketogenesis. Resulting in a drop in blood pH and leading to a life-threatening situation. Trials such as the CREDENCE trial have shown a higher even rate of SGLT2 inhibitor associated DKA compared to cardiovascular outcomes, whereas the DAPA-CKD trial there were no reported cases of DKA, thought this trial included patients with and without DM. Patients with concomitant insulin therapy or T2DM with insulin deficiency appeared to be associated with a higher risk of developing DKA. Trigger for SGLT2 inhibitor associated DKA can include stress such as infection or surgery, hypovolaemia, and fasting such as pre-operative [7,28].
Lower plasma calcium associated with COVID-19, but not with disease severity: a two-centre retrospective cohort study
Published in Infectious Diseases, 2022
Jan Arne Deodatus, Simone Anna Kooistra, Steef Kurstjens, Joram Cornèl Leon Mossink, Joris David van Dijk, Paul Hendrik Pieter Groeneveld, Brigitta (Britt) Yarine Maxime van der Kolk
Second, we found higher pH levels in COVID-19 positive patients than in COVID-19 negative patients (7.48 ± 0.07 vs. 7.41 ± 0.11, p < .001); this is a known phenomenon in COVID-19 patients primarily contributed to hypoxia-driven respiratory alkalosis [24]. Although errors in sample procedure may cause pH drift in blood samples [25], pH values in our study are likely to represent true blood pH of patients as all blood gas analyses in our ED were arterial, were drawn in anaerobic conditions, and were processed urgently. Because alkalosis lowers the amount of free ionized calcium in the blood due to increased albumin binding, differences in blood pH partially explain the difference in ionized calcium levels between COVID-19 positive and negative patients [25]. This effect is illustrated by the attenuation of the difference of uncorrected ionized calcium levels (Δ0.05 mmol/L, p < .001) after correction for pH (Δ0.02 mmol/L, p = .03) in univariate analysis (Table 2). However, the multivariate analyses show an association between ionized calcium and COVID-19 that persists even after adding pH to the model (p < .001; Table 3). A significant association between pH and ionized calcium was present in this model (p = .04), but did not decrease the validity of the relationship between ionized calcium and COVID-19, leading us to believe that despite an effect of pH, lower ionized calcium levels are associated with SARS-CoV-2 infection independently.
Estimation of the risk of local and systemic effects in infants after ingestion of low-concentrated weak acids from descaling products
Published in Clinical Toxicology, 2022
Arjen Koppen, Claudine C. Hunault, Regina G. D. M. van Kleef, Agnes G. van Velzen, Remco H. S. Westerink, Irma de Vries, Dylan W. de Lange
Moreover, it is difficult to predict the occurrence of systemic effects after such exposures. In case of a functional intestinal barrier, the rate of acid absorption, metabolism and excretion determines the acid load. At a steady state, blood pH is tightly regulated and buffered, since protein function is strongly dependent on pH. Mechanisms for pH auto-regulation include the carbonic acid–bicarbonate buffer system, renal bicarbonate homeostasis, renal excretion of ammonium ions, respiratory control of the partial pressure of carbon dioxide and buffering by bone [6,7]. Systemic effects may occur when acids enter the blood circulation after ingestion of large amounts. Damage to the gastrointestinal barrier promotes the absorption of larger amounts of acids. In some cases, the resulting acidemia (lowering of blood pH) cannot be corrected sufficiently and symptoms like hemolysis, thrombocytopenia, clotting disorders, changes in respiratory rate, Kussmaul respiration, kidney disorders, nausea and vomiting can be observed [8].