Thank you so much! I really love your UA-cam channel. There is one thing I want to add, though. I believe that at 22:17, the patient is experiencing pure AG metabolic acidosis(AGMA). If you calculate the delta ratio, it is less than 2, which indicates that it belongs to pure AGMA. The delta ratio is calculated as follows: delta ratio = (31-12) / (24-10) = 19 / 14 = 1.37 If AGMA is due to ketones, then a value of 1.2 above indicates the presence of AGMA and metabolic alkalosis. However, in this case, the lab glucose was 94. For AGMA due to other reasons to be present with metabolic alkalosis, the delta ratio would have to be above 2.
This makes me flash back to 2012 Icu rotations in residency. My attending use to say "I will come to your house in the middle of the night and wake you up from a deep sleep and you will be able to tell me winter's formula, or I will beat you with a stick" I was so terrified I mastered acid base, and have not used it since... but if u see Dr Carpati at Lenox hill tell him I still remember winter's formula
Well done video overall, though I would quibble with opioids as a cause of respiratory acidosis being bracketed along with anything causing a change in mental status. Opioids cause a very specific, largely mu mediated, respiratory depression even without obvious sedation, exemplified by the typical slow respiratory rate with largely preserved tidal volumes decreasing overall minute ventilation and resulting in an elevated pCO2.
Thank you so much! I really love your UA-cam channel. There is one thing I want to add, though. I believe that at 22:17, the patient is experiencing pure AG metabolic acidosis(AGMA). If you calculate the delta ratio, it is less than 2, which indicates that it belongs to pure AGMA. The delta ratio is calculated as follows: delta ratio = (31-12) / (24-10) = 19 / 14 = 1.37 If AGMA is due to ketones, then a value of 1.2 above indicates the presence of AGMA and metabolic alkalosis. However, in this case, the lab glucose was 94. For AGMA due to other reasons to be present with metabolic alkalosis, the delta ratio would have to be above 2.
Wow. This helped so much! Appreciation from south Africa!
This makes me flash back to 2012 Icu rotations in residency. My attending use to say "I will come to your house in the middle of the night and wake you up from a deep sleep and you will be able to tell me winter's formula, or I will beat you with a stick" I was so terrified I mastered acid base, and have not used it since... but if u see Dr Carpati at Lenox hill tell him I still remember winter's formula
Once you are of AD this page is going to generate some $$....you are talented and we are learning and remembering so much!!
This is amazing, I understood more this than my 8 years in college
Very good you are a great teacher! Can you teach us ventilator basics?
You are the best . God bless you . Keep on doing great work.
Thank you so much, I agree, please do more lectures, great teaching skills!
Your videos are so helpful!! I FINALLY get it. Thank you!
Thank you very much. You’re a genius.
Wow, amazing job
Very good and understandable even for me as a German. Thank you very much! Will you publish any more videos?
omg this is amazing. thank you! Please do more!
Thank you!!! Please keep posting!
Excellent !! Thank you.
Can you do a whole series for the non-intensivist? Maybe for the non-internist? Or the non-adultist? (Peds here)
Well done video overall, though I would quibble with opioids as a cause of respiratory acidosis being bracketed along with anything causing a change in mental status. Opioids cause a very specific, largely mu mediated, respiratory depression even without obvious sedation, exemplified by the typical slow respiratory rate with largely preserved tidal volumes decreasing overall minute ventilation and resulting in an elevated pCO2.
Thanks for quibbling. Interesting point.
You’re amazing!!!❤️
thanks great teacher i love you
that's superb
Really great discussion, can you discuss pressors and inotropes please
ua-cam.com/video/XvTTEr9SsLk/v-deo.html
Hope that helps! Have a great day!
in this fish bone cheat sheet, that 14 value which she said is bicarbonate section should actually be CO2 section.
At 12:23 you mention 116. Where does that come from? Checking your math like you asked. Thanks.
Cl + HCO3 = 102 + 14 = 116;
NA - (Cl+HCO3)= 138-116 = 22 = Anion gap
Thanks for checking!