#Respiratory alkalosis

[weirdstrangeandawful]

By the way, your fingers get numb and tingly when you have too little carbon dioxide in your blood even before reaching dangerous levels.

This happens to me when I overbreathe. My blood oxygen drops sometimes and I hyperventilate and often end up overcompensating and breathing off my carbon dioxide. This can also happen with panic attacks too. My body always figures itself out but just a tasty little whump nugget for your various I-want-to-cause-terrifying-but-benign-symptoms whump needs.

(It can be not benign if it gets to the point of respiratory alkalosis if you want to go that route too)

[phantalgia]

Respiratory alkalosis: Progress on my other physical symptoms

I was just reminded, one of the things I learned from my doctors appointment (outside of covid) was something called respiratory alkalosis. This is increased breathing that leads to reduced levels of CO2.

Funny enough, the symptoms of respiratory alkalosis looks familiar if you have dysautonomia and it certainly does. In fact it's started to get me to question if I even have dysautonomia at all.

I do a lot of sighing, and when I’m stressed my breathing changes. However. Something doesn't seem right.

Usually my breathing pattern is low and shallow, but there are points in which that changes. It's not exclusive to anxiety/stress or is it? I don’t know. In fact, this could be the reason why I've had symptoms for so long.

See, when I was younger. In the summer usually, I would notice that it got harder to take in air for whatever reason. This lead to a lot of anxiety of course which begs the question. Is this anxiety or something else?

I get that feeling of not enough air a lot. It's worse when I’m upright. I don’t really quite buy the idea that I hyperventilate. If I do, there's a reason. I get tired out, short of breathe for some random reason, cant focus, head hurts and need a big breathe or two. This can then lead into those episodes.

So, ok, respritory alkalosis. Why that? What is causing that? I found some extra details on this site:

https://www.potsuk.org/managingpots/breathing-pattern-disorders-in-pots/

There's a part where it says that low and shallow breathing decreases the fight or flight response. Now, I don’t know if POTS/dysautonomia applies to me, but some of this stuff on breathing pattern issues might at least and it could be a long term thing.

Something doesn't seem right. It doesn't seem to be only an anxiety/stress thing. There is definetly something in which it feels like I’m not getting enough air or need to breathe bigger as I’m idle and upright. What that is I have no idea. It could be anxiety for all I know or something else.

I havent seen any connections between autonomonic issues and breathing issues, this was the only closest thing. POTS has 80-90% association with breathing pattern dysfunction or hyperventilation. It doesn't mean anything in my case yet. I think the takeaway is that there might be a physicial aspect to my breathing pattern that has changed.

Perhaps it was those early panic attacks I had as a kid that caused the change. Perhaps not. I remember vividly a time in which I was complaining about not getting enough air. And it seemed physical which then lead to actual panic attacks or deep anxiety and conciousness about my breathing.

Over time I got used to it and I was desensitized to the point where I didnt even notice it anymore. But now that I learned about this. Something is clicking in my head and I’m kind of worried right now, which doesn't help of course.

If I had a long term change in my breathing pattern since I was a teenager, what the hell caused that change? Is there something messed up that makes me breathe that way? It might not be.

My doctor and my Dad both have the opposite problem. They'll hold in their breath, not breath for a while and then return. Yet here they both are still kicking.

Alas, this is actual progress on my long term issues. It's not a full answer but is in the right direction. The question now is where did this come from? Is it truly anxiety that altered my breathing pattern or something else?

The implications are big for me. No wonder why I couldnt focus in school, got headaches, was fatigued easily. I was breathing too much. This causes a decrease in blood flow to the brain, hence the headaches and trouble focusing.

I don’t want any long term problems and I hope I don’t get any. I really want answers. So it seems like we're much closer than before. But not at the full picture.

Another thing I do know is respiratory alkalosis has gotten worse since both my surgery and covid. One of the big things I've noticed is how sensitive I am to dizzy episodes from just my breathing. An example is laughing hard. I used to handle laughing fits pretty well. I had recently after a long time laughed super hard, I was practically covering my face with tears, I was dizzy as hell, lightheaded, and started to shake violently. Cleary that's not exclusive to respiratory alkalosis, and there is some autonomonic stuff in there if Im getting a reaction like that.

Who knows...the search and resolution still continues. But hey at least there's some progress...

[captainpissofff]

Tell me which is your WORST RE4R chapter and whY IS IT THIS FUCKING ONE???¿?

[frogeyedape]

Hiccup cure

I cannot for the life of me remeber where I saw the 3 part guaranteed hiccup cure (let's be honest, probably here), but ever since I did anytime I get the hiccups it's like I literally just *imagine* doing the first cure (dissolve a spoonful of sugar in your mouth) and my hiccups stop.

!! Went searching for the og b/c I couldn't remember cure three and instantly saw the Hiccup (picture of Hiccup from How to Train Your Dragon) Cure page on Diane Duane's site, and bing bing bing! Yep, saw it on tumblr and clicked through to that selfsame page, so thank you @dduane

Anyway, the reason for this post: is/why is *imagining* putting sugar in my mouth dtopping my hiccups?? Hypothesis: I have a pavlovian response to sugar/thinking of sugar that is as good as eating sugar for the purpose of this cure. That would be...wow. No proof of causality thus far beyond the anecdotal, but interesting.

[reality-detective]

Dr. Berg explains "Respiratory Alkalosis"

It's when your blood pH is slightly too alkaline, often linked to low stomach acids, possibly triggered by acid reflux.

Fix the root cause for better sleep! 🤔

[gynandromorph]

so strangulation is a running theme in idletry. an important one. with shiloh, if the prior content thus far hadn't made it obvious. the thing about naked mole rats is that they can survive without oxygen for up to 20 minutes. they do this by metabolizing fructose like a plant, circumventing the need for oxygen. this can be a problem for a mole rat who wants some kind of choke high. however, manual strangulation frequently incapacitates and kills by applying pressure on the arteries in the neck, which are much more essily compressed than the trachea. even a mole rat will black out (and die) if blood is completely cut off from the brain, at the same speed as any mammal, which is good news for shiloh.

relatedly, one may know from watching enough cave diving videos that a single gulp of air that is mostly carbon dioxide will incapacitate a human instantly due to a phenomenon called acute respiratory acidosis, where the sudden uptake of carbon dioxide beyond what the kidneys and lungs can handle causes the blood to become fatally acidic. this is a separate phenomenon from dying due to a lack of oxygen to power metabolic processes. I wondered if they are also resistant to high CO2 concentrations; it turns out that they aren't just resistant to high CO2 – naked mole rats may literally depend on high concentrations of CO2 produced by huddling together in deep tunnels, as studies have observed that naked mole rats can start to hyperventilate and have seizures as they enter respiratory alkalosis, or, the opposite of acidosis. this is due to a complicated mutation that affects GABAergenic processes due to a cascade of molecular interactions. GABA is an important inhibitory chemical that regulates activity in the brain, and it is why GABA targeted drugs such as benzodiazepines function as immediate rescue medications to stop cluster seizures.

tangentially, shiloh is shown in the comic to take benzos recreationally, so I will have to think about that. it is not an issue, of course, because these seizures in naked mole rats can be stopped with the same medications, and they likely react the same way to the drugs as other mammals, but produce and regulate GABA differently as an adaptation to high CO2 environments. they really are little freaks of nature

[obfuscated-abstract]

Title: Breathlessness and dysfunctional breathing in patients with postural orthostatic tachycardia syndrome (POTS): The impact of a physiotherapy intervention

Date: January 2020 Published in: Autonomic Neuroscience Publicly available: It is now.

Citation: Reilly, C. C., Floyd, S. V., Lee, K., Warwick, G., James, S., Gall, N., & Rafferty, G. F. (2020). Breathlessness and dysfunctional breathing in patients with postural orthostatic tachycardia syndrome (pots): The impact of a physiotherapy intervention. Autonomic Neuroscience, 223, 102601. https://doi.org/https://doi.org/10.1016/j.autneu.2019.102601

Full text

Abbreviations:

BPAT: breathing pattern assessment tool

COPD: chronic obstructive pulmonary disease

DB: dysfunctional breathing

HVS: hyperventilation syndrome

POTS: postural orthostatic tachycardia syndrome

Article summary

Abstract

Introduction

POTS is a chronic syndrome with complex symptoms of orthostatic intolerance. It is defined as an increase in heart rate of ≥ 30bpm in adults (≥40 bpm in children) within 10 minutes of standing with no orthostatic drop in blood pressure.

POTS is more common in women. Symptoms can be debilitating (impairment comparable to congestive heart failure and COPD) and include palpitations, light headedness/syncope, chest discomfort, breathlessness, neuropathic pain, chronic fatigue, poor sleep efficience, gastrointestinal symptoms, syncope, cognitive slowing, and psychological distress.

Breathlessness is a common symptom in POTS. Breathlessness is often attributed to changes in breathing pattern, frequency, and/or quality occuring alongside cardiac symptoms. Breathlessness can be episodic, triggered by physical activity, stressful thoughts and events.

Dysfunctional breathing (DB) is an umbrella term describing breathing disorders where chronic changes in breathing pattern result in breathlessness and other symptoms without respiratory or cardiac disease. The most studied form of DB is hyperventilation syndrome (HVS)

Boulding et al. (2016) suggest classifying dysfunctional breathing into the following: 1) Hyperventilation syndrome (a respiratory pattern associated with symptoms both related to respiratory alkalosis and independent of hypocapnia), 2) Periodic deep sighing (frequent sighing with an irregular breathing pattern), 3) Thoracis dominant breathing (a respiratory pattern occurring separate to somatic disease may be considered dysfunctional and results in dyspnoea), 4) Forced abdominal expiration (inappropriate and excessive use of abdominal muscle contraction to aid expiration), 5) Thoraco-abdominal asynchrony (a respiratory pattern in which there is delay between rib cage and abdominal contraction resulting in ineffective breathing movements)

Patients with POTS often undergo extensive investigations due to the complexity of potential comorbidities but there is no guidance or consensus on the assessment of breathlessness.

Methods

Retrospective study of POTS patients referred to repiratory physiotherapy

Respiratory physiotherapy outpatient's referral criteria: tests performed and identification of DB/HVS are explained

Physiotherapy assessment and outcome measures

A standardised physiotherapy assessment of symptoms was performed on all patients (details provided in the paper)

Physiotherapy intervention:

The physiotherapy intervention was standaradised in terms of education and breathing re-training exercises and was delivered by a consultant physiotherapist of a highly specialised respiratory physiotherapist. Each patient was assessed and treated by the same physiotherapist.

Physiotherapy treatment

The educational component focused on patient's understanding of respiratory physiology and the mind-body link

Breathing re-training intervention involved teaching breathing control (details provided). The breathing retraining exercises were standardised and progressive. All techniques used were standard respiratory physiotherapy techniques commonly applied for acute and chronic respiratory disease. Their use for breathlessness in POTS had no previously been assessed.

Patients were discharged when they were confident to continue the re-training programme independently or if they did not attend for follow-up appointments.

Data analysis: details and figures provided in the paper

Results

Demographic information is given in Table 1

Signficiant improvements were observed and are noted in Table 2

Discussion

This paper is the first to characterise DB/HVS and investigate the impact of physiotherapy in POTS. The results indicate that breathing retraining results in significant improvements in breathing pattern and symptom burden thus potentially improving their health related quality of life. Further studies are needed.

Significance of the findings

it is estimated that DB/HVS affects 10% of the general population and is more prevalent in women than men. Patients with POTS who reported respiratory symptoms had DB/HVS. DB/HVS may coexist alongside chronic respiratory diseases and COPDalthough the relationship is unclear.

Although there were statistically significant improvements for the patient cohort as a whole, not all patients had complete resolutions of their DB/HVS and there are several limitations in interpreting the results for this study.

Unexplained breathlessness or 'air hunger' are predominant symptoms of DB/HVS and can result in significant patient morbidity and an array of non-respiratory symptoms which can themselves provoke anxiety/panic and further breathing irregularity

Whilst orthostatic tachycardia is the main symptom of POTS, orthostasis causes a variety of other symptoms through a vaireity of different mechanisms. The paper provides an overview of the hypothesised mechanisms.

Psychological influences (stress, axniety, depression, etc.) are highly prevalent in POTS patients and predispose them to DB/HVS. The impact of this study's intervention could, therefore, be partly related to a change in anxiety thanks to education, greater understanding of DB/HVS, and empowerment.

Proposed improvements for further studies include the inclusion of pre-post PaCO2 measurements, the exclusion of asthma and pulmonary hypertension, analysis of why patients attended appointments (and addressing the issues)

Access to respiratory physiotherapy outpatient services is limited across the NHS and many POTS patients are instead seen by muscluloskeletal physiotherapists due to comorbidities. Increased awareness may improve treatment for these patients

More data is needed to investigate the prevalence of dysfunctional breathing in POTS and how it relateds to other chronic conditions. More detailed investigation and assessment guidelines and techniques are needed.

Limitations

No control data were available

Outcome measures were potentially not sensitive to non-hyperventilatory dysfunctional breathing

Observational nature and small sample size did not allow exploration of the role of confounding variables

A selection bias may have been introduced due to this being a convenience sample

The Nijmegen score used to characterise these patients has not been validated in this patient population. Its limitations highlight the need for a holistic POTS-specific measure.

Physiological outcome measures for the diagnosis of HVS are often limited to specialist services so alternative diagnostic tests are sought. The Breathing Pattern Assessment Tool (BPAT) has demonstrated good sensitivity and specificity for the diagnosis of DB in refractory asthma. Responsiveness of the BPAT to treatment remains to be ascertained.

Measuring Neural Respiratory Drive (NRD) in breathlessness patients with POTS may be advantageous. NRD provides a global measure of breathlessness and a physiological correlate to breathlessness but there is no data on whether NRD is increased in POTS or on NRD pre-post respiratory interventions

Conclusion

[survivingsusac]

What do you know about hyperchloremia?

It’s latin for high chloride in the blood.

Jumping right in today because I'm too tired for my typical rambles. Unusual, I know. And borderline concerning.

I got a complete blood panel workup done this week. It's a typical lab ordered for people who are on intravenous or subcutaneous immunoglobulins. I was on intravenous and now I do my own subcutaneous. A complete blood panel is used to make sure that the somewhat heavy medication isn't taking a negative toll on your body's organs, focusing on the kidney and liver function. As those are the organs that filter things out of the circulatory system.

Pretty much everything was in normal levels which is great. I like being “healthy."

That was ironic humor for those of you who may have missed it. Aurora is not “healthy,” but she finds it ironically funny that her levels are in the ”healthy” range.

Interestingly, there was one metric that was on the tippy top high end of the normal range. My chloride levels.

What is chloride?

Chloride is a mineral electrolyte in your blood which helps maintain the acid base balance in your blood. Chloride is measured on a spectrum called the pH scale, which ranges from zero to 14. 7, being smack dab in the middle, is true neutral. Healthy pH of blood is normally slightly basic with a pH range of about 7.35 to 7.45. Usually, the body maintains the pH of blood close to 7.40. Blood tests, like my full blood panel work up, measure the acid base balance by measuring the pH and levels of carbon dioxide-a gas which makes your blood more acidic-and bicarbonate-a base, present in antacids like Alka seltzer-in the blood.

Electrolytes help control nerve and muscle function.

*This information immediately connected little dots in my brain between spasticity and chloride*

The amount of chloride in your blood is often measured with other electrolytes to monitor kidney disease heart failure liver disease and high blood pressure.

What part of your body makes chloride?

High cortisol levels play a part in chloride increases. Cortisol, often called the stress hormone, is produced by the adrenal glands. The adrenal glands sit like tiny little berets on the top of each kidney.

Higher chloride levels in brain region weakens synaptic transmission in the cortex. High chloride = slow brain neuron firing, like you’re sleeping.

What does a high chloride level really mean? Explain it like I’m five, please.

High chloride can indicate that you are dehydrated, that you have kidney disease, that you have metabolic acidosis or respiratory alkalosis. Metabolic acidosis is when your blood is too acidic (low on the pH scale). Respiratory alkalosis is when you breathe excessively or hyperventilate so you have too much carbon dioxide in your blood so it’s more basic (high on the pH scale).

The most common culprit for elevated chloride is dehydration. And your girl Aurora is chronically dehydrated. So while I have my theories of why my adrenal glands began over-producing cortisol, I also recognize that I have a serious problem with keeping myself hydrated.

Side bar:

If you can’t connect the dots to how I would have experienced an increase in cortisol-the stress hormone-would play a role in a physiological response in my body, all I can say is have you read the blog? Not trying to be rude. But here’s the bullet point Spark Notes style version:

Fight or flight response active for entirety of marriage

Adrenal glands on, increase in cortisol and apparently chloride

Habitual issue with hydration (not helping the chloride processing situation)

That’s it. That’s my Spark Notes version.

Aurora is verbose by nature, but she can break things down into the short and sweet. But you’ll need the contextual knowledge for what is contained in those bullets points for it to mean much to you intrinsically.

So, just…read the blog.

Surviving Susac,

Aurora

[killed-by-choice]

“Louise Roe,” 25 (USA 1987)

In 1987, the Rhode Island Medical Journal published a case report of the death of a 25-year-old woman from a first-trimester abortion. Her name was never given in the report, so she was given the pseudonym “Louise Roe”.

Louise was 25 when she came to a doctor, who confirmed that she was pregnant and estimated that she was at 5 to 6 weeks. Louise indicated that she was thinking about an abortion, but with uncertainty that she would actually go through with it.

The doctor noticed that although Louise’s past medical history was unremarkable, a blood test taken shortly before she was pregnant had abnormal results and her spleen was enlarged. A bone marrow aspiration was performed and the findings showed severe erythroid and myeloid hyperplasia. The lab findings were consistent with polycythemia vera. Louise was medicated and seen by a doctor one month later.

Polycythemia rubra vera is typically seen in patients over the age of 60 and has almost never been reported in pregnant patients. Louise should have been treated with caution and care, especially given her elevated platelet count (which made abnormal clotting more likely).

Louise underwent the abortion one month after she was confirmed to be pregnant. Immediately after the surgical abortion by suction curettage was done, she turned blue and her heart stopped. She was intubated and an emergency CT scan was performed, showing extensive pulmonary emboli throughout her lungs.

Despite being intubated, Louise was suffering from hypoxia and respiratory alkalosis. She was brought to intensive care but died a week later because her pulmonary problems were intractable.

Her autopsy showed the extensive damage triggered by the abortion. Her lungs were riddled with pulmonary emboli with infarction. Left iliac vein thrombosis and segmental thrombosis in part of her brain were confirmed. Her liver and spleen were enlarged. She also suffered fatal DIC. With all of her injuries, she didn’t stand a chance at survival. It was apparent that the abortion triggered the fatal catastrophe.

[registerednursern]

ABG Interpretation Notes, Mnemonics, and Workbook by Nurse Sarah

ABG Interpretation Notes, Mnemonics, and Workbook by Nurse Sarah! If you are studying arterial blood gas interpretation, you may feel a little overwhelmed about all the material you must know in order to interpret the lab values. For example, you may be completely confused on acid-base imbalances (respiratory acidosis vs, respiratory alkalosis or metabolic acidosis vs, metabolic alkalosis), if…

[mcatmemoranda]

Pts with EtOH use disorder often have low phosphate because they don't eat. They also have low vitamin D intake-> secondary hyperparathyroidism-> high urinary phosphate excretion. Their serum phosphate may appear normal due to extracellular shift of phosphate. When you feed them or give IV fluids with glucose, insulin causes phosphate to shift intracellularly, so their phosphate level decreases. Respiratory alkalosis also shifts phosphate into cells. Rhabdomyolysis can occur from hypophosphatemia. Check CPK level. Pts with EtOH use disorder often have myopathy, so hypophosphatemia + myopathy-> symptomatic rhabdomyolysis.

[thisisthevoice]

It bothers me when pseudo science believers talk about making your body more alkaline via diet or whatever. It doesn't work. Your body tightly controls your blood's pH. You can eat straight up sodium bicarbonate (in limited amounts) and you'll just pee it out (we did this as an experiment in one of my nursing prerequisites - I peed, tested the pH, then drank a sodium bicarbonate solution and retested my pee after. It was indeed more basic. Kinda cool)

If your blood is too alkaline. That is not good. Your blood likes to be a certain pH for a reason. If its compensatory mechanisms fail there's either a huge issue with your respiratory system (respiratory alkalosis) or some other body process (metabolic alkalosis - from loss of fluid due to vomiting/diarrhea/dehydration, from ingesting too much bicarbonate/alkaline stuff, from a disease process,.etc etc).

Medical pseudoscience bothers me so much 😭

[cprcourseonline]

The Top 5 Do’s and Don’ts of Post-Arrest Care

The Top 5 Do’s and Don’ts of Post-Arrest Care

Table of Contents

Introduction 1

What are the top 5 dos and don’ts of post-arrest care? 1

What does post-arrest care mean? 3

Conclusion 4

Introduction

After a cardiac arrest, a patient who has received efficient CPR and a few advanced interventions may have a return of spontaneous circulation (ROSC). But that is not the end, as only restoring the heartbeat to normal rhythm following cardiac arrest does not ensure survival. Immediate post-cardiac arrest care procedures should be followed for a positive outcome.

Post-arrest care refers to the care provided to a cardiac arrest patient who has been successfully resuscitated. After resuscitation, a cardiac arrest patient may require transfer to an intensive care unit or specialized setting for continued care to prevent any further complications.

This article lists the top 5 do’s and don’ts of post-arrest care.

What are the top 5 do’s and don’ts of post-arrest care?

Post-arrest care is of critical importance for optimal patient outcomes. It requires a coordinated multidisciplinary effort by healthcare professionals and sticking to standard guidelines and procedures.

Here are the top 5 dos of post-arrest care.

Prompt initiation of targeted temperature management (TTM):

TTM is the only intervention that helps improve brain function after cardiac arrest. For the protection of the brain and other organs, induced TTM should be performed in unresponsive patients who have achieved ROSC. A target temperature between 33 degrees Celsius and 36 degrees Celsius should also be achieved and maintained for at least 24 hours. At the same time, shivering and fever should be prevented in cardiac arrest patients.

Use ventilation:

Hypoxia is a condition caused by a lack of oxygen caused by airway obstruction or pulmonary embolism. Irrespective of the cause of cardiac arrest, hypoxia after resuscitation can damage multiple organ systems. To avoid hypoxia, mechanical ventilation with the highest oxygen concentration is essential.

Maintain hemodynamics:

Post-arrest patients are often unstable hemodynamically. In such cases, the main goal after resuscitation is to avoid hypotension, as it can be extremely dangerous for the patient’s health. Post-arrest care involves achieving a systolic blood pressure of 90 mmHg and a mean arterial pressure of 65 mmHg. Intravenous fluids, appropriate vasopressors, and inotropic agents should be initiated as needed to optimize blood pressure.

Manage respiratory parameters:

Hyperventilation causes the patient to breathe faster and deeper than the body requires. This condition can further result in respiratory alkalosis, which occurs when carbon dioxide levels in the blood severely drop. Therefore, it is essential to deliver ventilation at the correct levels and volumes. During the post-cardiac arrest phase, ventilation should be delivered at a rate of 10 per minute while maintaining a PETCO2 of 35-45 mmHg.

Glycemic control:

Following ROSC, cardiac arrest patients are at an increased risk of hypoglycemia. This increase in blood sugar is associated with increased mortality and can worsen neurological function. During post-arrest care, attention should be focused on maintaining blood sugar levels at 6 to 10 mmol/L. Regular glucose monitoring to prevent hypoglycemia is crucial for optimizing recovery.

While you learn what to do after ROSC is achieved, there are certain things you should not do to ensure a cardiac patient's safe and healthy recovery.  

Here are the top 5 don’ts of post-arrest care

Do not use high concentrations of oxygen:

The patient's oxygenation should be monitored continuously post-cardiac arrest. High concentrations of supplemental oxygen can lead to oxygen toxicity. Although 100 percent oxygen is used during initial resuscitation, care should be taken to achieve an arterial oxygen saturation of less than 94 percent to avoid oxygen toxicity.

Do not ignore continuous monitoring:

Post-arrest care requires continuous assessment of vital signs, including the ECG, until stability has been achieved. Monitoring is crucial, as there is a risk of recurrent cardiac arrest within the first 48 hours.

Do not skip treating the cause of cardiac arrest:

Post-arrest care also involves identifying and treating the cause of cardiac arrest after ROSC. This is important to help prevent future cardiac arrest episodes.

Do not forget to evaluate mental condition:

After achieving ROSC, all cardiac arrest patients should undergo a detailed neurological exam to assess their mental condition.

Do not forget to work as a team:

Managing post-cardiac arrest patients requires a team effort. Multiple processes are carried out simultaneously, which requires proper communication and coordination. 

What does post-arrest care mean?

Post-cardiac arrest care is aimed at stabilizing the post-arrest patient and limiting organ damage. It should begin as soon as possible to improve outcomes. Intensive monitoring is required to sustain spontaneous circulation and prevent re-arrest. A multidisciplinary approach is usually followed, as managing cardiac patients after achieving ROSC is difficult.

Post-arrest care focuses on supporting organ function and addressing the underlying cause of arrest. Efficient post-arrest care involves optimizing ventilation and oxygenation, maintaining hemodynamics, and much more. These interventions can potentially help patients being discharged from the hospital without any effect on neurological function.

Conclusion

The quality of post-arrest care can greatly influence the survival of resuscitated individuals and minimize complications. Learning how to care for cardiac arrest patients after successful resuscitation can increase the likelihood of survival. As a healthcare professional, you need to be aware of what needs to be done and what to avoid post-cardiac arrest. A PALS training will give you a better understanding of the immediate post-arrest care algorithm that has to be followed to optimize the outcome.

[sciencesupermanus]

Human Physiology Practice Notes

This is a 62-page detailed PDF, complete with notes and diagrams for Unit 4 of a university upper-level Human Physiology course. The topics in this note pack include nephrons, the renal cortex and medulla, filtration and Starling Forces, glomerular filtration rate (GFR), regulation of MAP, reabsorption and secretion, sodium and potassium in the proximal tubule and the Loop of Henle, Renin, Aldosterone, Angiotensin I, Angiotensin II, the RAAS Pathway, solvent drag, water regulation, antidiuretic hormone (ADH), atrial natriuretic peptide, emptying and filling of the bladder, flow diagrams for decrease in MAP and increase in plasma volume, metabolic and respiratory alkalosis and acidosis, and pH.

Pre-Health Grade Boosters is a site from high-A scoring pre-health students. Our first two courses, General Chemistry II..

Human Physiology Practice Notes

[stocklivemarket]

Tricida, Inc. is a pharmaceutical business. It concentrates on the development and marketing of veverimer (TRC101), an orally administered, non-absorbed polymer that has successfully completed a Phase III trial to treat respiratory acidosis in patients suffering from chronic renal disease by eliminating acid first from gastrointestinal tract. The business was established in 2013 and has its main office in South San Francisco, California. As of November 28, 2022, Tricida, Inc.'s ISS Governance QualityScore is 9. Audit, Board, Shareholder Rights, and Compensation each received a score of three out of ten. The NASDAQ Global Select Market lists Tricida's common stock under the ticker TCDA. Institutional Shareholder Services provides scores on corporate governance (ISS). Scores represent decile rank in relation to region or index. A score of 1 on the decile scale denotes low lead to the damage, while a score of 10 denotes severe governance risk. The company's fifty-day and 200-day simple moving averages are $5.58 and $8.75, respectively. Owner Of Tricida? Tricida (NASDAQ: TCDA) is held by institutional shareholders (80.89%), Tricida insiders (101.55%), and retail investors (0.00%). With 16.00M shares, or 27.57% of the corporation, Brian M. Isern holds the biggest number of shares personally. The market value of Brian M. Isern's Tricida stock is $4.56M at the moment. The other stockholders may be listed as follows. Bonita, David P. Orbimed Advisors LLC, 17.81% 10,336,115 $2.12M 10.72 percent, or 10,280,947 dollars, to Orbimed Advisors LLC. 9.619,791 $1.97M, Vr Adviser LLC. 16.58% Sandra I. Coufal, 15.60% $9,050,064 $1,86 million Blackrock Inc. 11.25% 6,527,365 $1.34 million, David Hirsch, Longitude Capital Partners II LLC, 10.18% 5,907,889 $1.21 million, Venrock Healthcare Capital Partners Ii LP, 6.46% 3,751,406 $769.04 thousand. Business News About Tricida The top-line findings from Tricida's VALOR-CKD renal effects clinical study, which assessed veverimer's capacity to reduce the course of CKD in patients with alkalosis and chronic kidney disease, were released in October. The estimated glomerular filtration rate (eGFR), as well known as the DD40, was the primary endpoint of the VALOR-CKD trial and was measured as the time to the first onset of any event in the fiberglass endpoint of renal death, end-stage glomerular disease (ESRD). Or an affirmed greater than or equal to 40% reduction in eGFR. Veverimer's general safety profile in the trial was in line with what was anticipated for the majority of people with Stage 3 to 5 CKD. In order to maximize value for its stakeholders, Tricida declared in November that the Board of Directors had given the company permission to thoroughly analyze all of its strategic options. Tricida has hired SierraConstellation Partners LLC to act as a financial advisor as well as Stifel and its fully owned subsidiary, Miller Buckfire, to act as investment banking advisors. Results Of The Three And Nine Months' Business The cost of research and development for the three months ending September 30, 2021 and 2022, respectively, was $19.9 million and $26.6 million. A decrease in clinical development costs associated with the VALOR-CKD trial due to bureaucratic stop confirmed in May 2022, a decrease in personnel as well as related costs due to lower bonus expense. And a decrease in equity compensation expense were the main drivers of the decrease in research & design expense for the months that ended September 30, 2022, compared to the prior year. The cost of research and development for the nine months ending September 30, 2022 and 2021 was $55.3 million and $78.6 million, respectively. For the three months ended September 30, 2021 and 2022, respectively, overall and administrative cost was $4.1 million and $9.1 million. When comparing the three weeks ended September 30, 2022 to the previous year, the general and administrative expense decreased principally as a result of lower staff costs, including lower bonus expenses and stock-based compensation expenses.

Overview Of TCDA's Financial Health Financial health indicators for TCDA include its $80.22M in cash and short-term investments. This is sufficient to fund its $108.82M yearly cash burn. On the TCDA balance sheet, short-term assets exceed short-term liabilities. Indicators that TCDA's finances are not sound. The TCDA ratio of equity to debt is negative at -1.69. The total debt of TCDA is still negative. The cash burn for TCDA is 108817000. It lacks the liquidity and short-term investments necessary to cover this. On the TCDA financial statements, long-term liabilities outnumber short-term assets. Market Relations In order to halt the course of CKD in patients with alkalosis and CKD, Tricida, Inc., a pharmaceutical firm, is concentrating on the creation and marketing of their investigational medication candidate, veverimer. Veverimer is an oral, non-absorbed polymer. To find out if veverimer reduces the course of CKD in people with metabolic acidosis coupled with CKD, Tricida just finished the VALOR-CKD renal outcomes clinical study. It is thought that the dangerous state of metabolic acidosis, which is frequently brought on by CKD, speeds up the degenerative process of the kidneys. About 4.3 million CKD patients are thought to be at risk for health problems in the US. The FDA has not yet approved any treatments to stop the course of renal damage in people with CKD by treating chronic metabolic acidosis. What Were TCDA's Profits The Previous Quarter? Tricida (NASDAQ: TCDA) announced Q3 2022 revenue per share (EPS) of -$0.44, up 44.3% from the previous year, on November 14, 2022. Tricida reported a total loss of $25.76 million for the quarter. Tricida's earnings per share (EPS) during the same quarter last year were negative $0.79. Tricida's profits increased year over year as of Q4 2022. Tricida made a total loss of -$133.91 million last year. Tricida (NASDAQ: TCDA) announced Q3 2022 revenue of $0.00, up N/A from the prior-year quarter, on November 14, 2022. Tricida's revenue during the same period last year was $0.00. What Is The Price Target Set By TCDA? The average TCDA stock price goal is $25.00, with the highest and lowest TCDA stock price forecasts both coming in at $25.00, according to one Wall Street analyst who has published a TCDA price target for the next year. By October 25th, 2023, the Wall Street analyst projected Tricida's share price to reach $25.00. From the recent TCDA stock price of $0.29, the average Tricida stock price projection predicts a potential increase of 8,671.93%. Should I Buy TCDA Stock? Four Wall Street analysts who follow the (NASDAQ: TCDA) TCDA stock have come to the conclusion that it is best to hold. Out of 4 experts, 1 (25%) recommends TCDA as just a Strong Buy, 0 (%) suggests TCDA be purchased, 2 (50%) suggests TCDA be held, 0 (%) suggests TCDA be sold, and 1 (25%) suggests TCDA stock be sold at a strong discount. (TCDA, NASDAQ) Tricida's anticipated annual earnings growth rate of N/A is not anticipated to surpass the anticipated average earnings growth rate of 100.26% for the US Drug Manufacturers - Specialty & Generic industry. Nor is it anticipated to surpass the anticipated average earnings growth rate of 68.62% for the US market. Purchase Tricida Stock Pick a location to purchase Tricida stock. Don't worry, we've examined hundreds of online brokerage houses and apps to help you choose where to buy Tricida stock. You just need to choose a stock brokerage. Open a trading account. Join the top-rated brokerage we've found for 0% commission trading. The best location to purchase TCDA stock is here. Your investing account with Money. Select a payment option, then enter your information. Consider the TCDA stock. Get your TCDA stock trade done. Select whether you want to acquire TCDA stock at the current market value or at a specific price using a limit order. Watch your TCDA stock investment carefully. Make a watchlist of the most recent developments about your new Tricida stock purchase.

TCDA Stock Forecast 2022-2023 In 2022, Tricida will earn -$133,912,000. The lowest TCDA earnings TCDA stock forecast is -$127,662,159, as well as the highest earnings TCDA stock forecast is -$127,081,876. On average, 2 Wall Street analysts expect TCDA will earn -$127,662,159 in 2022. The estimated earnings for TCDA stock in 2023 are predicted to be -$54,546,559, with the lowest estimate being -$110,253,683 as well as the highest estimate being $1,160,565. (TCDA, NASDAQ) The current Earnings Per Share (EPS) for Tricida is $2.36. TCDA's EPS is expected to be -$2.20 on average in 2022. With the highest and lowest estimates coming in at -$2.20 and -$2.19. The estimated EPS for TCDA in 2023 will be -$0.94 (minimum: -$1.90, maximum: $0.02). (NASDAQ: TCDA) is expected to have a return on assets (ROA) of -58.1%, which is less than the predicted 9.8% average for US Drug Manufacturers - Specialty & Generic. TCDA Stock Forecast 2025 Twelve predictions are made for the Tricida stock in 2025, with an average estimate of $0.41, a high prognosis of $0.44, and a low prediction of $0.4. The typical Tricida stock estimate for 2025 shows a growth of 43.33% from the most recent price of $0.284799993038177. TCDA Stock Forecast 2027 Twelve TCDA stock forecast are made for each month of 2027 for the Tricida stock forecast for 2027 (5 years), with an average TCDA stock forecast of $0.48, a maximum forecast of $0.51. And a minimum TCDA stock forecast of $0.45. The typical Tricida stock estimate for 2027 shows a growth of 68.77% from the most recent price of $0.284799993038177. TCDA Stock Forecast 2030 Twelve forecasts are made for each quarter of 2030 for the TCDA stock forecast, with an average prognosis of $0.68, a high prediction of $0.69, and a low prediction of $0.65. When compared to the most recent price of $0.284799993038177, the average Tricida stock estimate for 2030 shows a 138.23% rise. TCDA Stock Forecast 2032 There are 11 TCDA stock forecast for each month of 2032 for the TCDA stock forecast for 2032 (10 years), with an averaged Tricida stock forecast of $0.71, a maximum forecast of $0.71, and a minimum forecast of $0.71. The typical TCDA stock forecasts estimate for 2032 shows a growth of 149.15% from the most recent price of $0.284799993038177. View more projections below, please. The Most Recent TCDA Analyst Recommendations On October 25, 2022, Jessica Fye, a top 8% analyst at JP Morgan, downgrades TCDA to a strong sell recommendation. On October 25, 2022, Serge Belanger, a Needham bottom 16% analyst, compromises TCDA to a hold rating. On October 24, 2022, Phil Nadeau, a Cowen & Co. bottom 17% analyst, changes TCDA to a hold rating. On May 24, 2022, a Goldman Sachs analyst decreases their price objective for TCDA from $22.00 to $16.00 while maintaining a strong buy recommendation. On April 13, 2022, Madhu Kumar, a top 2% analyst at Goldman Sachs, commences coverage of TCDA with a solid investment rating and publishes their $25.00 price objective. The Significance Of Analyst Ratings Analysts are the only people outside of management who have a thorough knowledge of the inner workings of the organizations they follow. Financial statements reveal a lot about a company, but analysts are more knowledgeable about the specifics of each industry they cover and ask questions during conference calls. Analysts are aware of the impact terrible weather in one region of the world can have on supply chains and consumer behavior. This enables traders to make choices ahead of a quarterly update that might be less favorable than anticipated. Tricida, Inc. (NASDAQ:TCDA) Stock Are Sold By Orbimed Advisors Llc. Orbimed Advisors Llc, a director of Tricida, Inc. (NASDAQ:TCDA - Get Rating), sold 3,629,226 shares of the company's stock on Friday, November 25th. For a total transaction value of $798,429.72, the stock was sold at an average price of $0.22. The transaction was detailed in a document submitted to the SEC, which can be accessed using this link.

Stock in Tricida rose 6.4%. On Friday, NASDAQ TCDA shares opened at $0.21. The company has a $11.43 million market cap, a PE ratio of -0.09, and a beta of 0.16. Tricida, Inc.'s 12-month high is $13.85, and its 12-month low is $0.19. The company's fifty-day and 200-day simple moving averages are $5.58 and $8.75, respectively.

[cavixorg]

Tricida, Inc. is a pharmaceutical business. It concentrates on the development and marketing of veverimer (TRC101), an orally administered, non-absorbed polymer that has successfully completed a Phase III trial to treat respiratory acidosis in patients suffering from chronic renal disease by eliminating acid first from gastrointestinal tract. The business was established in 2013 and has its main office in South San Francisco, California. As of November 28, 2022, Tricida, Inc.'s ISS Governance QualityScore is 9. Audit, Board, Shareholder Rights, and Compensation each received a score of three out of ten. The NASDAQ Global Select Market lists Tricida's common stock under the ticker TCDA. Institutional Shareholder Services provides scores on corporate governance (ISS). Scores represent decile rank in relation to region or index. A score of 1 on the decile scale denotes low lead to the damage, while a score of 10 denotes severe governance risk. The company's fifty-day and 200-day simple moving averages are $5.58 and $8.75, respectively. Owner Of Tricida? Tricida (NASDAQ: TCDA) is held by institutional shareholders (80.89%), Tricida insiders (101.55%), and retail investors (0.00%). With 16.00M shares, or 27.57% of the corporation, Brian M. Isern holds the biggest number of shares personally. The market value of Brian M. Isern's Tricida stock is $4.56M at the moment. The other stockholders may be listed as follows. Bonita, David P. Orbimed Advisors LLC, 17.81% 10,336,115 $2.12M 10.72 percent, or 10,280,947 dollars, to Orbimed Advisors LLC. 9.619,791 $1.97M, Vr Adviser LLC. 16.58% Sandra I. Coufal, 15.60% $9,050,064 $1,86 million Blackrock Inc. 11.25% 6,527,365 $1.34 million, David Hirsch, Longitude Capital Partners II LLC, 10.18% 5,907,889 $1.21 million, Venrock Healthcare Capital Partners Ii LP, 6.46% 3,751,406 $769.04 thousand. Business News About Tricida The top-line findings from Tricida's VALOR-CKD renal effects clinical study, which assessed veverimer's capacity to reduce the course of CKD in patients with alkalosis and chronic kidney disease, were released in October. The estimated glomerular filtration rate (eGFR), as well known as the DD40, was the primary endpoint of the VALOR-CKD trial and was measured as the time to the first onset of any event in the fiberglass endpoint of renal death, end-stage glomerular disease (ESRD). Or an affirmed greater than or equal to 40% reduction in eGFR. Veverimer's general safety profile in the trial was in line with what was anticipated for the majority of people with Stage 3 to 5 CKD. In order to maximize value for its stakeholders, Tricida declared in November that the Board of Directors had given the company permission to thoroughly analyze all of its strategic options. Tricida has hired SierraConstellation Partners LLC to act as a financial advisor as well as Stifel and its fully owned subsidiary, Miller Buckfire, to act as investment banking advisors. Results Of The Three And Nine Months' Business The cost of research and development for the three months ending September 30, 2021 and 2022, respectively, was $19.9 million and $26.6 million. A decrease in clinical development costs associated with the VALOR-CKD trial due to bureaucratic stop confirmed in May 2022, a decrease in personnel as well as related costs due to lower bonus expense. And a decrease in equity compensation expense were the main drivers of the decrease in research & design expense for the months that ended September 30, 2022, compared to the prior year. The cost of research and development for the nine months ending September 30, 2022 and 2021 was $55.3 million and $78.6 million, respectively. For the three months ended September 30, 2021 and 2022, respectively, overall and administrative cost was $4.1 million and $9.1 million. When comparing the three weeks ended September 30, 2022 to the previous year, the general and administrative expense decreased principally as a result of lower staff costs, including lower bonus expenses and stock-based compensation expenses.

Overview Of TCDA's Financial Health Financial health indicators for TCDA include its $80.22M in cash and short-term investments. This is sufficient to fund its $108.82M yearly cash burn. On the TCDA balance sheet, short-term assets exceed short-term liabilities. Indicators that TCDA's finances are not sound. The TCDA ratio of equity to debt is negative at -1.69. The total debt of TCDA is still negative. The cash burn for TCDA is 108817000. It lacks the liquidity and short-term investments necessary to cover this. On the TCDA financial statements, long-term liabilities outnumber short-term assets. Market Relations In order to halt the course of CKD in patients with alkalosis and CKD, Tricida, Inc., a pharmaceutical firm, is concentrating on the creation and marketing of their investigational medication candidate, veverimer. Veverimer is an oral, non-absorbed polymer. To find out if veverimer reduces the course of CKD in people with metabolic acidosis coupled with CKD, Tricida just finished the VALOR-CKD renal outcomes clinical study. It is thought that the dangerous state of metabolic acidosis, which is frequently brought on by CKD, speeds up the degenerative process of the kidneys. About 4.3 million CKD patients are thought to be at risk for health problems in the US. The FDA has not yet approved any treatments to stop the course of renal damage in people with CKD by treating chronic metabolic acidosis. What Were TCDA's Profits The Previous Quarter? Tricida (NASDAQ: TCDA) announced Q3 2022 revenue per share (EPS) of -$0.44, up 44.3% from the previous year, on November 14, 2022. Tricida reported a total loss of $25.76 million for the quarter. Tricida's earnings per share (EPS) during the same quarter last year were negative $0.79. Tricida's profits increased year over year as of Q4 2022. Tricida made a total loss of -$133.91 million last year. Tricida (NASDAQ: TCDA) announced Q3 2022 revenue of $0.00, up N/A from the prior-year quarter, on November 14, 2022. Tricida's revenue during the same period last year was $0.00. What Is The Price Target Set By TCDA? The average TCDA stock price goal is $25.00, with the highest and lowest TCDA stock price forecasts both coming in at $25.00, according to one Wall Street analyst who has published a TCDA price target for the next year. By October 25th, 2023, the Wall Street analyst projected Tricida's share price to reach $25.00. From the recent TCDA stock price of $0.29, the average Tricida stock price projection predicts a potential increase of 8,671.93%. Should I Buy TCDA Stock? Four Wall Street analysts who follow the (NASDAQ: TCDA) TCDA stock have come to the conclusion that it is best to hold. Out of 4 experts, 1 (25%) recommends TCDA as just a Strong Buy, 0 (%) suggests TCDA be purchased, 2 (50%) suggests TCDA be held, 0 (%) suggests TCDA be sold, and 1 (25%) suggests TCDA stock be sold at a strong discount. (TCDA, NASDAQ) Tricida's anticipated annual earnings growth rate of N/A is not anticipated to surpass the anticipated average earnings growth rate of 100.26% for the US Drug Manufacturers - Specialty & Generic industry. Nor is it anticipated to surpass the anticipated average earnings growth rate of 68.62% for the US market. Purchase Tricida Stock Pick a location to purchase Tricida stock. Don't worry, we've examined hundreds of online brokerage houses and apps to help you choose where to buy Tricida stock. You just need to choose a stock brokerage. Open a trading account. Join the top-rated brokerage we've found for 0% commission trading. The best location to purchase TCDA stock is here. Your investing account with Money. Select a payment option, then enter your information. Consider the TCDA stock. Get your TCDA stock trade done. Select whether you want to acquire TCDA stock at the current market value or at a specific price using a limit order. Watch your TCDA stock investment carefully. Make a watchlist of the most recent developments about your new Tricida stock purchase.

TCDA Stock Forecast 2022-2023 In 2022, Tricida will earn -$133,912,000. The lowest TCDA earnings TCDA stock forecast is -$127,662,159, as well as the highest earnings TCDA stock forecast is -$127,081,876. On average, 2 Wall Street analysts expect TCDA will earn -$127,662,159 in 2022. The estimated earnings for TCDA stock in 2023 are predicted to be -$54,546,559, with the lowest estimate being -$110,253,683 as well as the highest estimate being $1,160,565. (TCDA, NASDAQ) The current Earnings Per Share (EPS) for Tricida is $2.36. TCDA's EPS is expected to be -$2.20 on average in 2022. With the highest and lowest estimates coming in at -$2.20 and -$2.19. The estimated EPS for TCDA in 2023 will be -$0.94 (minimum: -$1.90, maximum: $0.02). (NASDAQ: TCDA) is expected to have a return on assets (ROA) of -58.1%, which is less than the predicted 9.8% average for US Drug Manufacturers - Specialty & Generic. TCDA Stock Forecast 2025 Twelve predictions are made for the Tricida stock in 2025, with an average estimate of $0.41, a high prognosis of $0.44, and a low prediction of $0.4. The typical Tricida stock estimate for 2025 shows a growth of 43.33% from the most recent price of $0.284799993038177. TCDA Stock Forecast 2027 Twelve TCDA stock forecast are made for each month of 2027 for the Tricida stock forecast for 2027 (5 years), with an average TCDA stock forecast of $0.48, a maximum forecast of $0.51. And a minimum TCDA stock forecast of $0.45. The typical Tricida stock estimate for 2027 shows a growth of 68.77% from the most recent price of $0.284799993038177. TCDA Stock Forecast 2030 Twelve forecasts are made for each quarter of 2030 for the TCDA stock forecast, with an average prognosis of $0.68, a high prediction of $0.69, and a low prediction of $0.65. When compared to the most recent price of $0.284799993038177, the average Tricida stock estimate for 2030 shows a 138.23% rise. TCDA Stock Forecast 2032 There are 11 TCDA stock forecast for each month of 2032 for the TCDA stock forecast for 2032 (10 years), with an averaged Tricida stock forecast of $0.71, a maximum forecast of $0.71, and a minimum forecast of $0.71. The typical TCDA stock forecasts estimate for 2032 shows a growth of 149.15% from the most recent price of $0.284799993038177. View more projections below, please. The Most Recent TCDA Analyst Recommendations On October 25, 2022, Jessica Fye, a top 8% analyst at JP Morgan, downgrades TCDA to a strong sell recommendation. On October 25, 2022, Serge Belanger, a Needham bottom 16% analyst, compromises TCDA to a hold rating. On October 24, 2022, Phil Nadeau, a Cowen & Co. bottom 17% analyst, changes TCDA to a hold rating. On May 24, 2022, a Goldman Sachs analyst decreases their price objective for TCDA from $22.00 to $16.00 while maintaining a strong buy recommendation. On April 13, 2022, Madhu Kumar, a top 2% analyst at Goldman Sachs, commences coverage of TCDA with a solid investment rating and publishes their $25.00 price objective. The Significance Of Analyst Ratings Analysts are the only people outside of management who have a thorough knowledge of the inner workings of the organizations they follow. Financial statements reveal a lot about a company, but analysts are more knowledgeable about the specifics of each industry they cover and ask questions during conference calls. Analysts are aware of the impact terrible weather in one region of the world can have on supply chains and consumer behavior. This enables traders to make choices ahead of a quarterly update that might be less favorable than anticipated. Tricida, Inc. (NASDAQ:TCDA) Stock Are Sold By Orbimed Advisors Llc. Orbimed Advisors Llc, a director of Tricida, Inc. (NASDAQ:TCDA - Get Rating), sold 3,629,226 shares of the company's stock on Friday, November 25th. For a total transaction value of $798,429.72, the stock was sold at an average price of $0.22. The transaction was detailed in a document submitted to the SEC, which can be accessed using this link.

Stock in Tricida rose 6.4%. On Friday, NASDAQ TCDA shares opened at $0.21. The company has a $11.43 million market cap, a PE ratio of -0.09, and a beta of 0.16. Tricida, Inc.'s 12-month high is $13.85, and its 12-month low is $0.19. The company's fifty-day and 200-day simple moving averages are $5.58 and $8.75, respectively.