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Initial treatment focuses on resuscitation which may include intravenous fluids and blood transfusions. [4] Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases.
Hematemesis is the vomiting of blood. [1] This is usually vomit that contains bright red blood. [2] Coffee ground vomiting is similar to hematemesis, but is distinct in not involving bright red blood. [3] Hematemesis must be differentiated from hemoptysis (coughing up blood) and epistaxis (nosebleed). [4] Both of these are more common conditions.
Gastric outlet obstruction (GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction ...
Serum creatinine (a blood measurement) is an important indicator of kidney function, because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys. Creatinine itself is produced [ 5 ] via a biological system involving creatine , phosphocreatine (also known as creatine phosphate), and adenosine ...
Gastric vomiting leads to the loss of acid (protons) [clarification needed] and chloride directly. Combined with the resulting alkaline tide, this leads to hypochloremic metabolic alkalosis (low chloride levels together with high HCO − 3 and CO 2 and increased blood pH) and often hypokalemia (potassium depletion).
Options include: Mild and asymptomatic hyponatremia is treated with adequate solute intake (including salt and protein) and fluid restriction starting at 500 millilitres per day (mL/d) of water with adjustments based on serum sodium levels. Long-term fluid restriction of 1,200–1,800 mL/d may maintain the person in a symptom-free state. [36]
Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. [1] The normal serum range for chloride is 96 to 106 mEq/L, [2] therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. [3]
Potassium levels can fluctuate severely during the treatment of DKA, because insulin decreases potassium levels in the blood by redistributing it into cells via increased sodium-potassium pump activity. A large part of the shifted extracellular potassium would have been lost in urine because of osmotic diuresis.