{"podcast":{"title":"Channel Your Enthusiasm","slug":"channel-your-enthusiasm-1374325","podcast_index_feed_id":1374325,"rss_url":"http://www.rosebook.club/episodes/?format=rss","website_url":"http://www.rosebook.club/episodes/","image_url":"https://images.squarespace-cdn.com/content/v1/548bc7f6e4b0a269c594ebc2/1611689941077-BL32D22Z1P27G4UAVKEE/Screen+Shot+2021-01-26+at+2.34.41+PM.png?format=1500w","author":"joel topf","episode_count":31,"summary":"A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.","last_synced_at":null,"page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325"},"episode":{"title":"Chapter Fourteen: Hypovolemic States, part 1","slug":"chapter-fourteen-hypovolemic-states-part-1","published_at":"2024-01-29T03:44:26+00:00","page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fourteen-hypovolemic-states-part-1","show_page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325","url":"http://www.rosebook.club/episodes/2023/2/12/chapter-fourteen","audio_url":"https://chrt.fm/track/47G747/static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/65b71d1fe8eba97d575ac688/1711290714564/Chapter+14+part+1.mp3","summary":"Outline Chapter 14 - Hypovolemic States - Etiology - True volume depletion occurs when fluid is lost from from the extracellular fluid at a rate exceeding intake - Can come the GI tract - Lungs - Urine - Sequestration in the body in a “third space” that is not in equilibrium with the extracellular fluid. - When losses occur two responses ameliorate them - Our intake of Na and fluid is way above basal needs - This is not the case with anorexia or vomiting - The kidney responds by minimizing further urinary losses - This adaptive response is why diuretics do not cause progressive volume depletion - Initial volume loss stimulates RAAS, and possibly other compensatory mechanisms, resulting increased proximal and collecting tubule Na reabsorption. - This balances the diuretic effect resulting in a new steady state in 1-2weeks - New steady state means Na in = Na out - GI Losses - Stomach, pancreas, GB, and intestines secretes 3-6 liters a day. - Almost all is reabsorbed with only loss of 100-200 ml in stool a day - Volume depletion can result from surgical drainage or failure of reabsorption - Acid base disturbances with GI losses - Stomach losses cause metabolic alkalosis - Intestinal, pancreatic and biliary secretions are alkalotic so losing them causes metabolic acidosis - Fistulas, laxative abuse, diarrhea, ostomies, tube drainage - High content of potassium so associated with hypokalemia - [This is a mistake for stomach losses] - Bleeding from the GI tract can also cause volume depletion - No electrolyte disorders from this unless lactic acidosis - Renal losses - 130-180 liters filtered every day - 98-99% reabsorbed - Urine output of 1-2 liters - A small 1-2% decrease in reabsorption can lead to 2-4 liter increase in Na and Water excretion - 4 liters of urine output is…","meta_description":"Outline Chapter 14 - Hypovolemic States - Etiology - True volume depletion occurs when fluid is lost from from the extracellular fluid at a rate exceeding…","key_points":[],"chapters":[],"topics":[],"duration_seconds":6356,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/channel-your-enthusiasm-1374325/episodes/chapter-fourteen-hypovolemic-states-part-1/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fourteen-hypovolemic-states-part-1.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}