{"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 Nineteen: Metabolic Acidosis, part 2","slug":"chapter-nineteen-metabolic-acidosis-part-2","published_at":"2025-10-11T18:40:02+00:00","page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-nineteen-metabolic-acidosis-part-2","show_page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325","url":"http://www.rosebook.club/episodes/2025/10/11/chapter19part2","audio_url":"https://static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/68eaa2f4f08a1c3f53bc56b8/1771771900042/Channel+chapter+19+Metabolic+Acidosis+part+2+.mp3","summary":"References Chapter 19, Part 12 Metabolic acidosis  June 14, 2023 References Chapter 19, Part 2 Roger mentioned MELAS syndrome MELAS syndrome: Clinical manifestations, pathogenesis, and treatment options Josh mentioned this blog on lactate- Understanding lactate in sepsis & Using it to our advantage We discussed the Warburg effect The Warburg Effect: How Does it Benefit Cancer Cells? - PMC and here’s a case from skeleton key- Skeleton Key Group Case #28: Mysterious Acidosis in Cancer - Renal Fellow Network Otto Warburg won the Nobel Prize in Physiology and Medicine in 1931 for describing how animal tumors produce large quantities of lactic acid ( Wikipedia ) Joel calls it the Lactate saline reflex, but the accepted term of art is Lacto-Bolo reflex The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis Buffer agents do not reverse intramyocardial acidosis during cardiac resuscitation. Josh mentioned this article the BICAR-ICU Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial - The Lancet Roger shared 3 quotes to make the point that there has been little movement in our knowledge the past 40 years: Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study from Cooper in the Annals Lactic Acidosis and Bicarbonate Therapy | Annals of Internal Medicine from Robert Hollander Lactic acidosis from Nick Madias Josh mentioned the use of sodium bicarbonate for CKD Eubicarbonatemic Hydrogen Ion Retention and CKD Progression - Kidney Medicine   (Madias) Bicarbonate therapy for prevention of chronic kidney disease progression (from Wesson),  Sodiu…","meta_description":"References Chapter 19, Part 12 Metabolic acidosis June 14, 2023 References Chapter 19, Part 2 Roger mentioned MELAS syndrome MELAS syndrome: Clinica…","key_points":[],"chapters":[],"topics":[],"duration_seconds":6311,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/channel-your-enthusiasm-1374325/episodes/chapter-nineteen-metabolic-acidosis-part-2/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-nineteen-metabolic-acidosis-part-2.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}