sodium-bicarbonate and Brain-Diseases

Cardiopulmonary resuscitation is effective if established early and coupled with specific therapeutic interventions. Most cardiopulmonary arrest is due to ventricular fibrillation and early defibrillation offers the highest probability of success. External cardiac compression alone is inadequate to provide adequate perfusion to vital organs and, therefore, cannot sustain life unless coupled with advanced therapeutic interventions. Many new techniques for increasing flow have been developed, but have not been established clinically. The American Heart Association guidelines for CPR are still valid and are the basis for our current CPR. A practical perspective is presented whereby the therapeutic interventions are pursued systematically in an expeditious and coordinated fashion so that the key interventions are made within the first 10 to 15 minutes of the arrest.

Topics: Anti-Arrhythmia Agents; Atropine; Bicarbonates; Brain Diseases; Calcium; Cardiac Pacing, Artificial; Catheterization; Electric Countershock; Heart Arrest; Heart Massage; Humans; Intubation, Intratracheal; Resuscitation; Sodium; Sodium Bicarbonate; Sympathomimetics; Tachycardia; Veins; Ventricular Fibrillation

For patients who have had a recent neurosurgical procedure, a visit to the emergency department for encephalopathy may automatically prompt a neurosurgical consult. We present a case of a patient with a history of Chiari malformation decompressed 6 months prior who presented with a 2-week history of slowly progressive altered mental status, headache and imbalance-symptoms consistent with her initial Chiari symptoms, so neurosurgery was consulted. Imaging showed no acute abnormality, but laboratory results revealed metabolic acidosis with high salicylate levels. When reporting medication use, this patient initially left out that she had been taking Goody's powder (845 mg aspirin) for headaches, and long-term use led to metabolic encephalopathy. Despite a recent history of surgery, it is important to keep the differential diagnosis broad especially when there are signs of metabolic derangement.

Topics: Acidosis; Aftercare; Arnold-Chiari Malformation; Brain; Brain Diseases; Diagnosis, Differential; Female; Headache; Humans; Infusions, Intravenous; Mental Disorders; Middle Aged; Neurosurgical Procedures; Salicylates; Sodium Bicarbonate; Tomography, X-Ray Computed; Treatment Outcome

Baking soda is a readily available household product composed of sodium bicarbonate. It can be used as a home remedy to treat dyspepsia. If used in excessive amounts, baking soda has the potential to cause a variety of serious metabolic abnormalities. We believe this is the first reported case of hemorrhagic encephalopathy induced by baking soda ingestion. Healthcare providers should be aware of the dangers of baking soda misuse and the associated adverse effects.

Topics: Adult; Brain Diseases; Emergency Service, Hospital; Humans; Male; Sodium Bicarbonate; Subarachnoid Hemorrhage

Ethylene glycol toxicity has produced central nervous system abnormalities including coma, cerebral edema, and cranial nerve dysfunction.. A 26-year-old male developed widespread brainstem and midbrain dysfunction with corresponding cranial computed tomography findings after ingesting ethylene glycol. The computed tomography scan which was obtained 3 days after ethylene glycol ingestion showed low density areas in the basal ganglia, thalami, midbrain, and upper pons. The neurologic findings in our patient reflected dysfunction of all the areas of hypodensity on the cranial computed tomography scan. A magnetic resonance imaging of the brain obtained 24 days after ingestion revealed bilateral putamen necrosis. The patient's neurologic sequelae resolved over the following 4 months.

Topics: Acute Kidney Injury; Adult; Arrhythmias, Cardiac; Brain Diseases; Brain Edema; Brain Stem; Calcium Gluconate; Charcoal; Coma; Cranial Nerve Diseases; Ethanol; Ethylene Glycol; Humans; Male; Mesencephalon; Putamen; Pyridoxine; Renal Dialysis; Sodium Bicarbonate; Thiamine; Tomography, X-Ray Computed; Treatment Outcome

Twenty-two sheep and 4 goats suffering from central nervous listeriosis were treated with a therapy that had proved to be successful in cattle. For one week they received daily subcutaneous injections of 50,000 IU Procaine Penicillin G per kg live weight and 5 to 10 mg Vitamin B1 per kg body weight. The base excess was tested by blood gas analysis, and it was compensated by intravenous infusion of Na-bicarbonate. Animals that could not eat or swallow received water and rumen liquid by stomach tube. Eight of 26 patients (31%) were healed. The prognosis of central nervous listeriosis depends mainly on the time of initial treatment and on the degree of general disturbances: More than 90% of the animals that were recumbent (16 of 17) or showed dysphagia (12 of 13) at the beginning of treatment died or had to be euthanized because of persistent central nervous disturbances. The correction of blood-pH was of no therapeutic benefit when the disease was already in progress. Treatment of central nervous listeriosis seems to be effective as long as the patients can stand and swallow. When patients received care at this early stage of disease, 77% (7 of 9) were healed and returned to the flock.

Topics: Acid-Base Equilibrium; Animals; Bicarbonates; Brain Diseases; Combined Modality Therapy; Goat Diseases; Goats; Infusions, Intravenous; Injections, Subcutaneous; Intubation, Gastrointestinal; Listeriosis; Penicillin G Procaine; Prognosis; Sheep; Sheep Diseases; Sodium; Sodium Bicarbonate

Topics: Alkalosis; Aluminum Hydroxide; Antacids; Bicarbonates; Brain Diseases; Calcium; Constipation; Diarrhea; Drug Interactions; Humans; Hydrogen-Ion Concentration; Hypercalcemia; Kidney Calculi; Magnesium Hydroxide; Osteomalacia; Phosphates; Sodium; Sodium Bicarbonate; Urine; Water-Electrolyte Imbalance