How low a pH can the human body handle? How bad is acidosis in cardiac arrest? Is there any point attempting to resuscitate a cardiac arrest patient with a pH of 6.8?
In this lecture from #SWEETs17, Jonathan Ilicki presents a poem covering cardiac arrest physiology, acidosis and the extreme boundaries of the human body. Discover what acidosis does to the human body and how low we can go!
UPDATE
Chris Turner contacted us in the comments to let us know about what seems to be the world record in extreme acidosis (pH 6,27) in survived cardiac arrest. Unfortunately, that case wasn’t identified prior to the lecture and was therefore not included. The case lives here.
And in the words of Chris himself: “There may be more…”
Video
Podcast
Slides
About Jonathan
- Emergency Medicine Resident, Clinical Innovation Fellow. EM resident at Karolinska, Stockholm. Special interest in arrestology and EBM. Find him on linkedin. Email: j dot ilicki at gmail.
- More content on his youtube channel
- He promises to be on twitter soon…
Credits
- Swedish Emergency Talks 2017 (www.sweets.nu/en)
- Johan Smedbäck (recording), Therese Djärv & Susanne Rysz (peer review)
- Music: Decktonic (http://freemusicarchive.org/music/Decktonic)
More from SWEETs17
Stay tuned for more talks from SWEETs17 here on scanFOAM. Also, make sure to follow the SWEETs team on twitter.
References
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England) 2005; 9: R357-62. [PubMed] - Spencer C, Randic L, Butler J. Survival following Profound Lactic Acidosis and Cardiac Arrest: Does Metformin Really Induce Lactic Acidosis? Journal of the Intensive Care
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[PubMed] - Di Rollo N, Caesar D, Ferenbach DA, Dunn MJG. Survival from profound metabolic acidosis due to hypovolaemic shock. A world record? BMJ case reports 2013;
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- Park JS, Lee BK, Jeung KW, et al. Reliability of blood color and blood gases in discriminating arterial from venous puncture during cardiopulmonary resuscitation. The American journal of emergency medicine 2015;
33: 553–8. [PubMed] - Spindelboeck W, Gemes G, Strasser C, et al. Arterial blood gases during and their dynamic changes after cardiopulmonary resuscitation: A prospective clinical study.
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critical care 2016; 31: 243–8. [PubMed] - Llitjos J-F, Mira J-P, Duranteau J, Cariou A. Hyperoxia toxicity after cardiac arrest: What is the evidence? Annals of intensive care 2016; 6: 23. [PubMed]
- Ilicki J, Djarv T. Survival in extremely acidotic cardiac arrest patients depends on etiology of acidosis. Resuscitation 2017; 113: e25. [PubMed]
Scandinavian paediatric anaesthetist / intensivist.
PHARM, ED, OR, ICU.
Digital MedEd
Co-founder scanFOAM.org
Co-organiser CphCC & TBS-Zermatt (aka The Big Sick)
Medical lead REPEL (resilience in pediatric emergency life support)
Web dev SSAI.info
Medical doctor and clinical innovation fellow passionate about Emergency Medicine and the intersection of science, EBM and technology. Currently leading medical innovation and development at a Scandinavian healthtech company.
Great talk! Truely impressive! Sorry to have missed it live.
Hi, a really good talk but I think you missed a lower pH survivor
http://www.resuscitationjournal.com/article/S0300-9572(09)00259-7/abstract
There may be more…
True, that seems to be the current no. 1. I wonder if we’ll ever get below 6. Getting rather close!
Fascinating! Pity I didn’t find that case prior to the lecture. Will add a note on the video to and reference that case, which is (to the best of my knowledge) the world record in acidosis and arrest.
Hello, I found your website searching for myself, in January of 2013 or 2014 I was admitted to United Memorial Medical Center in batavia, NY. I was there in a coma, that I was told when I woke that I shouldn’t be awake let alone speaking full sentences. Doctors came from every part of the hospital and I was told I was a miracle, several nurses cried. To Me it was nothing as I didn’t experience it, I thought I was just DKA As I have been a few times throughout my now 30 years as a diabetic. But one… Read more »
Dear Amanda
Thanks for stopping by and sharing your story. I hope the diabetes has been better controlled since that DKA episode. That sounds like a rough ride.
Your acidosis level must have been quite impressive for them to talk about a record and you have me curious too, but be aware that the extreme cases listed in this talk were from having cardiac arrest on top of some other disease state with acidosis which will always acutely worsen the acidosis.
You’re welcome to hit me up in my email to discuss if you want.
Mads