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The medical and metabolic consequences of administration of sodium acetate - ScienceDirect
"Acetate and D-lactate are normally present in human blood at levels below 0.1 mM. To understand how 35 to 45 mM concentrations of acetate and D,L-lactate came into widespread clinical use, it is helpful to understand the history of the development of parenteral fluids. It seems extremely unlikely if all parenteral fluids were to be designed de novo today, that they would have their present compositions. Rather the compositions of the parenteral fluids in use today reflect: the availability of components at the time they were first formulated, the costs and legal difficulties of meeting regulations now required for making even the most logical changes in existing compositions, and most importantly an inattention by physicians to the large deviations from physiological limits in the composition of the routine parenteral fluids they are prescribing and the biochemical and pathological consequences of their use."
"One hundred and fifty years ago in 1832, Thomas Latta gave the first recorded parenteral infusion of saline to a patient dying of cholera with dramatic life saving consequences (3). From that beginning, parenteral fluids became such an integral part of medical, surgical and pediatric practice they are simply accepted as a given by most physicians and scientists. It is startling to recognize that the compositions of the basic fluids in use in clinical medicine today were developed between 50 and 150 years ago, and remain unaltered and ignored today."
"In order to prevent hyperchloremic acidosis accompanying large volume infusions of normal saline, Ringers' lactate was formulated with D,L-lactate because that was the only form of lactate available at the time and use of bicarbonate alone was incompatible with addition of calcium. Sodium acetate was used later in parenteral fluids on the theory that it was the metabolic equivalent of sodium bicarbonate. These D,L-lactate or acetate containing fluids were more convenient than the more physiological Krebs-Henseleit because, if exposed to the atmosphere, they did not result in the precipitation of CaCO3. While all of this makes sense in an historical context, the continued use now of acetate and D,L-lactate makes absolutely no sense in the light of the availability of more physiologically compatible anions and the ease with which CO2 can be contained in fluids. It is now clear that the metabolic processes which convert acetate into bicarbonate result in profound alterations in cellular homeostasis. It is these alterations which may account for much of the reported toxicity of the current parenteral fluids."
"At low levels, acetate is a normal metabolite in man. It is ingested as food, and produced in the gut as the result of bacterial metabolism. Acetate is metabolized in liver, heart and other tissues by acetyl CoA synthase" "The acetyl CoA formed is subsequently metabolized in the reactions of the Krebs tricarboxylic acid cycle to be ultimately converted to CO2 and water."
There are many details further on, so read the entire document, you won't regret.
@Diokine @Such_Saturation
"Acetate and D-lactate are normally present in human blood at levels below 0.1 mM. To understand how 35 to 45 mM concentrations of acetate and D,L-lactate came into widespread clinical use, it is helpful to understand the history of the development of parenteral fluids. It seems extremely unlikely if all parenteral fluids were to be designed de novo today, that they would have their present compositions. Rather the compositions of the parenteral fluids in use today reflect: the availability of components at the time they were first formulated, the costs and legal difficulties of meeting regulations now required for making even the most logical changes in existing compositions, and most importantly an inattention by physicians to the large deviations from physiological limits in the composition of the routine parenteral fluids they are prescribing and the biochemical and pathological consequences of their use."
"One hundred and fifty years ago in 1832, Thomas Latta gave the first recorded parenteral infusion of saline to a patient dying of cholera with dramatic life saving consequences (3). From that beginning, parenteral fluids became such an integral part of medical, surgical and pediatric practice they are simply accepted as a given by most physicians and scientists. It is startling to recognize that the compositions of the basic fluids in use in clinical medicine today were developed between 50 and 150 years ago, and remain unaltered and ignored today."
"In order to prevent hyperchloremic acidosis accompanying large volume infusions of normal saline, Ringers' lactate was formulated with D,L-lactate because that was the only form of lactate available at the time and use of bicarbonate alone was incompatible with addition of calcium. Sodium acetate was used later in parenteral fluids on the theory that it was the metabolic equivalent of sodium bicarbonate. These D,L-lactate or acetate containing fluids were more convenient than the more physiological Krebs-Henseleit because, if exposed to the atmosphere, they did not result in the precipitation of CaCO3. While all of this makes sense in an historical context, the continued use now of acetate and D,L-lactate makes absolutely no sense in the light of the availability of more physiologically compatible anions and the ease with which CO2 can be contained in fluids. It is now clear that the metabolic processes which convert acetate into bicarbonate result in profound alterations in cellular homeostasis. It is these alterations which may account for much of the reported toxicity of the current parenteral fluids."
"At low levels, acetate is a normal metabolite in man. It is ingested as food, and produced in the gut as the result of bacterial metabolism. Acetate is metabolized in liver, heart and other tissues by acetyl CoA synthase" "The acetyl CoA formed is subsequently metabolized in the reactions of the Krebs tricarboxylic acid cycle to be ultimately converted to CO2 and water."
There are many details further on, so read the entire document, you won't regret.
@Diokine @Such_Saturation