ACID-BASE DISTURBANCES

ACID-BASE DISTURBANCES[1]

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ACIDEMIA    pH< 7.4			ALKALEMIA  pH> 7.4
P CO₂ > 40mmHg	P CO₂ < 40mmHg		PCO₂ <40mmHg		PCO₂ >40mmHg
pH↓PCO₂↑HCO₃↑	pH↓PCO₂↓HCO₃⁻↓		pH↑PCO₂↓HCO₃⁻↓		pH↑PCO₂↑HCO₃↑
Respiratory Acidosis	Metabolic Acidosis		RespiratoryAlkalosis		MetabolicAlkalosis
Hypoventilation .airway obstruction .acute lung disease .chronic long disease .opioids, narcotics, sedatives .weakening of respiratory muscles	Check anion gap [(Na⁺-(Cl⁻+HCO₃⁻)] Normal=12[2]		Hyperventilation (Early high altitude exposure) Aspirin ingestion(early)		Diuretic use Vomiting Antacid use Hyperaldosteronism
	↑anion gap .methanol(formic acid) .uremia .diabetic ketoacidosis .paraldehyde or phenformin .iron tablets or INH(isoniazid) .lactic acidosis .ethylene glycol .salicylates Normal anion gap .diarrhea .glue sniffing .renal tubular acidosis .hyperchloremia
COMPENSATORRY  RESPONSE
↑ renal HCO₃⁻ reabsorption		hyperventilation		↓renal HCO₃⁻ reabsorption	hypoventilation

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[1] (Le, Bhushan, & Grimm, 2011)

[2] (© 2009 mdcalc.com, 2011)