Acid Base Imbalances
Terms
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- Metabolic Acidosis
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pH < 7.35
HCO3 <22 mEq/L - Metabolic acidosis cause
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excess acids
bicarb deficiency -
Metabolic Acidosis
Common Causes -
Increased acid production - lactic acidosis, ketoacidosis
Decreased acid excretion - renal failure
Increased Bicarb loss - Diarrhea, ileosomy drainage, intestinal biliary or pancreatic fistulas
Increased Chloride - sodium chloride IV solutions, renal tubular acidosis, carbonic anhydrase inhibitors -
Metabolic Alkalosis
Common Causes -
Increased acid loss or excretion - vomiting, gastric suction, hypokalemia
Increased Bicarb - Alkali ingestion (bicarbonate of soda), excess bicarb administration - Metabolic acidosis compensation
- rate and depth of respirations increase, eliminating additional CO2
- Respiratory Acidosis
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pH < 7.35
PaCO2 > 45 mmHg - Metabolic Alkalosis
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pH > 7.45
HCO3 > 26 mEq/L - Metabolic alkalosis cause
- bicarb excess
- Metabolic acidosis effect on ABGs
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decrease pH
decrease HCO3
decrease PaCO2 - Respiratory Alkalosis
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pH 7.45
PaCO2 < 35 mmHg -
Respiratory Alkalosis
Common Causes - Anxiety induced hyperventilation, fever, early salicylate intoxication, hperventilation with mechanical ventilator
- Metabolic alkalosis compensation
- rate and depth of respirations decrease, retaining CO2
- Metabolic alkalosis effect on ABGs
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increase pH
increase HCO3
increase PaCO2 - Respiratory acidosis cause
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retained CO2
excess carbonic acid - Respiratory acidosis compensation
- Kidneys conserve bicarb to resore carbonic acid:bicarb ration of 1:20
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Respiratory Acidosis
Common Causes -
Acute respiratory conditions (pulmonary edema, pneumonia, acute asthma), opiate OD, foreign body aspiratio0n, chest trauma
Chronic respiratory acidosis, COPD, cystic fibrosis, MS, Stroke - Respiratory acidosis effect on ABGs
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decrease pH
Increase PaCO2
Increase HCO3 - Respiratory alkalosis cause
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loss of CO2
deficient carbonic acid - Respiratory alkalosis compensation
- Kidneys excrete bicarb and conserve H+ to restore carbonic acid: bicarb ratio
- Respiratory alkalosis effect on ABGs
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increase pH
decrease PaCO2
decrease HCO3