Renal Tubular Acidosis and Uraemic Acidosis
Metabolic acidosis can occur in both acute and chronic renal disorders; the anion gap may be elevated, due to uraemic acidosis; the anion gap may be normal, due to renal tubular acidosis (RTA)
Category Acid-base
Sodium Bicarbonate and Diabetic Ketoacidosis
Sodium Bicarbonate and Diabetic Ketoacidosis. The correction of the acidaemia in DKA is achieved by correcting the underlying pathophysiology with fluid replacement and insulin
Lactate and Lactic Acidosis
Lactate and Lactic Acidosis. Product of anaerobic glycolysis which reflects type A (oxygen delivery) or type B (altered metabolism) causes
Urinary Anion Gap
Urinary Anion Gap = [Na+]+ [K+] - [Cl-]
Sodium Bicarbonate Use
Sodium Bicarbonate Use. metabolic acidosis leads to adverse cardiovascular effects. bicarbonate must be administered in a solution as sodium bicarbonate
Respiratory Compensation in Metabolic Disorders
The extent of respiratory compensation for a metabolic disorder is determined by the balance between the abnormality in the pH (hence the drive to change) and how hard it is to get there (eg. work of respiratory muscles in hyperventilation)
Respiratory Alkalosis
Respiratory Alkalosis = a primary acid-base disorder in which arterial pCO2 falls to a level lower than expected.
Respiratory Acidosis
Respiratory acidosis = a primary acid-base disorder in which arterial pCO2 rises to an abnormally high level.
Normal Anion Gap Metabolic Acidosis
Normal Anion Gap Metabolic Acidosis (NAGMA). HCO3 loss and replaced with Cl- -> anion gap normal. if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis -> this could be considered a 'relative hyperchloraemia'.
Metformin-associated Lactic Acidosis
Metformin use is associated with lactic acidosis, but it remains controversial as a disease entity
Metabolic Alkalosis
Metabolic alkalosis is a a primary acid-base disorder that causes the plasma bicarbonate to rise to an abnormally high level. the severity of a metabolic alkalosis is determined by the difference between the actual [HCO3] and the expected [HCO3]
Metabolic Alkalosis Evaluation
Evaluation of causes of metabolic alkalosis requires a systematic approach involving history, examination and some specific investigations.