Franz Wiesbauer explains the relationship between pH, HCO3 and pCO2 and a simple rule which will help you decide whether the primary problem is respiratory or metabolic in nature.
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'.
a metabolic acidosis is an abnormal primary process or condition leading to an increase in fixed acids in the blood -> resulting in a fall in arterial plasma bicarbonate
A metabolic acidosis is a process which, if uncorrected, would lead to an acidaemia. It is usually associated with a low bicarbonate concentration (or total CO2), but an acidosis may be masked by a co-existing metabolic alkalosis.
Fulminant hepatic failure is defined as the appearance of hepatic encephalopathy in a patient with acute deterioration of liver function with no previous history of liver disease.
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