Mixed disorder of acid-base balance

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Mixed disorder of acid-base balance
ICD-10 E87.4
ICD-9 276.4

In a mixed disorder of acid-base balance more than one of the following four primary acid base disorders is occurring in the patient at the same time:

condition pH carbon dioxide compensation
metabolic acidosis down down respiratory
respiratory acidosis down up renal
metabolic alkalosis up up respiratory
respiratory alkalosis up down renal

(Exception: A person cannot have both a respiratory acidosis and a respiratory alkalosis at the same time.)

In contrast, with a simple acid base disorder, there is only one of the four primary acid base disorders present.

The patient can have an acidosis and alkosis at the same time that partially counteract each other, or there can be two different conditions effecting the pH in the same direction. The phrase "mixed acidosis", for example, refers to metabolic acidosis in conjunction with respiratory acidosis.

There is actually an easy way to identify if the Acid-Base balance disorder is Metabolic or Respiratory in origin.

  • If the pH and Carbon dioxide levels are either both increased or decreased, then it is Metabolic.
  • If the pH level is opposite to that of the Carbon dioxide level or vice versa, then it is Respiratory.

Determining if it is acidosis or alkalosis depends upon the pH of the blood which is normally regulated between pH 7.35 and 7.45.

  • If pH is above 7.45, then an alkalemia is present - this indicates the presence of an alkalosis.
  • If pH is below 7.35, then an acidemia is present - this indicates the presence of an acidosis.

See also

Acid base physiology

External links


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