Acidosis resident survival guide: Difference between revisions

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{{familytree | E01 |!| E02 | | | | E03 |!| E04 | | E05 |!| E06 |E01=PaCO<sub>2</sub> too low?<br><br> '''Mixed metabolic acidosis with respiratory alkalosis'''|E02=PaCO<sub>2</sub> too high?<br><br> '''Mixed metabolic acidosis with respiratory acidosis'''|E03=[HCO3<sup>2-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E04=[HCO3<sup>2-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis'''|E05=[HCO3<sup>2-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E06=E04=[HCO3<sup>2-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis''' }}
{{familytree | E01 |!| E02 | | | | E03 |!| E04 | | E05 |!| E06 |E01=PaCO<sub>2</sub> too low?<br><br> '''Mixed metabolic acidosis with respiratory alkalosis'''|E02=PaCO<sub>2</sub> too high?<br><br> '''Mixed metabolic acidosis with respiratory acidosis'''|E03=[HCO3<sup>2-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E04=[HCO3<sup>2-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis'''|E05=[HCO3<sup>2-</sup>] too low? <br><br> '''Mixed respiratory acidosis with metabolic acidosis'''|E06=E04=[HCO3<sup>2-</sup>] too high? <br><br> '''Mixed respiratory acidosis with metabolic alkalosis''' }}
{{familytree | | | E07 | | | | | | | | E08 | | | | | | E09 | |E07=Measured PaCO<sub>2</sub> is equal to expected value?<br><br> '''Compensated metabolic acidosis'''|E08=Measured [HCO3<sup>2-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis'''|E09=Measured [HCO3<sup>2-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis''' }}
{{familytree | |:| E07 |:| | | | | | | E08 | | | | | | E09 | |E07=Measured PaCO<sub>2</sub> is equal to expected value?<br><br> '''Compensated metabolic acidosis'''|E08=Measured [HCO3<sup>2-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis'''|E09=Measured [HCO3<sup>2-</sup>] is equal to expected value? <br><br> '''Compensated respiratory acidosis''' }}
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Revision as of 01:25, 2 August 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Rim Halaby

Definition

Acidosis occurs when the pH is less or equal to 7.35 due to excess of hydrogen ions.

Causes

Life Threatening Causes

Common Causes

Management

 
 
 
 
 
 
 
 
pH < 7.35
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acidosis
(High [H+])
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Determine the primary disorder
Metabolic or respiratory?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Check [HCO32-] and PaCO2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low [HCO32-]
and
Low PaCO2
 
 
 
 
 
 
 
 
 
 
 
High [HCO32-]
and
High PaCO2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Metabolic acidosis
 
 
 
 
 
 
 
 
 
 
 
Respiratory acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Check for respiratory compensation

Calculate expected PCO2
 
 
 
 
 
 
 
 
 
 
 
Check for renal compensation

Calculate expected [HCO32-]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Decrease in PaCO2=1.25 x (24- measured HCO32-)?
 
 
 
 
 
 
 
Acute acidosis?

Increase [HCO32-]=0.1 x (measure PaCO2-40)?
 
 
 
 
 
Chronic acidosis?

Increase [HCO32-]=0.1 x (measure PaCO2-40)?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PaCO2 too low?

Mixed metabolic acidosis with respiratory alkalosis
 
 
PaCO2 too high?

Mixed metabolic acidosis with respiratory acidosis
 
 
 
[HCO32-] too low?

Mixed respiratory acidosis with metabolic acidosis
 
 
[HCO32-] too high?

Mixed respiratory acidosis with metabolic alkalosis
 
[HCO32-] too low?

Mixed respiratory acidosis with metabolic acidosis
 
 
E04=[HCO32-] too high?

Mixed respiratory acidosis with metabolic alkalosis
 
 
 
Measured PaCO2 is equal to expected value?

Compensated metabolic acidosis
 
 
 
 
 
 
 
 
Measured [HCO32-] is equal to expected value?

Compensated respiratory acidosis
 
 
 
 
 
Measured [HCO32-] is equal to expected value?

Compensated respiratory acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
F01
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

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