Acidosis resident survival guide

Revision as of 00:19, 13 March 2014 by Rim Halaby (talk | contribs) (→‎Definition)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Rim Halaby

Overview

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 [HCO3-] and PaCO2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low [HCO3-]
and
Low to normal PaCO2
 
 
 
 
 
 
 
 
 
 
 
High PaCO2
and
High to normal [HCO3-]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Metabolic acidosis
 
 
 
 
 
 
 
 
 
 
 
Respiratory acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Check for respiratory compensation

Calculate expected PCO2
 
 
 
 
 
 
 
 
 
 
 
Check for renal compensation

Calculate expected [HCO3-]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Decrease in PaCO2=1.25 x (24- measured HCO3-)?
 
 
 
 
 
 
 
Acute acidosis?

Increase [HCO3-]=0.1 x (measure PaCO2-40)?
 
 
 
 
 
Chronic acidosis?

Increase [HCO3-]=0.1 x (measure PaCO2-40)?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PaCO2 too low?

Mixed metabolic acidosis with respiratory alkalosis
 
 
PaCO2 too high?

Mixed metabolic acidosis with respiratory acidosis
 
 
 
[HCO3-] too low?

Mixed respiratory acidosis with metabolic acidosis
 
 
[HCO3-] too high?

Mixed respiratory acidosis with metabolic alkalosis
 
[HCO3-] too low?

Mixed respiratory acidosis with metabolic acidosis
 
 
E04=[HCO3-] too high?

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

Compensated metabolic acidosis
 
 
 
 
 
 
 
 
 
Measured [HCO3-] is equal to expected value?

Compensated respiratory acidosis
 
 
 
 
 
 
 
Measured [HCO3-] is equal to expected value?

Compensated respiratory acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Click here for the management of metabolic acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Click here for the management of respiratory acidosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

References

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