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Related Concept Videos

Diagnosing Acidosis and Alkalosis01:24

Diagnosing Acidosis and Alkalosis

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Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
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The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
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The human body maintains a narrow pH range regulated through acid-base balance. This balance is crucial as changes in the hydrogen ion concentration can disrupt cell membrane stability, alter protein structures, and change enzyme activities. The normal pH of arterial blood is 7.4, venous blood and interstitial fluid is 7.35, and intracellular fluid averages 7.0.
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Metabolic reactions in the body produce nonvolatile acids, such as sulfuric acid, which generate an acid load of approximately 1 mEq of H+ per kilogram of body weight daily. Excreting H+ in the urine is essential to balance this acid load.
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Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
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Establishment of an Extracellular Acidic pH Culture System
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A Quick Reference on High Anion Gap Metabolic Acidosis.

Silvia Funes1, Helio Autran de Morais1

  • 1Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, 700 Southwest 30th Street, Corvallis, OR 97331, USA.

The Veterinary Clinics of North America. Small Animal Practice
|December 27, 2016
PubMed
Summary

High anion gap metabolic acidosis is diagnosed by low pH and increased anion gap, often caused by kidney failure, diabetic ketoacidosis, or lactic acidosis. Severe phosphorus increases can also lead to hyperphosphatemic acidosis.

Keywords:
AcidosisAnion gapUnmeasured anions

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Area of Science:

  • Nephrology
  • Internal Medicine
  • Biochemistry

Background:

  • Metabolic acidosis is characterized by a decrease in blood pH.
  • High anion gap (AG) metabolic acidosis indicates an accumulation of unmeasured anions.
  • The AG is calculated as the difference between unmeasured cations and unmeasured anions.

Purpose of the Study:

  • To define the diagnostic criteria for high anion gap metabolic acidosis.
  • To identify common etiologies of high anion gap metabolic acidosis.
  • To discuss the role of hyperphosphatemia in metabolic acidosis.

Main Methods:

  • Review of diagnostic parameters including pH, HCO3-, and AG.
  • Analysis of common causes such as renal failure, diabetic ketoacidosis, and lactic acidosis.
  • Evaluation of the impact of severe hyperphosphatemia on acid-base balance.

Main Results:

  • High AG metabolic acidosis is identified by decreased pH and elevated AG.
  • Common causes include renal failure, diabetic ketoacidosis, and lactic acidosis.
  • Severe hyperphosphatemia can result in hyperphosphatemic acidosis.

Conclusions:

  • Understanding high AG metabolic acidosis is crucial for diagnosis and management.
  • Prompt identification of underlying causes is essential for effective treatment.
  • Hyperphosphatemia represents a distinct cause of metabolic acidosis that warrants consideration.