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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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Bronsted-Lowry Acids and Bases02:58

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The acid-base reaction class has been studied for quite some time. In 1680, Robert Boyle reported traits of acid solutions that included their ability to dissolve many substances, to change the colors of certain natural dyes, and to lose these traits after coming in contact with alkali (base) solutions. In the eighteenth century, it was recognized that acids have a sour taste, react with limestone to liberate a gaseous substance (now known to be CO2), and interact with alkalis to form neutral...
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Disorders of Acid-Base Balance01:29

Disorders of Acid-Base Balance

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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.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
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Acid-Base Balance01:25

Acid-Base Balance

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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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Renal Regulation of Acid-Base Balance01:29

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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.
In the kidneys, cells within the proximal convoluted tubules (PCT) and the collecting ducts secrete hydrogen ions (H+) into the tubular fluid. Specifically, in the PCT, Na+/H+ antiporters secrete H+ while reabsorbing Na+.
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Titration of a Weak Acid with a Strong Base01:30

Titration of a Weak Acid with a Strong Base

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In titrating a weak acid with a strong base, different calculation methods are applied at various stages. Initially, the pH of a weak acid like acetic acid is calculated using its dissociation constant (Ka) and an ICE table. Upon addition of a strong base such as sodium hydroxide, a buffer forms, and its pH is determined using the Henderson-Hasselbalch equation. As more base is added and the titration reaches the halfway point, the pH becomes equal to the pKa of the acid, indicating equal...
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Measurement and Analysis of Extracellular Acid Production to Determine Glycolytic Rate
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The Acidemia Index: A Near Real-Time Risk Analytics Algorithm is Associated With Measured Acidemia in Pediatric

Ahmed Asfari1, Avihu Z Gazit2, Craig Futterman3

  • 1Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX.

Critical Care Explorations
|June 25, 2025
PubMed
Summary

A new algorithm accurately predicts acidemia (ACD), a dangerous condition in critically ill children, especially those with heart defects. This tool can help doctors intervene earlier to improve patient outcomes.

Keywords:
acidemiaacidosispediatric cardiac surgerypredictive analyticsrisk estimationserum pH

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Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
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Area of Science:

  • Pediatric Critical Care Medicine
  • Biomedical Data Science
  • Predictive Analytics in Healthcare

Background:

  • Acidemia is a common and dangerous complication in pediatric critical care, particularly in patients with congenital heart defects.
  • Early prediction of worsening acidemia is crucial for timely interventions and improved patient outcomes.

Purpose of the Study:

  • To evaluate the association of a novel, near real-time predictive analytics algorithm, the acidemia (ACD) index, with the occurrence of acidemia in pediatric intensive care unit (ICU) patients.
  • To assess the potential of the ACD index to identify patients at risk for acidemia.

Main Methods:

  • A retrospective observational study was conducted across nine tertiary institutions in the United States.
  • Data from 1858 pediatric patients (12 years or younger) admitted to ICUs between February 2018 and November 2020 were analyzed, including 24,431 arterial blood pH measurements.
  • An ACD index was validated using the Etiometry platform, calculated via a physiologic algorithm incorporating real-time laboratory and clinical data using Bayes' theorem.

Main Results:

  • The ACD index demonstrated strong performance in predicting acidemia, with an area under the receiver operating characteristic curve of 0.93.
  • Higher ACD index values were significantly associated with an increased likelihood of acidemia (p < 0.01).
  • The relative risk of acidemia was low (0.11) when the ACD index was less than 1, and the relative risk of not having acidemia was high (0.38) when the index was greater than 99.

Conclusions:

  • The novel ACD index is associated with the likelihood of acidemia in a large pediatric critical care cohort.
  • This predictive tool shows potential for identifying significant clinical status changes in pediatric patients.
  • Further prospective studies are warranted to confirm the clinical utility of the ACD index in managing pediatric critical illness.