[Combined disorders of the acid-base equilibrium. Clinical comments]

Area of Science:

• Biochemistry
• Physiology
• Clinical Medicine

Background:

• The acid-base balance is crucial for cellular function and overall homeostasis.
• Understanding combined acid-base disorders is essential for accurate diagnosis and treatment.
• Existing definitions of acid-base balance vary, impacting the evaluation of complex conditions.

Observation:

• The paper examines different definitions of acid-base balance and their relevance to combined disorders.
• It discusses parallel and opposing deviations occurring intracellularly and extracellularly.
• Disorders related to ion accumulation and impaired energy balance are explored.

Findings:

• The study highlights the importance of various definitions for evaluating combined acid-base disturbances.
• It details the mechanisms of parallel and opposite deviations within and outside cells.
• Clinical examples illustrate how impaired acid-base balance can lead to atypical laboratory results.

Implications:

• Accurate evaluation of combined acid-base disorders requires a comprehensive understanding of definitions and deviations.
• Clinicians should be aware of potential atypical laboratory findings in patients with acid-base imbalances.
• This review aids in refining diagnostic approaches for complex acid-base disturbances.