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''' }} | ||
{{familytree | |:| |:| |:| | | | | | | | | | | | | }} | {{familytree | |:| |:| |:| | | | | |:| |:| |:| | | |:| |:| |:| | }} | ||
{{familytree | |L| F01 |J| | | | | | | | | | | |F01=[[Metabolic acidosis resident survival guide|'''Click here for management of metabolic acidosis''']] }} | {{familytree | |L| F01 |J| | | | | |L|~|A|~|A| F02 |A|~|A|~|J| | F01=[[Metabolic acidosis resident survival guide|'''Click here for management of metabolic acidosis''']]|F02=[[Respiratory acidosis resident survival guide|'''Click here for management of respiratory acidosis''']] }} | ||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 01:36, 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
- Diabetic ketoacidosis
- Diarrhea
- Ethylene glycol
- Lactic acidosis
- Methanol
- Renal tubular acidosis
- Salicylates
- Uremia
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 | |||||||||||||||||||||||||||||||||||||||||||||||||
| Click here for management of metabolic acidosis | Click here for management of respiratory acidosis | ||||||||||||||||||||||||||||||||||||||||||||||||||