Compensatory responses for acid-base disorders: Difference between revisions
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==Adequacy of compensatory responses for acid-base disorders== | ==Adequacy of compensatory responses for acid-base disorders== | ||
Compensatory responses are not potent enough to correct the acid-base derangement but only to blunt the changes in pH resulted from the primary deficits. Ranges and limits of appropriate compensations are given as follows: | Compensatory responses are not potent enough to correct the acid-base derangement but only to blunt the changes in pH resulted from the primary deficits. Ranges and limits of appropriate compensations are given as follows:<ref name="isbn0-7216-8956-6">{{cite book | author = Brenner, Barry M.; L. Lee Hamm; Thomas D. Dubose | authorlink = | editor = | others = | title = Acid-base and electrolyte disorders: a companion to Brenner & Rector's The kidney | edition = | language = | publisher = Saunders | location = Philadelphia | year = 2002 | origyear = | pages = | quote = | isbn = 0-7216-8956-6 | oclc = | doi = | url = | accessdate = }}</ref><ref name="isbn0-443-08774-1">{{cite book | author = DeFronzo, Ralph A.; Arieff, Allen I. | authorlink = | editor = | others = | title = Fluid, electrolyte, and acid-base disorders | edition = | language = | publisher = Churchill Livingstone | location = Edinburgh | year = 1995 | origyear = | pages = | quote = | isbn = 0-443-08774-1 | oclc = | doi = | url = | accessdate = }}</ref><ref name="isbn1-4160-3105-7">{{cite book | author = Rector, Floyd C.; Brenner, Barry M. | authorlink = | editor = | others = | title = Brenner & Rector's the kidney | edition = | language = | publisher = Saunders Elsevier | location = | year = 2008 | origyear = | pages = | quote = | isbn = 1-4160-3105-7 | oclc = | doi = | url = | accessdate = }}</ref> | ||
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| Chronic: Δ[HCO<sub>3</sub><sup>-</sup>] = - 0.4 to 0.5 mEq/L x ΔP<sub>CO<sub>2</sub></sub> || [HCO<sub>3</sub><sup>-</sup>] = 15 mEq/L | | Chronic: Δ[HCO<sub>3</sub><sup>-</sup>] = - 0.4 to 0.5 mEq/L x ΔP<sub>CO<sub>2</sub></sub> || [HCO<sub>3</sub><sup>-</sup>] = 15 mEq/L | ||
|- | |- | ||
| [[Metabolic acidosis]] || P<sub>CO<sub>2</sub></sub> = 1.5 x [HCO<sub>3</sub><sup>-</sup>] + 8 ± 2 ([[Winters' formula]]) <BR> P<sub>CO<sub>2</sub></sub> = 15 + [HCO<sub>3</sub><sup>-</sup>] <BR> P<sub>CO<sub>2</sub></sub> = last 2 digits of pH || P<sub>CO<sub>2</sub></sub> = 15 mm Hg | | [[Metabolic acidosis]] || P<sub>CO<sub>2</sub></sub> = 1.5 x [HCO<sub>3</sub><sup>-</sup>] + 8 ± 2 ([[Winters' formula]])<ref name="pmid6016545">{{cite journal | author = Albert MS, Dell RB, Winters RW | title = Quantitative displacement of acid-base equilibrium in metabolic acidosis | journal = [[Annals of Internal Medicine]] | volume = 66 | issue = 2 | pages = 312–22 | year = 1967 | month = February | pmid = 6016545 | doi = | url = http://www.annals.org/article.aspx?volume=66&page=312 | issn = }}</ref> <BR> P<sub>CO<sub>2</sub></sub> = 15 + [HCO<sub>3</sub><sup>-</sup>] <BR> P<sub>CO<sub>2</sub></sub> = last 2 digits of pH || P<sub>CO<sub>2</sub></sub> = 15 mm Hg | ||
|- | |- | ||
| [[Metabolic alkalosis]] || P<sub>CO<sub>2</sub></sub> = 0.6 x [HCO<sub>3</sub><sup>-</sup>] <BR> P<sub>CO<sub>2</sub></sub> = 15 + [HCO<sub>3</sub><sup>-</sup>] || P<sub>CO<sub>2</sub></sub> = 55 mm Hg | | [[Metabolic alkalosis]] || P<sub>CO<sub>2</sub></sub> = 0.6 x [HCO<sub>3</sub><sup>-</sup>] <BR> P<sub>CO<sub>2</sub></sub> = 15 + [HCO<sub>3</sub><sup>-</sup>] || P<sub>CO<sub>2</sub></sub> = 55 mm Hg | ||
Revision as of 23:23, 4 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Compensatory changes for acid-base disorders include renal compensation and respiratory compensation.
Adequacy of compensatory responses for acid-base disorders
Compensatory responses are not potent enough to correct the acid-base derangement but only to blunt the changes in pH resulted from the primary deficits. Ranges and limits of appropriate compensations are given as follows:[1][2][3]
| Primary Deficit | Expected Ranges of Compensation | Limits of Compensation |
| Respiratory acidosis | Acute: Δ[HCO3-] = + 0.1 mEq/L x ΔPCO2 | [HCO3-] = 38 mEq/L |
| Chronic: Δ[HCO3-] = + 0.25 to 0.5 mEq/L x ΔPCO2 | [HCO3-] = 45 mEq/L | |
| Respiratory alkalosis | Acute: Δ[HCO3-] = - 0.25 mEq/L x ΔPCO2 | [HCO3-] = 18 mEq/L |
| Chronic: Δ[HCO3-] = - 0.4 to 0.5 mEq/L x ΔPCO2 | [HCO3-] = 15 mEq/L | |
| Metabolic acidosis | PCO2 = 1.5 x [HCO3-] + 8 ± 2 (Winters' formula)[4] PCO2 = 15 + [HCO3-] PCO2 = last 2 digits of pH |
PCO2 = 15 mm Hg |
| Metabolic alkalosis | PCO2 = 0.6 x [HCO3-] PCO2 = 15 + [HCO3-] |
PCO2 = 55 mm Hg |
References
- ↑ Brenner, Barry M.; L. Lee Hamm; Thomas D. Dubose (2002). Acid-base and electrolyte disorders: a companion to Brenner & Rector's The kidney. Philadelphia: Saunders. ISBN 0-7216-8956-6.
- ↑ DeFronzo, Ralph A.; Arieff, Allen I. (1995). Fluid, electrolyte, and acid-base disorders. Edinburgh: Churchill Livingstone. ISBN 0-443-08774-1.
- ↑ Rector, Floyd C.; Brenner, Barry M. (2008). Brenner & Rector's the kidney. Saunders Elsevier. ISBN 1-4160-3105-7.
- ↑ Albert MS, Dell RB, Winters RW (1967). "Quantitative displacement of acid-base equilibrium in metabolic acidosis". Annals of Internal Medicine. 66 (2): 312–22. PMID 6016545. Unknown parameter
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