Acidosis resident survival guide: Difference between revisions
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==Management== | ==Management== | ||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | | | | | | | A01 | | | | | |A01= | {{familytree | | | | | | | | | A01 | | | | | |A01='''pH<7.35'''}} | ||
{{familytree | | | | | | | | | |!| | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | | | | | B01 | | | | | |B01= | {{familytree | | | | | | | | | B01 | | | | | |B01='''Acidosis'''<br>(High [H<sup>+</sup>])}} | ||
{{familytree | | | | | | | | | |!| | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | | | | | B02 | | | | | |B02= | {{familytree | | | | | | | | | B02 | | | | | |B02='''Determine the primary disorder'''<br> Metabolic or respiratory?}} | ||
{{familytree | | | | | | | | | |!| | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | | | | | B03 | | | | | |B03= | {{familytree | | | | | | | | | B03 | | | | | |B03=Check [HCO3<sup>2-</sup>] and PaCO<sub>2</sub>}} | ||
{{familytree | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|.| }} | {{familytree | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|.| }} | ||
{{familytree | | | C01 | | | | | | | | | | | |C02|C01= | {{familytree | | | C01 | | | | | | | | | | | |C02|C01=Low [HCO3<sup>2-</sup>] <br>and<br> Low PaCO<sub>2</sub>|C02=High [HCO3<sup>2-</sup>] <br>and<br> High PaCO<sub>2</sub>}} | ||
{{familytree | | | |!| | | | | | | | | | | | | |!| }} | {{familytree | | | |!| | | | | | | | | | | | | |!| }} | ||
{{familytree | | | C03 | | | | | | | | | | | |C04|C03= | {{familytree | | | C03 | | | | | | | | | | | |C04|C03='''Metabolic acidosis'''|C04='''Respiratory acidosis'''}} | ||
{{familytree | | | |!| | | | | | | | | | | | | |!| }} | {{familytree | | | |!| | | | | | | | | | | | | |!| }} | ||
{{familytree | | | C05 | | | | | | | | | | | |C06|C05= | {{familytree | | | C05 | | | | | | | | | | | |C06|C05='''Check for respiratory compensation'''<br><br>Calculate expected PCO<sub>2</sub>|C06='''Check for renal compensation'''<br><br> Calculate expected HCO3<sup>2-</sup>] }} | ||
{{familytree | | | |!| | | | | | | | | | | | | |!| }} | {{familytree | | | |!| | | | | | | | | | | | | |!| }} | ||
{{familytree | | | |!| | | | | | | | | |,|-|-|-|^|-|-|-|-|.|}} | {{familytree | | | |!| | | | | | | | | |,|-|-|-|^|-|-|-|-|.|}} | ||
{{familytree | | | D01 | | | | | | | | D02 | | | | | | D03 |D01= | {{familytree | | | D01 | | | | | | | | D02 | | | | | | D03 |D01=Decrease in PaCO<sub>2</sub>=1.25 x (24- measured HCO3<sup>2-</sup>?|D02='''Acute acidosis?'''<br><br>Increase [HCO3<sup>2-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?|D03='''Chronic acidosis?'''<br><br>Increase [HCO3<sup>2-</sup>]=0.1 x (measure PaCO<sub>2</sub>-40)?}} | ||
{{familytree | |,|-|^|-|.| | | | | |,|-|^|-|.| | | |,|-|^|-|.| | }} | {{familytree | |,|-|^|-|.| | | | | |,|-|^|-|.| | | |,|-|^|-|.| | }} | ||
{{familytree | E01 | | E02 | | | | E03 | | E04 | | E05 | | E06 |E01=E01|E02=E02|E03=E03|E04=E04|E05=E05|E06=E06 }} | {{familytree | E01 | | E02 | | | | E03 | | E04 | | E05 | | E06 |E01=E01|E02=E02|E03=E03|E04=E04|E05=E05|E06=E06 }} | ||
Revision as of 01:01, 2 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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)? | |||||||||||||||||||||||||||||||||||||||||||||||||
| E01 | E02 | E03 | E04 | E05 | E06 | ||||||||||||||||||||||||||||||||||||||||||||||