Metabolic acidosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Prognosis and recovery of Metabolic Acidosis is dependent on the causative factor. Appropriate and timely treatment takes time but help in recovery. Some people totally recover from Metabolic Acidosis whereas others may develop

• Cardiovascular System: Dec contractility, Arterial vasodilatation, Dec MAP, Dec CO, Dec response to Catecholamine, Inc risk of arrhythmias
• Respiratory System: Hyperventilation(compensatory), Dec Respiratory Muscle Strength, Metabolic Acidosis Increase Potassium(Due to H+/K+ pump exchanging excess H+ with Intracellular K+)
• Neurological: Altered Mental Status, lethargy

• Multiple organ dysfunction
• Renal System: Renal failure, Kidney stones
• Musculoskeletal: Bone disease, delayed growth
• severe acidosis can also result in shock and rarely death
• Glucose tolerance can be impaired because of interference with the actions of insulin
• predisposes patients to amyloidosis because of production Beta 2 micro globulins.

COMPLICATIONS FROM USE OF BICARBONATES:

Caution with bicarbonate therapy is indicated because of its potential complications, including the following:

• Volume overload
• Hypokalemia
• CNS acidosis
• Hypercapnia
• Tissue hypoxia via leftward shift of hemoglobin-oxygen dissociation curve
• Alkali stimulation of organic acidosis (lactate)
• Overshoot alkalosis