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Acid/Base Disorders Cheat Sheet by

abd

Defini­tions

Acid
CO2; proton donor
Base
HCO3-; proton acceptor
Acidemia
pH < 7.35
Alkalemia
pH > 7.45
Acidosis
Process that results in decreased blood pH
Alkalosis
Process that results in increased blood pH
Respir­atory regulation
Regulates CO2; compen­sation occurs in min to hrs
Renal regulation
Regulates HCO3-; compen­sation takes up to 1wk

Conseq­uences of Alkalemia

Hypoka­lemia
Arteriolar constr­iction
Reduced coronary blood flow
Decreased plasma ionized [Ca]
Decreased Mg and PO4
Reduced cerebral blood flow
Tetany, seizures

Conseq­uences of Acidemia

Hyperk­alemia
Impaired cardiac contra­ctility
Reduced ATP synthesis
Impaired response to catech­ola­mines
Reduced cardiac output
Insulin resistance
Coma

Primary Disorders

 
pH
PaCO2
HCO3-
Respir­atory Acidosis
decreased
increased
normal
Respir­atory Alkalosis
increased
decreased
normal
Metabolic Acidosis
decreased
normal
decreased
Metabolic Alkalosis
increased
normal
increased

Partially Compen­sated States

 
pH
PaCO2
HCO3-
Respir­atory Acidosis
decreased
increased
increased
Respir­atory Alkalosis
increased
decreased
decreased
Metabolic Acidosis
decreased
decreased
decreased
Metabolic Alkalosis
increased
increased
increased

Fully Compen­sated States

 
pH
PaCO2
HCO3-
Respir­atory Acidosis
Normal, but < 7.40
increased
increased
Respir­atory Alkalosis
Normal, but > 7.40
decreased
decreased
Metabolic Acidosis
Normal, but < 7.40
decreased
decreased
Metabolic Alkalosis
Normal, but > 7.40
increased
increased
 

Arterial Blood Gas Ranges

pH
7.35-7.45
PaCO2
35-45mmHg
PaO2
80-100mmHg
HCO3-
22-26 mEq/L
SaO2
>95%

Anion Gap (AG)

Definition
Concen­tration of unmeasured anions in plasma
Unmeasured anions
Sulfates, phosph­ates, blood proteins such as albumin
Use
Determines type of metabolic acidosis
Equation
[Na+] - ([Cl-] + [HCO3-])
Normal AG
12 mEq/L; range of 8–16 acceptable
Elevated AG
>20 mEq/L
Metabolic alkalosis
Excess AG+HCO3 > normal HCO3-
Metabolic acidosis
Excess AG+HCO3 < normal HCO3-
AG: Difference in electrical charge between cations and anions in blood.

Causes of Elevated Anion Gap

Methanol
Uremia
Diabetic ketoac­idosis
Propylene glycol
Isoniazid
Lactic acidosis
Ethylene glycol
Renal Failure
*MUD­PILER

Diagnosing Acid/Base Disorders

1. Determine if patient is acidic or basic
2. Determine if it is an anion gap acidosis (normally due to MUDPILER)
3. Determine if metabolic alkalosis or non-anion gap acidosis

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