Acid Base Disorders

What pH level is acidemia?

pH < 7.35

What pH level is alkalemia?

pH > 7.45

What PCO2 is considered respiratory acidosis?

< 35

What PCO2 is considered respiratory alkalosis?

> 45

What HCO3 is considered metabolic acidosis?

< 22

What HCO3 is considered metabolic alkalosis?

> 26

What is the rate of respiratory compensation?

within minutes

What is the rate of metabolic compensation?

days to weeks

ABG of Respiratory Alkalosis

↑ pH

↓ CO2

normal or ↓ HCO3 (if compensated)

ABG of Respiratory Acidosis

↓ pH

↑ CO2

normal or ↑ HCO3 (if compensated)

ABG of Metabolic Alkalosis

↑ pH

↑ HCO3

normal or ↑ CO2 (if compensated)

ABG of Metabolic Acidosis

↓ pH

↓ HCO3

normal or ↓ CO2 (if compensated)

What are the causes of high anion gap metabolic acidosis?

Methanol, uremia, DKA, Propylene Glycol, Iron, Lactate, Ethanol, Salicylates "MUDPILES"

What are the causes of non anion gap metabolic acidosis?

GI bicarbonate loss, renal bicarbonate loss, hypercholermia due to saline resucinations

How is metabolic acidosis treated?

treat the underlying case +/- sodium bicarbonate if its severe

What are the causes of metabolic alkalosis with urine chloride < 25 and how is it treated?

GI losses, diuretics, cystic fibrosis; treated with fluids

What are the causes of metabolic alkalosis with urine chloride > 25 and how is it treated?

Barter's, Cushing, Hyperaldosteronism, Potassium depletion, citrate toxicity, diuretics; treat underlying cause +/- potassium

What causes respiratory acidosis?

OSA, COPD, PNA, ARDS, MG, aspiration, tumor, foreign body

What is the treatment for respiratory acidosis?

treat underlying cause +/- respiratory support

What causes respiratory alkalosis?

Hyperventilation, sepsis, pain, CNS< salicylate overdose, pregnancy, high altitude

What are some symptoms of respiratory alkalosis?

lightheadedness, palpitations, tachypnea, +/- paresthesias

What is the treatment for respiratory alkalosis?

treat underlying cause +/- respiratory support

How is anion gap calculated?

Na - (Cl + HCO3)

What is considered a normal anion gap?

8-12