All things blood work & Interpretation

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Last updated 7:40 AM on 8/22/26
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8 Terms

1
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What is metabolic acidosis?

It is usually noticed with gas result
You will see low pH (acidosis) low bicarb & negative base excess

2
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What are some of the triggers or pathophysiological events that could lead to metabolic acidosis?

  1. Asphyxia,

  2. Loss of base (gastrointestinal such as ostomy losses or renal, or post-operative losses)

  3. Excessive intake of H+ ions beyond what the kidneys can eliminate

  4. Excessive generation of H+ ions from abnormal cellular metabolism, especially lactic acidosis in hypoxia and sepsis

  5. Severe tissue-level hypoxia secondary to either poor perfusion or oxygen delivery can shift metabolism towards anerobic glycolysis with the generation of H+ ions and lower ATP production, and subsequent production of lactic acid
    Sepsis

  6. Persistent pulmonary hypertension


3
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What is the mnemonic to remember causes of (both metabolic or respiratory acidosis) in newborn?

Neonatal metabolic acidosis mnemonic
“ACID SHOCK”

A

Asphyxia

C

Cardiac disease (left sided obstruction, cyanotic heart disease, cardiac failure, PDA)

I

Infection (Sepsis), Inborn errors of metabolism

D

Diarrhea

S

Shock

H

Hypoxia

O

Ostomy loss

C

Chloride excess/carbonic anhydrase inhibitors

K

Kidney Losses (distal/proximal RTA)


4
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What are the consequences of not treating acidosis?

Hemodynamic instability

  1. Reduces myocardial contractility, predisposing to arrhythmia.

  1. Induces vasodilation, and impairing the response to catecholamines by reducing cellular calcium influx, increasing extracellular potassium, and depleting pituitary vasopressin reserves



5
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What are some of the adverse effects of giving sodium bicarbonate for metabolic acidosis?

known adverse effects associated with NaHCO3 administration, such as 1. fluctuations in cerebral blood flow

  1. cardiovascular hemodynamics

  2. increased rates of severe IVH in preterm babies


6
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What does Thrombocytopenia mean?

low blood platelet count (below 150,000/µL)

7
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What are some early causes of thrombocytopenia (less than 72hours)?

  • Preterm birth

  • Low birth weight

  • Maternal preeclampsia

  • Placental insufficiency 

  • Growth restrictions


8
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What are some late causes or other causes?

  1. Late-Onset ( After 72hrs)

  • Usually caused by sever infections: bacterial or fungal infections

  • NEC

  1. Immune-Mediated

  • Maternal antibodies attack the baby’s platelets: FNAIT