Recording-2025-03-24T15:57:20.224Z

Overview of Acid-Base Balance

• Understanding the significance of bicarbonate (bicarb) levels in patients is critical for diagnosing acid-base disorders.

Bicarbonate and CO2 Levels

• Chronic high CO2 levels indicate prolonged compensation; hence conditions like COPD are common causes.

  • Key Point: A sudden increase is unlikely due to drug overdose because compensation doesn’t happen immediately.

Respiratory Alkalosis

• Characterized by hyperventilation and causes such as:

  • Anxiety

  • Fear

  • Pain

  • Use of respiratory stimulants can increase drive to breathe, risking alkalosis.

Types of Metabolic Disturbances

Metabolic Acidosis

• Identified by bicarb level below 22, caused by:

  • Deficit of base or excess of acids (not CO2).

• Calculation of Anion Gap:

  • High Anion Gap: Indicates excess acids in the body (e.g., metabolic conditions like DKA, renal failure).

  • Normal/Low Anion Gap: Suggests a base deficit (e.g., hyperkalemia).

• Common causes of metabolic acidosis include:

  • Renal Failure

  • Diabetic Ketoacidosis (DKA)

  • Anaerobic Metabolism (e.g., sepsis)

Metabolic Alkalosis

• Defined by a bicarb level greater than 26 and pH greater than 7.45.

• Causes include:

  • Excess Base: e.g., excessive ingestion of antacids or bicarbonate treatment in hospitals.

  • Loss of Acid: e.g., vomiting, gastric suctioning, diuretics.

• Metabolic alkalosis is less frequently a quiz topic, but still essential to understand.

Breathing Patterns Related to Acidosis/Alkalosis

• Recognizing breathing patterns helps in patient assessment:

  • DKA: Kussmaul's breathing indicates compensatory mechanisms due to acidosis.

  • CNS Issues: Head trauma can lead to:

    • Cheyne-Stokes respiration

    • Biot's breathing

Exam Preparation Tips

• Focus on the major points and mechanisms of respiratory acidosis/alkalosis and metabolic acidosis/alkalosis.

• Familiarize yourself with triggers and responses of body systems to acid-base imbalances.

• Review past quizzes and key breathing patterns to solidify understanding of assessment techniques.