Clinical Approach to Acid-base Disorders - University at Buffalo

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Rule #3: Determine if the primary problem is metabolic or respiratory • A primary metabolic disorder is present if the [HCO 3 ] - is abnormal. The pH and P a CO 2 change in the same direction. • A primary respiratory disorder is present if the P a CO 2 is abnormal. The pH and P a CO 2 change in the opposite direction.
Rule #4:Calculate the anion gap • The anion gap (AG) is an estimate of unmeasured anions and is calculated as follows: AG = Na - (Cl + HCO 3 ). Normal range is 6-12 mEq/L. Reduction in plasma proteins, particularly albumin may decrease the AG by about 1/3. • AG helps to determine if the metabolic acidosis is due to accumulation of [H + ] e.g. DKA or a loss of [HCO 3 ] - as in diarrhea. • Calculate ΔAG/ Δ [HCO - 3 ] ratio or add ΔAG to [HCO 3 ] - to obtain ‘corrected’ [HCO 3 ] -
Page 1 and 2: Clinical Approach to Acid-base Diso
Page 3 and 4: Acid-Base Disorders • Metabolic D
Page 5 and 6: Maintenance of Acid-Base Balance
Page 7 and 8: Rule #1: Check for Internal Consist
Page 9: Rule #2: Examine the pH • A reduc
Page 13 and 14: Mixed Disturbance • Acidosis •
Page 15 and 16: Mixed Disturbance (contd) • Alkal
Page 17 and 18: Expected Compensatory Responses •
Page 19 and 20: Metabolic Acidosis 2. High AG acido
Page 21 and 22: Metabolic Alkalosis 1. Chloride sen
Page 23: Respiratory Alkalosis 1.Problem cau

Clinical Approach to Acid-base Disorders - University at Buffalo

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