![]() We will review the primary acid-base disorders starting with metabolic acidosis, which is the result of decreases in bicarbonate. Nonetheless, mixed acid-base disorders can occur with more than one primary disorders occurring simultaneously. The metabolic disorders include metabolic acidosis and metabolic alkalosis, while the respiratory disorders include respiratory acidosis and respiratory alkalosis. The difference depends on whether it originated from a metabolic dysfunction, identified by a change in the bicarbonate level or a ventilatory dysfunction, identified by a change in the carbon dioxide. The acid-base disorders are grouped into two categories, metabolic or respiratory. Since pKa is a constant, and pH and carbon dioxide are measured during blood gas analysis, bicarbonate can, therefore, be determined using this equation. Four variables are present in this equation knowing three variables allows for calculation of the fourth. Where pKa is the pH at which the concentration of protonated and unprotonated species are equal, and 0.0307 is the solubility coefficient of carbon dioxide. Slide 4:īecause the bicarbonate buffer system is the major buffer system of blood, estimation of pH using the Henderson-Hasselbalch equation is usually performed, expressed as a ratio of bicarbonate and carbon dioxide. Carbon dioxide is the respiratory component and is controlled by the lungs.Ĭhanges in the respiratory and metabolic components, as depicted here, can lead to a decrease in pH termed acidosis, or an increase in pH termed alkalosis. In the bicarbonate buffer system, bicarbonate, which is the metabolic component, is controlled by the kidneys. The bicarbonate buffer system is the major buffer system in the blood. For example, bicarbonate, plasma proteins, and hemoglobin buffer systems. To maintain pH within physiologic limits, there are several buffer systems that help regulate hydrogen ion concentration. Welcome to this Pearl of Laboratory Medicine on “Acid-Base Disorders.” Slide 2:ĭuring metabolism, the body produces hydrogen ions which affect metabolic processes if concentration is not regulated. Lurie Children’s Hospital of Chicago, and an Assistant Professor of Pathology at Northwestern Feinberg School of Medicine. I am an Assistant Director of Clinical Chemistry and Mass Spectrometry at Ann & Robert H.
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