Acid-base Balance3

• Metabolic acidosis/alkalosis • Respiratory acidosis/alkalosis

By a decrease in plasma bicarbonate levels.

• production of organic acids that exceeds the rate of elimination • Reduced excretion of acids (H+) as occurs in renal failure • Excessive loss of bicarbonate due to increased renal excretion

• Production of organic acids (such as in ketoacidosis) that exceeds the rate of elimination. • Reduced excretion of acids (H⁺), which occurs in conditions like renal failure and some renal tubular acidosis (RTAs). • Excessive loss of bicarbonate, either due to increased renal excretion or excessive loss from the duodenum.

Ketoacidosis refers to the production of organic acids (such as ketone bodies) that exceeds the rate at which they are eliminated.

Reduced excretion of acids (H⁺) in conditions like renal failure and RTAs results in an accumulation of acid that consumes bicarbonate, leading to metabolic acidosis.

• Increased renal excretion 2.Excessive loss from the duodenum (part of the small intestine).

Stimulates respiratory compensation via hyperventilation. This process lowers the partial pressure of carbon dioxide (PCO₂) and raises the pH.

• Increased anion gap acidosis (organic acidosis) • Normal anion gap acidosis (inorganic acidosis)

• Methanol poisoning • Uremia of renal failure • Ketoacidosis • Paraldehyde toxicity • Lactic acidosis • Salicylate intoxication

It is caused by the loss of bicarbonate rich fluid from the kidney or GIT

More cl- ions are absorbed with Na + or k+

• Hypokalemic normokalemic • Hyperkalemic acidoses

Normal anion gap metabolic acidosis is caused by the loss of bicarbonate-rich fluid from the kidney or the gastrointestinal tract.

Normal anion gap acidosis can be divided into hypokalemic, normokalemic, and hyperkalemic acidoses.

As bicarbonate is lost, more chloride ions (Cl⁻) are reabsorbed along with sodium (Na⁺) or potassium (K⁺) ions

In healthy individuals, the average Anion gap value is 12 mmol/L.

• when excess base is added into the system • When base elimination is decreased • When acid rich fluids are lost

Metabolic alkalosis occurs when there is an excess base added to the system, base elimination is decreased, or acid-rich fluids are lost.

Conditions such as excess base addition, decreased base elimination, or loss of acid-rich fluids can lead to a primary bicarbonate excess.

In response to metabolic alkalosis, the patient will hyperventilate to raise PCO2 (partial pressure of carbon dioxide), thereby lowering the pH toward normal.

Respiratory acidosis is a condition that results from an increase in carbon dioxide (CO2) through the lungs, leading to an elevated level of CO2 in the blood.

It occurs due to lung conditions that cause an accumulation of carbon dioxide. These conditions can be either acute or chronic

• acute • chronic.