Acid and Base Disorder

Acid and Base Disorder

1. 1.Symptoms

   • Hyperventilation(Fast removal of Co2)= Respiratory Alkalosis
     • Define Respiratory Alkalosis= Decrease in pCo2
   • Hypoventilation (not enough Co2 out) = Respiratory Acidosis
     • Define Respiratory Acidosis= Increase in pCo2
   • Diabetic Ketoacidosis (Nail varnish breath)= Metabolic Acidosis
     • Metabolic Acidosis= Increase in conc of bicarbonate
   • Duodenal Fistula (Trauma, Cancer or disease and cause leaks)= Metabolic Alkalosis
     • Metabolic Alkalosis= Decrease conc of bicarbonate

2. Ways of getting Metabolic Acidosis

   • 1. Increased H+ formation= Ketoacidosis, lactic acidosis (increase prod of lactic acid) or poisoning
     • 2.Less H+ removal= Renal tube acidosis, acute or chronic renal failure, inhibition of carbonate dehydratase or deficiency of mineralcorticoid
       • 3. Eating Acid= Acid posioning, increase amino acid intake, drinking battery acid
         • 4. Lose bicarbs= Diarrhoea or Pancreatic fistula
   • Clinical effect: Hyperventilation and neuromuscular irritability & CNS depression
     • Treat underlying cause

3. 2. Diagnose the disease=

   • Is it diabetes?
   • Hyperventilation
   • Poisoning
   • Renal Failure
   • Relate to case study and try guess before addressing test results.
   • whats the cause in metabolic alkalosis? Gi loss of H+ via vomit?
     • Loss H+ in renal= Conns, cushing (syndromes), carbenoxlone, K depletion
       • Ingest Alkali, poor treatment of acidosis

4. 3.Treatments/Manage

   • Give bicarb to fix acidosis
     • Metabolic Acidosis
   • treat underlying cause
   • Infusion of Na chloride in hypovalaemia and hypochloraemia
     • Low Cl levels in blood or low levels of blood = in metabolic Alkalosis
   • Improve alveolar ventilation and pCo2 (resp acidosis)
     • In Respiratory Acidosis and Alkalosis

5. Respiratory Acid base disorders= Change of air in and out of lungs, ability of gases to diffuse across alveoli

   • Resp Acidosis, causes incl chronic obstruction of airway,respiratory center inhibited (anasthetics, sedatives, cerebral trauma or tumours)
     • Neuromuscular disease incl, polio, tetanus, neurotoxin. Pulmonary diseases incl; pulmomnary fibrosis, pneumonia, resp distress
       • Effects: Periphary Vasodilation and headache and CNS depression
         • Manage: Alveolar ventilation and physio used
   • Resp Alkalosis, causes incl, hypoxia (high altitude, anaemia, pulmonary disease.) Increased respiration, (resp stims, hyperventilation, fake hypervents). Primary Odema or embolism
     • Effects; confusion, coma, headache and dizziness.
       • Treat; treat underlying cause.
   • Mixed acid base disorder= common, seen as acidaemia or alkaemia.
     • But W/ Abnormal pCO2 and Bicarbs

6. Blood gas Analysis, measure H+ conc and pCO2 in artery blood. Calc Bicarbonate levels.