Test Your Knowledge: Acid-Base Disturbances
June 29, 2020

Posted by Andy Jagoda MD in: Brain Tease , trackback

Acid-base disturbances are physiological responses to a wide variety of underlying conditions and critical illnesses. Homeo-stasis of acid-base physiology is complex and interdependent with the function of the lungs, kidneys, and endogenous buffer systems.

Our June issue Acid-Base Disturbances: An Emergency Department Approach outlines several approaches to characterizing disturbances, with a case-based format and algorithms to aid in diagnostic testing and interpretation of arterial blood gases.

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Here are a few key points:

  • Ventilatory compensation begins within minutes, but takes up to 24 hours for maximal effect; the renal response occurs over hours to days.
  • Lactate accumulates due to tissue hypoxia and aerobic glycolysis. Type A lactic acidosis refers to that characterized by poor perfusion and acute hypoxia; type B lactic acidosis occurs in the absence of overt hypoperfusion or hypoxia.
  • Mortality associated with hyperlactatemia occurs more often when buffer systems can no longer compensate and a lactic acidosis ensues.

Read the full issue and earn 4 CME credits!

Comments »

1. Yash - July 22, 2020

It’s the metabolites of alcohol that produce the acid gap…. alcohol converted to lactate by lactate-dehydrogenase

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