Acid-Base Disturbances: An Emergency Department Approach | Digest

Acid-Base Disturbances: An Emergency Department Approach

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Point and Pearls Excerpt

  • The bicarbonate buffer system is the predominant buffer system maintained via actions of the kidneys and lungs: CO2 + H2O = H2CO3 = HCO3- + H+
  • 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.

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Publication Information

Michael Boniface, MD; Ivan Porter, MD

Peer Reviewed By

Daniel J. Egan, MD; Gabriel Wardi, MD, MPH

Publication Date

June 1, 2020

CME Expiration Date

June 1, 2023   

Pub Med ID: 32470246

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