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mixed acid-base disorder
Etiology:
1) cardiac arrest
a) respiratory acidosis
b) metabolic acidosis
2) sepsis
a) metabolic acidosis, lactic acidosis
b) respiratory alkalosis
3) drug intoxication
a) metabolic acidosis (all)
b) metabolic alkalosis (vomiting)
c) respiratory alkalosis (salicylates)
d) respiratory acidosis (sedatives)
4) renal failure
a) metabolic acidosis
b) metabolic alkalosis
1] oral alkali
2] antacids
3] cationic exchange resins
5) respiratory failure
6) hepatic failure
a) respiratory alkalosis
b) metabolic alkalosis
1] vomiting
2] diuretics
c) metabolic acidosis due to inability to metabolize lactate
Laboratory:
1) arterial blood gas
a) pH may be low, high or normal
2) plasma lactate if lactic acidosis is suspected
Management:
1) specific for specific etiology
1) bicarbonate for pH of < 7.10
Related
acid-base balance
cardiac arrest
renal failure; kidney failure
sepsis
toxicity; poisoning; overdose
General
acid-base disorder
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 17.
American College of Physicians, Philadelphia 1998, 2015
- Rastegar A.
Use of the DeltaAG/DeltaHCO3- ratio in the diagnosis of mixed
acid-base disorders.
J Am Soc Nephrol. 2007 Sep;18(9):2429-31. Epub 2007 Jul 26. Review.
PMID: 17656477 Free Article