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Contributor: Nick Tsipis, MD
Educational Pearls:
- pH <7.35 = acidemia; pH>7.45=alkalemia
- If pH low and pCO2 high, indicates a respiratory acidosis
- If pH low and pCO2 low, indicates metabolic acidosis
- After determining type of acidosis, check bicarb to determine compensation for acidosis and check electrolytes to calculate anion gap
- Metabolic acidosis can present with tachypnea (Kussmaul breathing) and hypotension due to loss of catecholamine function and suboptimal cardiac function at low pH
- Treat with IV fluids and address the underlying cause, limited role for bicarb
References
Burger MK, Schaller DJ. Metabolic Acidosis. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
Cadogan M. Acid Base Disorders. Life in the Fast Lane • LITFL. https://litfl.com/acid-base-disorders/. Published November 3, 2020. Accessed June 23, 2021.
Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD
