ACID-BASE IMBALANCE
ACIDOSIS
(pH<7.35)
Metabolic
Characteristics
Mechanism
>concentration of noncarbonic acids.
Bicarbonate loss
Results when the normal
buffer system is
compromised and
bicarbonate to carbonic
acid ratio decreases to <
20:1
For Increased non-carbonic
acids :- ketoacidosis; lactic
acidosis; ingestion; uremia;
distal renal tubule
acidosis.
For Hyperchloremic
Acidosis :- Diarrhea; renal
failure; proximal renal
tubular acidosis
Causes
Symptoms
Headache, lethargy,
confusion, coma
Respiratory
Alveolar
hypoventilation.
Hypercapnia
Results form the
decreased alveolar
ventilation in relation
to the CO2 metabolic
production
Depression of the
respiratory centre;
paralysis of the
respiratory muscles;
disorders of the chest
wall; disorders of the
lung parenchyma
Headache, blurred
vision, breathlessness,
restlessness, lethargy,
disorientation, muscle
twitching, tremors,
convulsions, coma
ALKALOSIS
(pH>7.35)
Metabolic
Loss of metabolic
acids.
excess Bicarbonate
Ineffective renal
compensation as loss
of chloride stimulates
bicarbonate retention.
Hyperaldosteronism;
use of diuretics
Respiratory
Alveolar
hyperventilation.
Hypocapnia
The reduced C)@ plasma
levels lead to decreased
carbonic acid
concentration
Hypoxemia;
hypermetabolic states;
early salicylate
intoxication; hysteria;
cirrhosis; gram negative
sepsis; improper
ventilator use
Dizziness, confusion,
Weakness, muscle
tingling of extremities,
cramps, hyperactive
convulsions, coma,
reflexes, tetany,
symptoms of
confusion, convulsions,
hypocalcemia like tetany
atrial tachycardia,
and carpopedal spasm.
hypocalcemia
Reference
El-Hussein, M., T.; Power-Kean, K.; Zettel, S., (2018, March). Understanding Pathophysiology (Canadian ed.). Elsevier.