Disorders of acid base balance. Gamal El Naggar Internal Medicine Department Tanta Faculty of Medicine Nephrology Unit. by. Acid-base disorders.
Gamal El Naggar
Internal Medicine Department
Tanta Faculty of Medicine
*= change due to compensation.
Normally pH (7.35-7.45) will vary as the bicarbonate and PCO2
Change so pH depends on (HCO3)- = (22-28mEq/L)
There are two types of disorders:
1- metabolic disorders:
due to alternation arterial blood of bicarbonate concentration.
due to changes in arterial blood Co2 tension.
Metabolic acidosis is characterized by a fall in both the bloob pH and the serum HCO3- concentration and is normally accompanied by a compensatory respiratory alkalosis. It develops as the result of amarked increase in endogenous production of acid (such as lactic acid and ketoacids),loss of HCO3 stores (diarrhea or renal tuular acidosis (RTA), or progressive accumulation of endogenous acids (renal failure).
correction should be gradual by NaHCO3 should be provided 1-3mmoL/Kg/day.K+ and Ca++ supplementation may de needed 1/6 Na+ lactate could be used if NaHCO3 is not available.
or HCO3 deficit ×body weight (Kg) × 0.8 if the deficit more than 10mEq/L
Hypercapnic respiratory failure that caused by hypoventilation
CLINICAL FEATURES OF RESPIRATORY ACIDOSIS:
Causes (hyperventilationCO2 wash)