Approach to Acid-Base Disturbances

1
Approach to Acid-Base Disturbances
Step 1 Evaluate pH
Decreased lt 7.35
Normal
Increased gt 7.45
Step 2 Evaluate HCO3
Normal
Low
Low
Normal
High
High
Normal
PCO2
PCO2
compensated
compensated
Metabolic Acidosis
Respiratory Alkalosis
Metabolic Alkalosis
Respiratory Acidosis
Respiratory failure
Acid production Lactate Ketone HCO3 Loss
Protracted vomiting Upper GI obstruction
Hypoxemic drive O2 diffusion barrier
Normal