Labs and Levels
The normal blood pH is between these values.
7.35-7.45
This is the acid-base metabolism equation.
CO2+H2O↔H2CO3↔H++HCO3−
This is the first step in differentiating acid-base disorders.
Determine if the pH is low or high (acidosis/alkalosis)
This respiratory acid-base disorder develops in early aspirin toxicity.
Respiratory alkalosis, Low CO₂
This is how you calculate the anion gap, and this is the normal range.
Na+−(Cl−+HCO3−), 8-12
This is the name of the type of breathing that occurs with hyperventilation.
Kussmaul breathing
This is how you determine if the disorder is a metabolic or respiratory acid-base disorder.
Look at: carbon dioxide and bicarbonate levelsRespiratory = CO₂ problem, Metabolic = HCO₃⁻ problem
This response is triggered in early aspirin toxicity.
Respiratory center in brain is stimulated→ patient hyperventilates
A patient has pH 7.51, CO₂ 28, HCO₃⁻ 22. The primary disorder is this.
Respiratory alkalosis
The lungs regulate this compound to compensate for metabolic acid-base disorders.
Carbon dioxide (CO2)
These are normally the causes of normal anion gap acidosis.
Bicarbonate loss or impaired acid secretion
This response is triggered in late aspirin toxicity.
Salicylates accumulate → organic acid production
A patient with diarrhea develops metabolic acidosis, but the anion gap remains normal because this electrolyte increases to compensate.
Chloride
This respiratory mechanism occurs when the pH is too low.
Hyperventilation, blow off CO2, decrease acid
In acidosis, this is how the kidneys regulate bicarbonate resorption and hydrogen ion excretion respectively.
increase HCO₃⁻ reabsorption, increase H⁺ secretion
These two acid-base disorders occur in response to late aspirin toxicity.
Metabolic acidosis + respiratory alkalosis
Aspirin toxicity is more likely than panic attack in a tachypneic patient whose ABG shows low CO₂ and whose chemistry panel demonstrates this additional abnormality.
Low bicarbonate level- elevated anion gap
These are the three ways the kidneys maintain pH.
1. Reabsorbing bicarbonate in the PCT
2. Excreting H+ ions
3. Generating new bicarbonate (ammonium buffering and phosphate buffering) NH₃ + H⁺ → NH₄⁺ (trapped in urine), HPO₄²⁻ + H⁺ → H₂PO₄⁻
These are the common causes of high anion gap metabolic acidosis (list 3).
Glycols, Oxoproline, L-lactate, D-lactate, Methanol, Aspirin (salicylates), Renal failure (uremia), Ketoacidosis
This is how the values of bicarbonate and carbon dioxide would appear in a mixed disorder secondary to aspirin toxicity.
Low CO₂, low HCO₃⁻, pH may be low OR near normal