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Hydrogen ion (acidosis)

Metabolic Acidosis Defined:

State of excess acid accumulation and deficient base bicarbonate. Symptoms are a result of the body’s attempt to compensate for and correct the acidotic condition.

Causes:

anaerobic metabolism- lactic acid production, chronic alcoholism, diabetic ketoacidosis, diarrhea, low carb/high-fat diet, malnutrition, renal insufficiency/failure (kidneys regulate hydrogen ions H⁺ and bicarbonate ion HCO₃^–

Signs and Symptoms:

• drowsiness
• headache
• Kussmaul’s respirations (a form of hyperventilation, deep, labored, gasping)
• lethargy/stupor
• ABG results in pH below 7.35 and a Bicarbonate level less than 24mEq/L

Treatment:

Treatment of the underlying symptoms

Endotracheal intubation and mechanical intubation to ensure adequate respiratory compensation

Intravenous administration of Sodium Bicarbonate

**If the cause is diabetic ketoacidosis- administer insulin and IV fluids

 

Respiratory Acidosis Defined:

An Acid-base disturbance characterized by excess of CO₂ in the blood (hypercapnia). It is the result of a reduction in alveolar ventilation either from acute or chronic lung conditions (PE vs. COPD)




Causes:

airway obstruction, CNS trauma, chronic metabolic acidosis, opioids, anesthetics, neuromuscular diseases

Signs and Symptoms:

• tachycardia, hypertension, arrhythmias
• coma
• confusion
• dyspnea and tachypnea
• headaches
• tremors
• hypoxemia
• PaCO₂ exceeds 45mmHg and pH is usually below 7.35.

Treatment:

Treatment of the underlying symptoms

Endotracheal intubation and mechanical intubation if needed

Intravenous administration of Sodium Bicarbonate (severe cases)

Dialysis to remove toxic drugs

Bronchodilators

Removal of Foreign bodies if appropriate

Hypokalemia