Metabolic Acidosis
In 1920, HL Mencken wrote in the Baltimore Sun: “Life is a battle against hydrogen ions.” Simply stated, the pathogenesis of metabolic acidosis involves either a net gain of acid (hydrogen ions) or a net deficit of bicarbonate ions from the extracellular
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Metabolic Acidosis
Contents 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 9.35
The Pathogenesis of Metabolic Acidosis ...................................................................... The pH, PCO2 and Base Excess: Relationships ............................................................ The Law of Electroneutrality and the Anion Gap ......................................................... Electrolytes and the Anion Gap .................................................................................... Electrolytes That Influence the Anion Gap ................................................................... The Derivation of the Anion Gap.................................................................................. Calculation of the Anion Gap ....................................................................................... Causes of a Wide-Anion-Gap Metabolic Acidosis ....................................................... The Corrected Anion Gap (AGc)................................................................................... Clues to the Presence of Metabolic Acidosis ................................................................ Normal Anion-Gap Metabolic Acidosis ....................................................................... Pathogenesis of Normal-Anion Gap Metabolic Acidosis ............................................. Negative Anion Gap ...................................................................................................... Systemic Consequences of Metabolic Acidosis ........................................................... Other Systemic Consequences of Metabolic Acidosis ................................................. Hyperkalemia and Hypokalemia in Metabolic Acidosis .............................................. Compensatory Response to Metabolic Acidosis........................................................... Compensation for Metabolic Acidosis.......................................................................... Total CO2 (TCO2) .......................................................................................................... Altered Bicarbonate Is Not Specific for a Metabolic Derangement ............................. Actual Bicarbonate and Standard Bicarbonate ............................................................. Relationship Between ABC and SBC ........................................................................... Buffer Base ................................................................................................................... Base Excess................................................................................................................... Ketosis and Ketoacidosis .............................................................................................. Acidosis in Untreated Diabetic Ketoacidosis................................................................ Acidosis in Di
