807:
97:
145:
823:
233:
occurs whenever the demand for oxygen by tissues exceeds the supply and the more efficient aerobic metabolism is supplemented by anaerobic metabolism that produces lactate. Increased demand occurs, for example, with high intensity exercise such as sprinting. Inadequate supply occurs, for example,
503:, compensatory mechanisms will be unable to reverse this acidotic condition. As metabolic bicarbonate production becomes exhausted, and extraneous bicarbonate infusion can no longer reverse the extreme buildup of carbon dioxide associated with uncompensated respiratory acidosis,
87:
The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g., healthy human-arterial blood pH varies between 7.35 and 7.45).
369:. The amount of metabolic acid accumulating can also be quantitated by using buffer base deviation, a derivative estimate of the metabolic as opposed to the respiratory component. In hypovolemic shock for example, approximately 50% of the metabolic acid accumulation is
381:
Treatment of uncompensated metabolic acidosis is focused upon correcting the underlying problem. When metabolic acidosis is severe and can no longer be compensated for adequately by the lungs or kidneys, neutralizing the acidosis with infusions of
83:
analysis and other tests are required to separate the main causes. In certain situations the main cause is clear. For instance, a diabetic with ketoacidosis is a recognizable case where the main cause of acidemia is essentially obvious.
495:
is either normal (uncompensated) or increased (compensated). Compensation occurs if respiratory acidosis is present, and a chronic phase is entered with partial buffering of the acidosis through renal bicarbonate retention.
68:
is used to describe the processes leading to these states. The use of acidosis for a low pH creates an ambiguity in its meaning. The difference is important where a patient has factors causing both acidosis and
877:
862:
291:
Metabolic acidosis is compensated for in the lungs, as increased exhalation of carbon dioxide promptly shifts the buffering equation to reduce metabolic acid. This is a result of stimulation to
249:
occurring in muscle cells, as seen during strenuous exercise. Once oxygenation is restored, the acidosis clears quickly. Another example of increased production of acids occurs in
107:
involvement may be seen with acidosis and occurs more often with respiratory acidosis than with metabolic acidosis. Signs and symptoms that may be seen in acidosis include
658:
Yeomans, ER; Hauth, JC; Gilstrap, LC III; Strickland DM (1985). "Umbilical cord pH, PCO2, and bicarbonate following uncomplicated term vaginal deliveries (146 infants)".
203:
Metabolic acidosis may result from either increased production of metabolic acids, such as lactic acid, or disturbances in the ability to excrete acid via the
620:
Yee AH, Rabinstein AA (February 2010). "Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies".
318:'a4' or 'B1' isoforms result in distal renal tubular acidosis, a condition that leads to metabolic acidosis, in some cases with sensorineural
966:
725:
499:
However, in cases where chronic illnesses that compromise pulmonary function persist, such as late-stage emphysema and certain types of
705:
1133:
1107:
750:
1000:
959:
184:
100:
General symptoms of acidosis. These usually accompany symptoms of another primary defect (respiratory or metabolic).
811:
351:
166:
535:). Fetal respiratory acidemia is defined as an umbilical vessel pH of less than 7.20 and an umbilical artery
952:
487:
One key to distinguish between respiratory and metabolic acidosis is that in respiratory acidosis, the CO
775:
Hobler KE, Carey LC. Effect of acute progressive hypoxemia on cardiac output and plasma excess lactate.
1112:
1027:
556:
162:
73:, wherein the relative severity of both determines whether the result is a high, low, or normal pH.
892:
527:
pH is normally 7.20 to 7.38). In the fetus, the lungs are not used for ventilation. Instead, the
45:
is the negative log of hydrogen ion concentration and so it is decreased by a process of acidosis.
1032:
561:
155:
1037:
1015:
975:
504:
208:
104:
20:
932:
832:
739:
721:
1091:
1084:
1010:
254:
480:
are among the most frequent causes. It can also occur as a compensatory response to chronic
1057:
1049:
581:
477:
423:
296:
246:
8:
1079:
881:
481:
308:
828:
714:
992:
576:
566:
500:
366:
325:
300:
198:
80:
30:
886:
903:
701:
675:
671:
637:
112:
667:
629:
524:
403:
304:
307:). Should this situation persist, the patient is at risk of exhaustion leading to
245:, e.g., in mixed venous blood, is termed "excess lactate", and is an indicator of
1020:
897:
791:
698:
Interpreting
Umbilical Cord Gases: For Clinicians Caring for the Fetus or Newborn
586:
433:
355:
230:
520:
399:
212:
871:
633:
1127:
746:
657:
571:
428:
Respiratory acidosis results from a build-up of carbon dioxide in the blood (
292:
908:
1005:
782:
Hobler KE, Napodano RJ. Tolerance of swine to acute blood volume deficits.
641:
532:
457:
34:
679:
927:
492:
453:
445:
441:
429:
411:
383:
370:
285:
806:
519:, the normal range differs based on which umbilical vessel is sampled (
465:
398:, the normal range differs based on which umbilical vessel is sampled (
262:
250:
224:
220:
169: in this section. Unsourced material may be challenged and removed.
120:
96:
944:
854:
358:. In the clinical setting, this equation is usually used to calculate
1071:
473:
461:
344:
266:
235:
131:
of the brain which may progress to coma if there is no intervention.
124:
76:
70:
60:
The term acidemia describes the state of low blood pH, when arterial
144:
792:
Clinical
Physiology of Acid-Base and Electrolyte Disorders, 5th ed.
747:"eMedicine - Respiratory Acidosis : Article by Jackie A Hayes"
528:
449:
407:
319:
315:
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242:
128:
108:
54:
795:(No content available.) 2000. New York: McGraw Hill Professional.
258:
373:, which disappears as blood flow and oxygen debt are corrected.
866:
469:
273:
204:
116:
516:
410:
is defined as an umbilical vessel pH of less than 7.20 and a
395:
257:. It is due to the accumulation of ketoacids (via excessive
38:
591:
536:
437:
359:
333:
281:
216:
299:, leading to respiratory compensation, otherwise known as
596:
64:
falls below 7.35 (except in the fetus ā see below) while
722:"MedlinePlus Medical Encyclopedia: Respiratory acidosis"
354:
is useful for calculating blood pH, because blood is a
329:
61:
42:
284:
in the blood, and chronically decreased production of
844:
241:
A rise in lactate out of proportion to the level of
19:
For acidosis referring to acidity of the urine, see
53:"Acidemia" redirects here. Not to be confused with
1125:
347:can also differentiate between possible causes.
406:pH is normally 7.18 to 7.38). Fetal metabolic
223:as well as metabolic acid residues of protein
215:, which is associated with an accumulation of
960:
619:
510:
691:
689:
389:
16:Biological process which decreases blood pH
967:
953:
695:
653:
651:
615:
613:
185:Learn how and when to remove this message
686:
343:. In addition to arterial blood gas, an
95:
974:
417:
1126:
648:
610:
37:and increasing their concentration in
948:
753:from the original on October 29, 2008
728:from the original on 11 December 2008
542:of 66 or higher or umbilical vein PCO
365:from measurements of pH and PaCO2 in
288:may also produce metabolic acidosis.
134:
91:
167:adding citations to reliable sources
138:
1108:Mixed disorder of acid-base balance
261:) and reflects a severe shift from
13:
14:
1145:
800:
821:
805:
531:performs ventilatory functions (
238:as occurs in hemorrhagic shock.
143:
154:needs additional citations for
352:Henderson-Hasselbalch equation
280:ingestion, elevated levels of
1:
810:The dictionary definition of
603:
523:pH is normally 7.25 to 7.45;
436:. It is most often caused by
402:pH is normally 7.25 to 7.45;
672:10.1016/0002-9378(85)90523-x
376:
7:
696:Pomerance, Jeffrey (2004).
549:
48:
10:
1150:
511:Fetal respiratory acidemia
421:
196:
79:occurs at a pH over 7.45.
52:
18:
1100:
1070:
1048:
991:
982:
918:
848:
634:10.1016/j.ncl.2009.09.002
507:will usually be applied.
456:can cause this acidemia.
127:, and dysfunction of the
779:1973 Feb;177(2):199-202.
390:Fetal metabolic acidemia
339:, and normal or low PaCO
491:is increased while the
1134:Acidābase disturbances
1016:Alcoholic ketoacidosis
700:. Pasadena, CA: BNMG.
505:mechanical ventilation
272:Acid consumption from
209:renal tubular acidosis
101:
21:Renal tubular acidosis
1113:Acidābase homeostasis
1085:Contraction alkalosis
1011:Diabetic ketoacidosis
786:1974 Aug;14(8):716-8.
557:Acidābase homeostasis
255:diabetic ketoacidosis
99:
582:Chemical equilibrium
444:, drugs (especially
424:Respiratory acidosis
418:Respiratory acidosis
367:arterial blood gases
326:Arterial blood gases
303:(a specific type of
297:alveolar ventilation
247:anaerobic glycolysis
163:improve this article
976:Acidābase disorders
789:Rose, BD, Post TW.
660:Am J Obstet Gynecol
562:Acidābase imbalance
482:metabolic alkalosis
440:problems, although
309:respiratory failure
211:or the acidosis of
919:External resources
831:has a profile for
577:Arterial blood gas
567:Alkalinizing agent
501:muscular dystrophy
328:will indicate low
301:Kussmaul breathing
295:, which increases
269:for energy needs.
199:Metabolic acidosis
135:Metabolic acidosis
102:
92:Signs and symptoms
81:Arterial blood gas
31:biological process
1121:
1120:
1066:
1065:
942:
941:
837:
707:978-0-9752621-0-8
546:of 50 or higher.
414:of less than ā8.
386:may be required.
314:Mutations to the
207:, such as either
195:
194:
187:
1141:
1028:Normal anion gap
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525:umbilical artery
404:umbilical artery
305:hyperventilation
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147:
139:
41:or body fluids.
1149:
1148:
1144:
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587:Lactic acidosis
552:
545:
540:
513:
490:
434:hypoventilation
426:
420:
392:
379:
363:
356:buffer solution
342:
337:
231:Lactic acidosis
201:
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174:
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148:
137:
125:flapping tremor
94:
58:
51:
24:
17:
12:
11:
5:
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1033:Hyperchloremic
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1024:
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1001:High anion gap
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849:Classification
827:
820:
819:
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816:at Wiktionary
802:
801:External links
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797:
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666:(6): 798ā800.
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521:umbilical vein
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422:Main article:
419:
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400:umbilical vein
391:
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378:
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361:
340:
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293:chemoreceptors
236:hypoperfusion
213:kidney failure
197:Main article:
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105:Nervous system
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1038:Renal tubular
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572:Alkaline diet
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442:head injuries
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152:This section
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126:
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118:
114:
113:feeling tired
111:, confusion,
110:
106:
98:
89:
85:
82:
78:
74:
72:
67:
63:
56:
46:
44:
40:
36:
35:hydrogen ions
32:
28:
22:
1006:Ketoacidosis
983:
926:
902:
891:
876:
861:
833:
812:
804:
790:
783:
776:
755:. Retrieved
741:
730:. Retrieved
716:
697:
663:
659:
625:
621:
533:gas exchange
514:
498:
486:
458:Pneumothorax
454:brain tumors
446:anaesthetics
427:
393:
380:
349:
332:, low blood
324:
313:
290:
271:
240:
229:
202:
181:
175:October 2014
172:
161:Please help
156:verification
153:
103:
86:
75:
65:
59:
26:
25:
1092:Respiratory
1058:Respiratory
1050:Respiratory
928:MedlinePlus
628:(1): 1ā16.
622:Neurol Clin
493:bicarbonate
430:hypercapnia
412:base excess
384:bicarbonate
371:lactic acid
286:bicarbonate
904:DiseasesDB
777:Ann. Surg.
757:2008-12-06
732:2008-12-06
604:References
478:aspiration
466:bronchitis
464:, chronic
263:glycolysis
251:starvation
225:catabolism
221:creatinine
121:sleepiness
33:producing
1080:Metabolic
1072:Alkalosis
993:Metabolic
836:(Q185089)
834:acidosis
784:J Trauma.
474:pneumonia
472:, severe
462:emphysema
450:sedatives
438:pulmonary
432:) due to
377:Treatment
345:anion gap
274:poisoning
267:lipolysis
109:headaches
77:Alkalemia
71:alkalosis
1128:Category
984:Acidosis
813:acidosis
751:Archived
726:Archived
642:19932372
550:See also
529:placenta
408:acidemia
320:deafness
316:V-ATPase
278:methanol
276:such as
243:pyruvate
129:cerebrum
66:acidosis
55:Academia
49:Acidemia
27:Acidosis
898:D000138
829:Scholia
680:3919587
515:In the
452:), and
394:In the
259:ketosis
205:kidneys
117:tremors
1021:Lactic
933:001181
704:
678:
640:
476:, and
470:asthma
1101:Other
887:276.2
872:E87.2
769:Notes
517:fetus
396:fetus
234:with
39:blood
29:is a
893:MeSH
882:9-CM
702:ISBN
676:PMID
638:PMID
592:pCO2
448:and
350:The
282:iron
253:and
219:and
217:urea
878:ICD
863:ICD
668:doi
664:151
630:doi
597:pKa
537:PCO
360:HCO
334:HCO
265:to
165:by
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909:87
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867:10
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724:.
688:^
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624:.
612:^
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468:,
460:,
330:pH
322:.
311:.
227:.
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62:pH
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57:.
23:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
