Metabolic acidosis

Revision as of 20:10, 2 March 2011 by Jswartz (talk | contribs) (→‎Types)

Types

1. Gap

  • Lactic acidosis
  • Renal failure
  • Ketoacidosis
    • DM
    • ETOH
    • Starvation
    • High fat diet
  • Tox ingestion
    • Inc osm gap
      • Methanol
      • Ethylene glycol
    • Nl osm gap
      • Salicylate
      • Paraldehyde
      • Cyanide

2. Non-gap

  • Hyperkalemia
    • Resolving DKA
    • Early uremic acidosis
    • Early obstructive
    • RTA Type IV
    • Hypoaldo
    • K-sparing diuretics
  • Hypokalemia
    • RTA Type I
    • RTA Type II
    • Acetazolamide
    • Acute diarrhea (lose HCO3, retain Cl)

Treatment

Bicarbonate Indications

1) Bicarb <4

2) pH <7.20 + Sx shock/myocardial irritability

3) Severe hyperchloremic acidemia + Sx shock/myocardial irritability


Source

2/21/06 DONALDSON (adapted from Tintinalli)

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