818:
108:
156:
834:
244:
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,
514:, 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,
98:
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).
380:. 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
392:
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
94:
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.
506:
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.
79:
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
888:
873:
302:
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
260:
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
118:
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
669:
Yeomans, ER; Hauth, JC; Gilstrap, LC III; Strickland DM (1985). "Umbilical cord pH, PCO2, and bicarbonate following uncomplicated term vaginal deliveries (146 infants)".
214:
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
631:
Yee AH, Rabinstein AA (February 2010). "Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies".
329:'a4' or 'B1' isoforms result in distal renal tubular acidosis, a condition that leads to metabolic acidosis, in some cases with sensorineural
977:
736:
510:
However, in cases where chronic illnesses that compromise pulmonary function persist, such as late-stage emphysema and certain types of
716:
1144:
1118:
761:
1011:
970:
195:
111:
General symptoms of acidosis. These usually accompany symptoms of another primary defect (respiratory or metabolic).
822:
362:
177:
546:). Fetal respiratory acidemia is defined as an umbilical vessel pH of less than 7.20 and an umbilical artery
963:
498:
One key to distinguish between respiratory and metabolic acidosis is that in respiratory acidosis, the CO
786:
Hobler KE, Carey LC. Effect of acute progressive hypoxemia on cardiac output and plasma excess lactate.
1123:
1038:
567:
173:
84:, wherein the relative severity of both determines whether the result is a high, low, or normal pH.
903:
538:
pH is normally 7.20 to 7.38). In the fetus, the lungs are not used for ventilation. Instead, the
56:
is the negative log of hydrogen ion concentration and so it is decreased by a process of acidosis.
17:
1043:
572:
166:
1048:
1026:
986:
515:
219:
115:
31:
943:
843:
750:
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1102:
1095:
1021:
265:
491:
are among the most frequent causes. It can also occur as a compensatory response to chronic
1068:
1060:
592:
488:
434:
307:
257:
8:
1090:
892:
492:
319:
839:
725:
1003:
587:
577:
511:
377:
336:
311:
209:
91:
41:
897:
914:
712:
686:
682:
648:
123:
678:
640:
535:
414:
315:
318:). Should this situation persist, the patient is at risk of exhaustion leading to
256:, e.g., in mixed venous blood, is termed "excess lactate", and is an indicator of
1031:
908:
802:
709:
Interpreting
Umbilical Cord Gases: For Clinicians Caring for the Fetus or Newborn
597:
444:
366:
241:
531:
410:
223:
882:
644:
1138:
757:
668:
582:
439:
Respiratory acidosis results from a build-up of carbon dioxide in the blood (
303:
919:
1016:
793:
Hobler KE, Napodano RJ. Tolerance of swine to acute blood volume deficits.
652:
543:
468:
45:
690:
938:
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464:
456:
452:
440:
422:
394:
381:
296:
817:
530:, the normal range differs based on which umbilical vessel is sampled (
476:
409:, the normal range differs based on which umbilical vessel is sampled (
273:
261:
235:
231:
180: in this section. Unsourced material may be challenged and removed.
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107:
955:
865:
369:. In the clinical setting, this equation is usually used to calculate
1082:
484:
472:
355:
277:
246:
142:
of the brain which may progress to coma if there is no intervention.
135:
87:
81:
71:
The term acidemia describes the state of low blood pH, when arterial
155:
803:
Clinical
Physiology of Acid-Base and Electrolyte Disorders, 5th ed.
758:"eMedicine - Respiratory Acidosis : Article by Jackie A Hayes"
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330:
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139:
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269:
384:, which disappears as blood flow and oxygen debt are corrected.
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480:
284:
215:
127:
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is defined as an umbilical vessel pH of less than 7.20 and a
406:
268:. It is due to the accumulation of ketoacids (via excessive
49:
602:
547:
448:
370:
344:
292:
227:
310:, leading to respiratory compensation, otherwise known as
607:
75:
falls below 7.35 (except in the fetus ā see below) while
733:"MedlinePlus Medical Encyclopedia: Respiratory acidosis"
365:
is useful for calculating blood pH, because blood is a
340:
72:
53:
295:
in the blood, and chronically decreased production of
855:
252:
A rise in lactate out of proportion to the level of
30:
For acidosis referring to acidity of the urine, see
64:"Acidemia" redirects here. Not to be confused with
1136:
358:can also differentiate between possible causes.
417:pH is normally 7.18 to 7.38). Fetal metabolic
234:as well as metabolic acid residues of protein
226:, which is associated with an accumulation of
971:
630:
521:
702:
700:
400:
27:Biological process which decreases blood pH
978:
964:
706:
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662:
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624:
196:Learn how and when to remove this message
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354:. In addition to arterial blood gas, an
106:
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428:
14:
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659:
621:
48:and increasing their concentration in
959:
764:from the original on October 29, 2008
739:from the original on 11 December 2008
553:of 66 or higher or umbilical vein PCO
376:from measurements of pH and PaCO2 in
299:may also produce metabolic acidosis.
145:
102:
178:adding citations to reliable sources
149:
1119:Mixed disorder of acid-base balance
272:) and reflects a severe shift from
24:
25:
1156:
811:
832:
816:
542:performs ventilatory functions (
249:as occurs in hemorrhagic shock.
154:
165:needs additional citations for
363:Henderson-Hasselbalch equation
291:ingestion, elevated levels of
13:
1:
821:The dictionary definition of
614:
534:pH is normally 7.25 to 7.45;
447:. It is most often caused by
413:pH is normally 7.25 to 7.45;
683:10.1016/0002-9378(85)90523-x
387:
7:
707:Pomerance, Jeffrey (2004).
560:
59:
10:
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522:Fetal respiratory acidemia
432:
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90:occurs at a pH over 7.45.
63:
29:
1111:
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1002:
993:
929:
859:
645:10.1016/j.ncl.2009.09.002
518:will usually be applied.
467:can cause this acidemia.
138:, and dysfunction of the
790:1973 Feb;177(2):199-202.
401:Fetal metabolic acidemia
350:, and normal or low PaCO
502:is increased while the
1145:Acidābase disturbances
1027:Alcoholic ketoacidosis
711:. Pasadena, CA: BNMG.
516:mechanical ventilation
283:Acid consumption from
220:renal tubular acidosis
112:
32:Renal tubular acidosis
1124:Acidābase homeostasis
1096:Contraction alkalosis
1022:Diabetic ketoacidosis
797:1974 Aug;14(8):716-8.
568:Acidābase homeostasis
266:diabetic ketoacidosis
110:
593:Chemical equilibrium
455:, drugs (especially
435:Respiratory acidosis
429:Respiratory acidosis
378:arterial blood gases
337:Arterial blood gases
314:(a specific type of
308:alveolar ventilation
258:anaerobic glycolysis
174:improve this article
987:Acidābase disorders
800:Rose, BD, Post TW.
671:Am J Obstet Gynecol
573:Acidābase imbalance
493:metabolic alkalosis
451:problems, although
320:respiratory failure
222:or the acidosis of
930:External resources
842:has a profile for
588:Arterial blood gas
578:Alkalinizing agent
512:muscular dystrophy
339:will indicate low
312:Kussmaul breathing
306:, which increases
280:for energy needs.
210:Metabolic acidosis
146:Metabolic acidosis
113:
103:Signs and symptoms
92:Arterial blood gas
42:biological process
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953:
952:
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718:978-0-9752621-0-8
557:of 50 or higher.
425:of less than ā8.
397:may be required.
325:Mutations to the
218:, such as either
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16:(Redirected from
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1039:Normal anion gap
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52:or body fluids.
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598:Lactic acidosis
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367:buffer solution
353:
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242:Lactic acidosis
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136:flapping tremor
105:
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860:Classification
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827:at Wiktionary
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812:External links
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433:Main article:
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304:chemoreceptors
247:hypoperfusion
224:kidney failure
208:Main article:
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163:This section
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124:feeling tired
122:, confusion,
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83:
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46:hydrogen ions
43:
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1017:Ketoacidosis
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766:. Retrieved
752:
741:. Retrieved
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544:gas exchange
525:
509:
497:
469:Pneumothorax
465:brain tumors
457:anaesthetics
438:
404:
391:
360:
343:, low blood
335:
324:
301:
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186:October 2014
183:
172:Please help
167:verification
164:
114:
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36:
1103:Respiratory
1069:Respiratory
1061:Respiratory
939:MedlinePlus
639:(1): 1ā16.
633:Neurol Clin
504:bicarbonate
441:hypercapnia
423:base excess
395:bicarbonate
382:lactic acid
297:bicarbonate
915:DiseasesDB
788:Ann. Surg.
768:2008-12-06
743:2008-12-06
615:References
489:aspiration
477:bronchitis
475:, chronic
274:glycolysis
262:starvation
236:catabolism
232:creatinine
132:sleepiness
44:producing
1091:Metabolic
1083:Alkalosis
1004:Metabolic
847:(Q185089)
845:acidosis
795:J Trauma.
485:pneumonia
483:, severe
473:emphysema
461:sedatives
449:pulmonary
443:) due to
388:Treatment
356:anion gap
285:poisoning
278:lipolysis
120:headaches
88:Alkalemia
82:alkalosis
1139:Category
995:Acidosis
824:acidosis
762:Archived
737:Archived
653:19932372
561:See also
540:placenta
419:acidemia
331:deafness
327:V-ATPase
289:methanol
287:such as
254:pyruvate
140:cerebrum
77:acidosis
66:Academia
60:Acidemia
38:Acidosis
18:Acidemia
909:D000138
840:Scholia
691:3919587
526:In the
463:), and
405:In the
270:ketosis
216:kidneys
128:tremors
1032:Lactic
944:001181
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689:
651:
487:, and
481:asthma
1112:Other
898:276.2
883:E87.2
780:Notes
528:fetus
407:fetus
245:with
50:blood
40:is a
904:MeSH
893:9-CM
713:ISBN
687:PMID
649:PMID
603:pCO2
459:and
361:The
293:iron
264:and
230:and
228:urea
889:ICD
874:ICD
679:doi
675:151
641:doi
608:pKa
548:PCO
371:HCO
345:HCO
276:to
176:by
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