Acid-Base Disorders
The body’s normal cellular processes have evolved to function within a narrow range of pH, and the body has developed mechanisms to maintain this tightly balanced homeostatic state by compensating for increased production or loss of acid or base. These regulatory mechanisms can be overwhelmed by rapid and/or large changes in acid-base status leading to acidemia or alkalemia. Acid-base disorders are common in critically ill patients, and correctly identifying if measured acid-base derangements represent respiratory, metabolic, or mixed pathology is key to defining the underlying disease process and selecting appropriate treatment. This chapter provides a critical breakdown of acid-base analysis, identification of primary metabolic vs. respiratory derangements, and how they overlap and compensate for each other and lists the potential diagnoses responsible for various acid-base disorders.
