Metabolic Acidosis

• Metabolic Acidosis

  Bicarbonate Deficit
• Metabolic Acidosis 


  Results from abnormal accumulation of fixed acids or loss of base.
• Causes: Metabolic Acidosis

  1. Increased acid production:

  • Diabetic ketoacidosis (DKA): Accumulation of ketoacids due to uncontrolled diabetes.
  • Lactic acidosis: Due to shock, hypoxia, or severe infection.

  1. Decreased acid excretion:

  • Chronic kidney disease: Inability to excrete hydrogen ions.

  1. Bicarbonate loss:

  • Severe diarrhea: Loss of bicarbonate from the intestines.
  • Renal tubular acidosis: Kidneys' inability to reabsorb bicarbonate.

  1. Toxin ingestion:

  • Salicylate toxicity (aspirin overdose), methanol, ethylene glycol.
• Metabolic Acidosis

  Manifestations:

  1. Headache (cerebral vasodilation)
  2. Hyperkalemia (exchange of H to +K)
  3. Kussmaul's Breathing (deep, rapid breathing - compensatory)
• Metabolic Acidosis

  Treatment

  • Treat underlying cause:
  • DKA: Insulin, IV fluids.
  • Renal failure: Dialysis.
  • Diarrhea: Replace fluids and bicarbonate.
  • Correct metabolic imbalance:
  • Sodium bicarbonate: For severe acidosis (pH < 7.1), though used cautiously to avoid overcorrection.