Primary metabolic and respiratory acid-base disorders and their expected compensation, distinct from the sodium and potassium focus of the fluid and electrolyte deck.
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- What is the primary defect in metabolic acidosis?
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A primary decrease in plasma bicarbonate (HCO3-).- What is the primary defect in metabolic alkalosis?
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A primary increase in plasma bicarbonate (HCO3-).- What is the primary defect in respiratory acidosis?
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A primary increase in PaCO2 caused by hypoventilation.- What is the primary defect in respiratory alkalosis?
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A primary decrease in PaCO2 caused by hyperventilation.- In metabolic acidosis, the expected compensatory response is ____.
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hyperventilation to lower PaCO2- In metabolic alkalosis, the expected compensatory response is ____.
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hypoventilation to raise PaCO2- How do the kidneys compensate for respiratory acidosis?
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By increasing bicarbonate reabsorption and generation, raising plasma HCO3-.- How do the kidneys compensate for respiratory alkalosis?
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By decreasing bicarbonate reabsorption, lowering plasma HCO3-.- Which organ provides fast, minutes-scale compensation for a metabolic acid-base disorder?
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The lungs, by changing the respiratory rate.- Which organ provides slow, days-scale compensation for a respiratory acid-base disorder?
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The kidneys, by adjusting bicarbonate handling.- What formula predicts the expected PaCO2 in a simple metabolic acidosis?
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Winter's formula: PaCO2 = 1.5 x HCO3- + 8 (plus or minus 2).- In metabolic acidosis, if the measured PaCO2 is higher than Winter's formula predicts, what does this indicate?
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A superimposed (concurrent) respiratory acidosis.- In metabolic acidosis, if the measured PaCO2 is lower than Winter's formula predicts, what does this indicate?
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A superimposed (concurrent) respiratory alkalosis.- In metabolic alkalosis, about how much does PaCO2 rise for every 1 mEq/L rise in HCO3-?
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About 0.7 mmHg.- In acute respiratory acidosis, about how much does plasma HCO3- rise for every 10 mmHg rise in PaCO2?
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About 1 mEq/L.
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