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Approach to patients with acid-base disorders.

Abstract

Disorders of acid-base balance are commonly encountered in clinical practice and can have a substantial impact on the prognosis of the patient. Moreover, identification of a particular acid-base disturbance can provide a clue to an underlying disorder. Proper evaluation and treatment of acid-base disorders requires a systematic and analytic approach including: (1) assess the accuracy of the acid-base values using the Henderson equation or Henderson-Hasselbalch equation, (2) obtain a complete history and physical examination, (3) calculate the serum anion gap, (4) identify the primary acid-base disturbance and determine whether a simple or mixed disturbance is present, (5) examine serum electrolytes and additional laboratory data, and (6) measure urine pH and urine electrolytes and calculate the urine anion and osmolal gaps. Strict adherence to these principles will enable the clinician to diagnose the acid-base disturbance in the majority of cases. To illustrate these principles, 5 cases of patients with acid-base disturbances are analyzed.

Authors+Show Affiliations

,

University of California, Los Angeles, School of Medicine, USA. jkraut@ucla.edu

Source

Respiratory care 46:4 2001 Apr pg 392-403

MeSH

Acid-Base Equilibrium
Acid-Base Imbalance
Adult
Aged
Carbon Dioxide
Clinical Protocols
Diabetic Ketoacidosis
Electrolytes
Ethanol
Female
Humans
Hydrogen-Ion Concentration
Male
Middle Aged
Sodium Bicarbonate

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

11262558

Citation

TY - JOUR T1 - Approach to patients with acid-base disorders. AU - Kraut,J A, AU - Madias,N E, PY - 2001/3/23/pubmed PY - 2001/7/28/medline PY - 2001/3/23/entrez SP - 392 EP - 403 JF - Respiratory care JO - Respir Care VL - 46 IS - 4 N2 - Disorders of acid-base balance are commonly encountered in clinical practice and can have a substantial impact on the prognosis of the patient. Moreover, identification of a particular acid-base disturbance can provide a clue to an underlying disorder. Proper evaluation and treatment of acid-base disorders requires a systematic and analytic approach including: (1) assess the accuracy of the acid-base values using the Henderson equation or Henderson-Hasselbalch equation, (2) obtain a complete history and physical examination, (3) calculate the serum anion gap, (4) identify the primary acid-base disturbance and determine whether a simple or mixed disturbance is present, (5) examine serum electrolytes and additional laboratory data, and (6) measure urine pH and urine electrolytes and calculate the urine anion and osmolal gaps. Strict adherence to these principles will enable the clinician to diagnose the acid-base disturbance in the majority of cases. To illustrate these principles, 5 cases of patients with acid-base disturbances are analyzed. SN - 0020-1324 UR - https://www.unboundmedicine.com/medline/citation/11262558/Approach_to_patients_with_acid_base_disorders_ ER -