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# Acidosis and Alkalosis ## **Acidosis Metabólica** **Causes:** * Defect in kidney's ability to excrete H+ and reabsorb HCO3+ (renal insufficiency/renal tubular acidosis). * Loss of HCO3+ (alkaline diarrhea, intestinal fistulas, vomiting). * Increased acid intake (diabetes, fasting, anaerobic exe...

# Acidosis and Alkalosis ## **Acidosis Metabólica** **Causes:** * Defect in kidney's ability to excrete H+ and reabsorb HCO3+ (renal insufficiency/renal tubular acidosis). * Loss of HCO3+ (alkaline diarrhea, intestinal fistulas, vomiting). * Increased acid intake (diabetes, fasting, anaerobic exercise, methanol or salicylate ingestion). * Hypoaldosteronism (Addison's disease) **Compensation:** * Hyperpnea or tachypnea (rapid and deep breathing). * If the cause is not renal, bicarbonate retention or proton excretion (or both) occurs in the kidney. **Treatment:** * Oral NaHCO3 administration. * Infusion of slightly alkaline isotonic solutions (e.g., tromethamine) ## **Acidosis Respiratoria** **Causes:** * Pulmonary ventilation issues (pulmonary edema, emphysema, pneumonia, bronchitis). * Intake of drugs that depress the respiratory center (e.g., barbiturates). * Breathing elevated CO2 levels. **Compensation:** * Kidneys increase HCO3+ reabsorption, and H+ excretion. **Treatment:** * Increase in ventilation (or mechanical ventilation). ## **Alcalosis Metabólica** **Causes:** * Increased acid loss (vomiting, loss of HCl). * Diuretic use (increased Na+ reabsorption, H+ excretion). * Intake of alkaline compounds (alkaline drugs, gastritis, ulcers in the duodenum, or stomach). * Hyperaldosteronism (Conn's syndrome). **Compensation:** * Bradypnea or hypopnea (slow, shallow breathing). * Increased HCO3+ excretion or H+ retention. **Treatment:** * Oral ammonium chloride. * L-Lysine and L-arginine monohydrochlorides IV. ## **Alcalosis Respiratoria** **Causes:** * Hyperventilation (stimulation of respiratory center, anxiety, neurosis, or nervous crisis). * Hypoxia (high altitude breathing, anemia, heart failure). **Compensation:** * Kidneys increase HCO3- excretion and H+ retention. * Increased lactic and pyruvic acid production, reduced CO2 and an elevated pH. **Treatment:** * Increased non-oxygenated area, plastic bag over nose and mouth to force patient to breathe CO2 enriched air.