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Chapter: Clinical Anesthesiology: Perioperative & Critical Care Medicine: Acid-Base Management

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Acid-Base Clinical Disorders

A clear understanding of acid–base disorders and compensatory physiological responses requires pre-cise terminology.

CLINICAL DISORDERS

 

A clear understanding of acid–base disorders and compensatory physiological responses requires pre-cise terminology (Table 50–1). The suffix “-osis” is used here to denote any pathological process that alters arterial pH. Thus, any disorder that tends to reduce pH to a less than normal value is an acidosis,


whereas one tending to increase pH is termed an alkalosis. If the disorder primarily affects [HCO3], itis termed metabolic. If the disorder primarily affects Paco2, it is termed respiratory. Secondary compensa-tory responses  should be referred to as just that and not as an “-osis.” One might therefore refer to a metabolic acidosis with respiratory compensation.

 

When only one pathological process occurs by itself, the acid–base disorder is considered to be sim-ple. The presence of two or more primary processes indicates a mixed acid–base disorder.

 

The suffix “-emia” is used to denote the net effect of all primary processes and compensatory physi-ological responses  on arterial blood pH. Because arterial blood pH is normally 7.35–7.45 in adults, the term acidemia signifies a pH <7.35, whereas alkalemia signifies a pH >7.45.

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