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Metabolic Acidosis Vs Alkalosis Chart

Common Laboratory (lab) Values - Abgs

Common Laboratory (lab) Values - Abgs

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Laboratory VALUES Home Page Arterial Blood Gases Arterial blood gas analysis provides information on the following: 1] Oxygenation of blood through gas exchange in the lungs. 2] Carbon dioxide (CO2) elimination through respiration. 3] Acid-base balance or imbalance in extra-cellular fluid (ECF). Normal Blood Gases Arterial Venous pH 7.35 - 7.45 7.32 - 7.42 Not a gas, but a measurement of acidity or alkalinity, based on the hydrogen (H+) ions present. The pH of a solution is equal to the negative log of the hydrogen ion concentration in that solution: pH = - log [H+]. PaO2 80 to 100 mm Hg. 28 - 48 mm Hg The partial pressure of oxygen that is dissolved in arterial blood. New Born – Acceptable range 40-70 mm Hg. Elderly: Subtract 1 mm Hg from the minimal 80 mm Hg level for every year over 60 years of age: 80 - (age- 60) (Note: up to age 90) HCO3 22 to 26 mEq/liter (21–28 mEq/L) 19 to 25 mEq/liter The calculated value of the amount of bicarbonate in the bloodstream. Not a blood gas but the anion of carbonic acid. PaCO2 35-45 mm Hg 38-52 mm Hg The amount of carbon dioxide dissolved in arterial blood. Measured. Partial pressure of arterial CO2. (Note: Large A= alveolor CO2). CO2 is called a “volatile acid” because it can combine reversibly with H2O to yield a strongly acidic H+ ion and a weak basic bicarbonate ion (HCO3 -) according to the following equation: CO2 + H2O <--- --> H+ + HCO3 B.E. –2 to +2 mEq/liter Other sources: normal reference range is between -5 to +3. The base excess indicates the amount of excess or insufficient level of bicarbonate in the system. (A negative base excess indicates a base deficit in the blood.) A negative base excess is equivalent to an acid excess. A value outside of the normal r Continue reading >>

Acid-base Disorders - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

Acid-base Disorders - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincents Ascension Health, Birmingham Acid-base disorders are pathologic changes in carbon dioxide partial pressure (Pco2) or serum bicarbonate (HCO3) that typically produce abnormal arterial pH values. Acidosis refers to physiologic processes that cause acid accumulation or alkali loss. Alkalosis refers to physiologic processes that cause alkali accumulation or acid loss. Actual changes in pH depend on the degree of physiologic compensation and whether multiple processes are present. Primary acid-base disturbances are defined as metabolic or respiratory based on clinical context and whether the primary change in pH is due to an alteration in serum HCO3 or in Pco2. Metabolic acidosis is serum HCO3< 24 mEq/L. Causes are Metabolic alkalosis is serum HCO3> 24 mEq/L. Causes are Respiratory acidosis is Pco2> 40 mm Hg (hypercapnia). Cause is Decrease in minute ventilation (hypoventilation) Respiratory alkalosis is Pco2< 40 mm Hg (hypocapnia). Cause is Increase in minute ventilation (hyperventilation) Compensatory mechanisms begin to correct the pH (see Table: Primary Changes and Compensations in Simple Acid-Base Disorders ) whenever an acid-base disorder is present. Compensation cannot return pH completely to normal and never overshoots. A simple acid-base disorder is a single acid-base disturbance with its accompanying compensatory response. Mixed acid-base disorders comprise 2 primary disturbances. Compensatory mechanisms for acid-base disturbances cannot return pH completely to normal and never overshoot. Primary Changes and Compensations in Simple Acid-Base Disorders 1.2 mm Hg decrease in Pco2 for every 1 mmol/L decrease in HC Continue reading >>

Abg’s—it’s All In The Family

Abg’s—it’s All In The Family

By Cyndi Cramer, BA, RN, OCN, PCRN RealNurseEd.com 3.0 Contact Hour Self Learning Module Objectives: Identify the components of the ABG and their normal ranges Interpret ABG values and determine the acid base abnormality given Identify the major causes of acid base abnormalities Describe symptoms associated with acid base abnormalities Describe interventions to correct acid base abnormalities Identify the acceptable O2 level per ABG and Pulse Oximetry Identify four causes of low PaO2 The Respiratory System (Acid); CO2 is a volatile acid If you increase your respiratory rate (hyperventilation) you "blow off" CO2 (acid) therefore decreasing your CO2 acid—giving you ALKLAOSIS If you decrease your respiratory rate (hypoventilation) you retain CO2 (acid) therefore increasing your CO2 (acid)—giving you ACIDOSIS The Renal System (Base); the kidneys rid the body of the nonvolatile acids H+ (hydrogen ions) and maintain a constant bicarb (HCO3). Bicarbonate is the body’s base You have Acidosis when you have excess H+ and decreased HCO3- causing a decrease in pH. The Kidneys try to adjust for this by excreting H+ and retaining HCO3- base. The Respiratory System will try to compensate by increasing ventilation to blow off CO2 (acid) and therefore decrease the Acidosis. You have Alkalosis when H+ decreases and you have excess (or increased) HCO3- base. The kidneys excrete HCO3- (base) and retain H+ to compensate. The respiratory system tries to compensate with hypoventilation to retain CO2 (acid) To decrease the alkalosis Compensation The respiratory system can effect a change in 15-30 minutes The renal system takes several hours to days to have an effect. RESPIRATORY ACIDOSIS: pH < 7.35 (Normal: 7.35 - 7.45) CO2 > 45 (Normal: 35 – 45) 1. Causes: Hypoventilation a. Depressio Continue reading >>

The Quick And Dirty Guide To Acid Base Balance | Medictests.com

The Quick And Dirty Guide To Acid Base Balance | Medictests.com

Your patient has a ph of 6.9 Is he acidic or alkalotic? Your patient has a ph of 7.4 Is he acidic or alkalotic? Your patient has a ph of 7.7 Is he acidic or alkalotic? Your patient has a ph of 7.25 Is he acidic or alkalotic? Your patient has a ph of 7.43 Is he acidic or alkalotic? Your patient has a ph of 8.0 Is he acidic or alkalotic? 1. acidic 2. normal 3. Alkaline 4. Acidic 5. Normal 6. Alkaline You take in oxygen by inhaling, your body turns oxygen into carbon dioxide, you exhale and remove the carbon dioxide from your body. Carbon dioxide is "respiratory acid."When you're not breathing adequately, you are not getting rid of this "respiratory acid" and it builds up in the tissues. The extra CO2 molecules combine with water in your body to form carbonic acid and makes your pH go up. This is bad. We can measure the amount of respiratory acid in the arterial blood using blood gases. They measure the amount of each gas in your blood. We measure the pH, the amount of carbon dioxide (PaCO2) and the amount of oxygen in the blood (PaO2). PaCO2 is the partial pressure of carbon dioxide. We can measure it to see how much respiratory acid (CO2) there is in the blood. We use arterial blood gas tests to check it. How much respiratory acid (CO2) should there be? The normal value is 35-45 mmHg (mmHg just means millimeters of mercury, its a measurement of pressure.) The (a) in PaCO2 just stands for arterial. If you measured venous blood gasses, the levels are different and PvCO2 is used. If CO2 is HIGH, it means there is a buildup of respiratory acids because he's not breathing enough CO2 away. If your pH is acidic, and your CO2 is HIGH, its considered respiratory acidosis. If CO2 is LOW, it means there are not enough respiratory acids because he's probably hyperventilating too mu Continue reading >>

Intro To Arterial Blood Gases, Part 2

Intro To Arterial Blood Gases, Part 2

Arterial Blood Gas Analysis, Part 2 Introduction Acute vs. Chronic Respiratory Disturbances Primary Metabolic Disturbances Anion Gap Mixed Disorders Compensatory Mechanisms Steps in ABG Analysis, Part II Summary Compensatory Mechanisms Compensation refers to the body's natural mechanisms of counteracting a primary acid-base disorder in an attempt to maintain homeostasis. As you learned in Acute vs. Chronic Respiratory Disturbances, the kidneys can compensate for chronic respiratory disorders by either holding on to or dumping bicarbonate. With Chronic respiratory acidosis: Chronic respiratory alkalosis: the kidneys hold on to bicarbonate the kidneys dump bicarbonate With primary metabolic disturbances, the respiratory system compensates for the acid-base disorder. The lungs can either blow off excess acid (via CO2) to compensate for metabolic acidosis, or to a lesser extent, hold on to acid (via CO2) to compensate for metabolic alkalosis. With Metabolic acidosis: Metabolic alkalosis: ventilation increases to blow off CO2 ventilation decreases to hold on to CO2 The body's response to metabolic acidosis is predictable. With metabolic acidosis, respiration will increase to blow off CO2, thereby decreasing the amount of acid in the blood. Recall that with metabolic acidosis, central chemoreceptors are triggered by the low pH and increase the drive to breathe. For now, it is only important to learn (qualitatively) that there is a predictable compensatory response to metabolic acidosis. Later, during your 3rd or 4th year rotations, you might learn how to (quantitatively) determine if the compensatory response to metabolic acidosis is appropriate by using the Winter's Formula. The body's response to metabolic alkalosis is not as complete. This is because we would need to hypov Continue reading >>

Davenport Diagram - Wikipedia

Davenport Diagram - Wikipedia

In acid base physiology , the Davenport Diagram is a graphical tool, developed by Horace W. Davenport , that allows a clinician or investigator to describe blood bicarbonate concentrations and blood pH following a respiratory and/or metabolic acid-base disturbance. The diagram depicts a three-dimensional surface describing all possible states of chemical equilibria between gaseous carbon dioxide , aqueous bicarbonate and aqueous protons at the physiologically complex interface of the alveoli of the lungs and the alveolar capillaries . Although the surface represented in the diagram is experimentally determined, the Davenport Diagram is primarily a conceptual tool, allowing the investigator to envision the effects of physiological changes on blood acid-base chemistry. The Davenport Diagram is rarely used in the clinical setting. When a sample of blood is exposed to air , either in the alveoli of the lung or in an in vitro laboratory experiment , carbon dioxide in the air rapidly enters into equilibrium with carbon dioxide derivatives and other species in the aqueous solution . Figure 1 illustrates the most important equilibrium reactions of carbon dioxide in blood relating to acid-base physiology: Note that in this equation, the HB/B- buffer system represents all non-bicarbonate buffers present in the blood, such as hemoglobin in its various protonated and deprotonated states. Because many different non-bicarbonate buffers are present in human blood , the final equilibrium state reached at any given pCO2 is highly complex and cannot be readily predicted using theory alone. By depicting experimental results, the Davenport Diagram provides a simple approach to describing the behavior of this complex system. Figure 2 shows a Davenport Diagram as commonly depicted in textbo Continue reading >>

Simple Method Of Acid Base Balance Interpretation

Simple Method Of Acid Base Balance Interpretation

A FOUR STEP METHOD FOR INTERPRETATION OF ABGS Usefulness This method is simple, easy and can be used for the majority of ABGs. It only addresses acid-base balance and considers just 3 values. pH, PaCO2 HCO3- Step 1. Use pH to determine Acidosis or Alkalosis. ph < 7.35 7.35-7.45 > 7.45 Acidosis Normal or Compensated Alkalosis Step 2. Use PaCO2 to determine respiratory effect. PaCO2 < 35 35 -45 > 45 Tends toward alkalosis Causes high pH Neutralizes low pH Normal or Compensated Tends toward acidosis Causes low pH Neutralizes high pH Step 3. Assume metabolic cause when respiratory is ruled out. You'll be right most of the time if you remember this simple table: High pH Low pH Alkalosis Acidosis High PaCO2 Low PaCO2 High PaCO2 Low PaCO2 Metabolic Respiratory Respiratory Metabolic If PaCO2 is abnormal and pH is normal, it indicates compensation. pH > 7.4 would be a compensated alkalosis. pH < 7.4 would be a compensated acidosis. These steps will make more sense if we apply them to actual ABG values. Click here to interpret some ABG values using these steps. You may want to refer back to these steps (click on "linked" steps or use "BACK" button on your browser) or print out this page for reference. Step 4. Use HC03 to verify metabolic effect Normal HCO3- is 22-26 Please note: Remember, the first three steps apply to the majority of cases, but do not take into account: the possibility of complete compensation, but those cases are usually less serious, and instances of combined respiratory and metabolic imbalance, but those cases are pretty rare. "Combined" disturbance means HCO3- alters the pH in the same direction as the PaCO2. High PaCO2 and low HCO3- (acidosis) or Low PaCO2 and high HCO3- (alkalosis). Continue reading >>

8-step Guide To Abg Analysis: Tic-tac-toe Method

8-step Guide To Abg Analysis: Tic-tac-toe Method

An arterial blood gas (ABG) is a blood test that measures the acidity (pH) and the levels of oxygen and carbon dioxide in the blood . Blood for an ABG test is taken from an artery whereas most other blood tests are done on a sample of blood taken from a vein. This test is done to monitor several conditions that can cause serious health complications especially to critically ill individuals. Every day, a lot of nursing and medical students assigned in acute areas encounter ABG results, which they may not necessarily be able to interpret with its knotty aspect. They struggle over the interpretation of its measurements, but they are not especially complicated nor difficult if you understand the basic physiology and have a step by step process to analyze and interpret them. There may be various tips and strategies to guide you, from mnemonics, to charts, to lectures, to practice, but this article will tell you how to interpret ABGs in the easiest possible way. And once you have finished reading this, youll be doing actual ABG analysis in the NCLEX with fun and excitement! Here are the steps: Know the normal and abnormal ABG values when you review the lab reports. Theyre fairly easy to remember: for pH, the normal value is 7.35 to 7.45; 35-45 for paCO2; and 22-26 for HCO3. Remember also this diagram and note that paCO2 is intentionallyinverted for the purpose of this method. 2. Determine if pH is under acidosis or alkalosis Next thing to do is to determine the acidity or alkalinity of the blood through the value of pH. The pH level of a healthy human should be between 7.35 to 7.45. The human body is constantly striving to keep pH in balance. 3. Determine if acid-base is respiratory or metabolic Next thing you need to determine is whether the acid base is Respiratory or Meta Continue reading >>

Acidosis Vs. Alkalosis

Acidosis Vs. Alkalosis

In this lesson, we're going to learn about acidosis and alkalosis. We'll take a look at the causes, signs, and symptoms that are associated with each condition. Balanced Blood We are constantly having to find balance in our lives. From balancing work and play time to saving and spending money, sleep and awake time. Well, ideally at least. We do this because we know that we function best when we're balanced. There are many similar balances that are going on inside of our bodies. An important balance that must be maintained to allow us to function properly is the balance between acids and bases in our bodies. When these are balanced, the acids pair up with the bases, and our blood is close to neutral. If too much acid is in the blood, then we experience acidosis. If too much base is in the blood, we experience alkalosis. Acidosis and alkalosis are caused by different conditions in our bodies, and they can cause different problems to occur. Acidosis Acidosis results from the build-up of acids in the blood or from the loss of base in the blood. Acids are put into our bloodstream through two systems in the body: the digestive system and the respiratory system. Acidosis that occurs from the digestive system is referred to as metabolic acidosis. In this instance, acids accumulate in the blood due to consumption of acidic foods or foods that are broken down into acids, excess acids being produced during metabolism, kidneys not properly removing acid from the bloodstream during filtration, or production of acid by the body due to other medical conditions, such as diabetes. The other possible way to develop acidosis is by the malfunctioning of the respiratory system, which we refer to as respiratory acidosis. This can happen if breathing is extremely slow or shallow, the lungs do Continue reading >>

Tic Tac Toe Method Arterial Blood Gas (abg) Interpretation For Nurses & Nursing Students

Tic Tac Toe Method Arterial Blood Gas (abg) Interpretation For Nurses & Nursing Students

Tic Tac Toe Method Arterial Blood Gas (ABG) Interpretation for Nurses & Nursing Students Didnt you love ABG problems in nursing school? Well, I didnt because I found them so confusing, and I could never remember if the value was acidotic or alkalosis. But then I found the TIC TAC TOE Method for ABGs and actually found solving ABG problems to be fun (like tic tac toe haha). Below I show you how to solve ABG problems using the Tic Tac Toe method. After you read and watch the video on using the Tic Tac Toe Method, dont forget to that the ABGs practice quiz to test your knowledge. Respiratory Acidosis vs Respiratory Alkalosis Why Learn How to Interpret Arterial Blood Gases asNurse? Being able to interpret Arterial Blood Gases (ABGs) as a nurse is very important. Many new nurses feel they are not comfortable with interpreting Arterial Blood Gases after they graduate. Some of these nurses feel they will never use it in their job and feel it is the respiratory therapists job or find it too confusing to understand. However, as the nurse taking care of the patient with abnormal Arterial Blood Gases (ABGs) it is your responsibility to know what to report to the doctor and how to properly oxygenate your patient based on their ABGs. For example, patients with COPD are known as CO2 retainers and their pCO2 levels will be higher than someone who does not have COPD. However, patients with COPD can experience abnormally highpCO2 levelswhich can cause confusion, dizziness, unconsciousness, increased heart rate/blood pressure, etc. So it is very importantthenurse knows how to interpret ABGS. Luckily there is a super easy way to help you interpret ABGs and I want to share it with you below. Easy Way on How to Interpret Arterial Blood Gases ABGs with Tic Tac Toe First, we need to lay the Continue reading >>

Uncompensated, Partially Compensated, Or Combined Abg Problems

Uncompensated, Partially Compensated, Or Combined Abg Problems

Arterial Blood Gas (ABG) analysis requires in-depth expertise. If the results are not understood right, or are wrongly interpreted, it can result in wrong diagnosis and end up in an inappropriate management of the patient. ABG analysis is carried out when the patient is dealing with the following conditions: • Breathing problems • Lung diseases (asthma, cystic fibrosis, COPD) • Heart failure • Kidney failure ABG reports help in answering the following questions: 1. Is there acidosis or alkalosis? 2. If acidosis is present, whether it is in an uncompensated state, partially compensated state, or in fully compensated state? 3. Whether acidosis is respiratory or metabolic? ABG reports provide the following descriptions: PaCO2 (partial pressure of dissolved CO2 in the blood) and PaO2 (partial pressure of dissolved O2 in the blood) describe the efficiency of exchange of gas in the alveolar level into the blood. Any change in these levels causes changes in the pH. HCO3 (bicarbonate in the blood) maintains the pH of the blood within normal range by compensatory mechanisms, which is either by retaining or increasing HCO3 excretion by the kidney. When PaCO2 increases, HCO3 decreases to compensate the pH. The following table summarizes the changes: ABG can be interpreted using the following analysis points: Finding acidosis or alkalosis: • If pH is more it is acidosis, if pH is less it is alkalosis. Finding compensated, partially compensated, or uncompensated ABG problems: • When PaCO2 is high, but pH is normal instead of being acidic, and if HCO3 levels are also increased, then it means that the compensatory mechanism has retained more HCO3 to maintain the pH. • When PaCO2 and HCO3 values are high but pH is acidic, then it indicates partial compensation. It means t Continue reading >>

Interpretation Of Arterial Blood Gas

Interpretation Of Arterial Blood Gas

Go to: Introduction Arterial blood gas (ABG) analysis is an essential part of diagnosing and managing a patient’s oxygenation status and acid–base balance. The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. Disorders of acid–base balance can create complications in many disease states, and occasionally the abnormality may be so severe so as to become a life-threatening risk factor. A thorough understanding of acid–base balance is mandatory for any physician, and intensivist, and the anesthesiologist is no exception. The three widely used approaches to acid–base physiology are the HCO3- (in the context of pCO2), standard base excess (SBE), and strong ion difference (SID). It has been more than 20 years since the Stewart’s concept of SID was introduced, which is defined as the absolute difference between completely dissociated anions and cations. According to the principle of electrical neutrality, this difference is balanced by the weak acids and CO2. The SID is defined in terms of weak acids and CO2 subsequently has been re-designated as effective SID (SIDe) which is identical to “buffer base.” Similarly, Stewart’s original term for total weak acid concentration (ATOT) is now defined as the dissociated (A-) plus undissociated (AH) weak acid forms. This is familiarly known as anion gap (AG), when normal concentration is actually caused by A-. Thus all the three methods yield virtually identical results when they are used to quantify acid–base status of a given blood sample.[1] Continue reading >>

Respiratory Vs. Metabolic Acidosis

Respiratory Vs. Metabolic Acidosis

Don't miss your chance to win free admissions prep materials! Click here to see a list of raffles . In a question involving the determination between if a shift in PCO2 / HCO3- / pH, is it safe to say that if the PCO2 is what is changing first, then it is respiratory and metabolic is the compensatory mechanism? In respiratory, PCO2 is changing which then changes the HCO3-, so how do you tell between metabolic vs. respiratory if they don't tell you which comes first? A change in the pCO2 = change in the respiratory component ==> primary respiratory acidosis or alkalosis A change in the bicarbonate level = renal or metabolic function ==> nonrespiratory disorder (i.e. metabolic) In respiratory acidosis, there is increase in CO2 due to hypoventilation (caused by lung related pathology such as COPD) ==> kidneys will increase the excretion of H+ and re-absorption of HCO3- to compensate Metabolic acidosis: Decrease in bicarbonate causing a decrease in pH due to several reasons like decreased elimination of acids, diabetic ketoacidosis.... Compensation is through hyperventilation (gets rid of CO2) and increased retention of HCO3- by the kidneys. pH is usually proportional to (HCO3-)/(pCO2) The question should be clear as to what's going on first. Continue reading >>

Abg Interpretation

Abg Interpretation

Arterial blood gas (ABG) interpretation is something many medical students find difficult to grasp (we’ve been there). We’ve created this guide, which aims to provide a structured approach to ABG interpretation whilst also increasing your understanding of each results relevance. The real value of an ABG comes from its ability to provide a near immediate reflection of the physiology of your patient, allowing you to recognise and treat pathology more rapidly. To see how to perform an arterial blood gas check out our guide here. If you want to put your ABG interpretation skills to the test, check out our ABG quiz here. Normal ranges pH: 7.35 – 7.45 PaCO2: 4.7-6.0 kPa PaO2: 11-13 kPa HCO3-: 22-26 mEg/L Base excess: -2 to +2 mmol/L Patient’s clinical condition Before getting stuck into the details of the analysis, it’s important to look at the patient’s current clinical status, as this provides essential context to the ABG result. Below are a few examples to demonstrate how important context is when interpreting an ABG. A normal PaO2 in a patient on high flow oxygen – this is abnormal as you would expect the patient to have a PaO2 well above the normal range with this level of oxygen therapy A normal PaCO2 in a hypoxic asthmatic patient – a sign they are tiring and need ITU intervention A very low PaO2 in a patient who looks completely well, is not short of breath and has normal O2 saturations – likely a venous sample Oxygenation (PaO2) Your first question when looking at the ABG should be “Is this patient hypoxic?” (because this will kill them long before anything else does). PaO2 should be >10 kPa on air in a healthy patient If the patient is receiving oxygen therapy their PaO2 should be approximately 10kPa less than the % inspired concentration / FiO Continue reading >>

Acid Base Disorders

Acid Base Disorders

Arterial blood gas analysis is used to determine the adequacy of oxygenation and ventilation, assess respiratory function and determine the acid–base balance. These data provide information regarding potential primary and compensatory processes that affect the body’s acid–base buffering system. Interpret the ABGs in a stepwise manner: Determine the adequacy of oxygenation (PaO2) Normal range: 80–100 mmHg (10.6–13.3 kPa) Determine pH status Normal pH range: 7.35–7.45 (H+ 35–45 nmol/L) pH <7.35: Acidosis is an abnormal process that increases the serum hydrogen ion concentration, lowers the pH and results in acidaemia. pH >7.45: Alkalosis is an abnormal process that decreases the hydrogen ion concentration and results in alkalaemia. Determine the respiratory component (PaCO2) Primary respiratory acidosis (hypoventilation) if pH <7.35 and HCO3– normal. Normal range: PaCO2 35–45 mmHg (4.7–6.0 kPa) PaCO2 >45 mmHg (> 6.0 kPa): Respiratory compensation for metabolic alkalosis if pH >7.45 and HCO3– (increased). PaCO2 <35 mmHg (4.7 kPa): Primary respiratory alkalosis (hyperventilation) if pH >7.45 and HCO3– normal. Respiratory compensation for metabolic acidosis if pH <7.35 and HCO3– (decreased). Determine the metabolic component (HCO3–) Normal HCO3– range 22–26 mmol/L HCO3 <22 mmol/L: Primary metabolic acidosis if pH <7.35. Renal compensation for respiratory alkalosis if pH >7.45. HCO3 >26 mmol/L: Primary metabolic alkalosis if pH >7.45. Renal compensation for respiratory acidosis if pH <7.35. Additional definitions Osmolar Gap Use: Screening test for detecting abnormal low MW solutes (e.g. ethanol, methanol & ethylene glycol [Reference]) An elevated osmolar gap (>10) provides indirect evidence for the presence of an abnormal solute which is prese Continue reading >>

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