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What Does Metabolic Acidosis Mean?

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Acidemia Vs. Acidosis

By Wanda Thibodeaux ; Updated July 27, 2017 What Is a Dangerously Low Blood Pressure? In medicine, doctors, nurses and lab technicians sometimes use terms interchangeably that are very closely related, but which technically are different. One example is acidemia and acidosis. Although both of these terms refer to an abnormally low pH level in the body, they are not the same thing and should be treated accordingly. Acidosis refers to all of the physical processes and chemical reactions that result in an abnormally low pH. Specifically, it refers to the metabolism of substances that can be broken down into acids. Acidosis may lead to acidemia if the physical processes and chemical reactions of metabolism result in a pH level that is low enough. Acidosis may involve bodily fluids other than just blood. Acidemia is the state of having an abnormally low pH level (less than 7.35). Specifically, acidemia refers to a low pH level in the blood (all medical terms ending in "emia" generally mean "in the blood"). A person cannot have acidemia without some abnormality in metabolic processes (acidosis). Acidemia is the actual diagnosis given by a physician. Acidosis can be caused by respiratory Continue reading >>

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  1. One of our CDI noted an elevated lactic acid and queried the physician for a diagnosis. The patient did not have Sepsis. Our physician advisor said not to do that because the next lactic acid was normal. She said we should also be looking for the underlying cause of the lactic acidosis and not querying for the diagnosis. A diagnosis of lactic acidosis will give us a CC. Other CDI's have said that if the elevated lactic acid was treated, monitored or evaluated we should be querying for the diagnosis. Does anyone have any direction on how this should be handled?
    Is lactic acidosis always inherent in other conditions and that's what we should focus on?
    What can we pick up the diagnosis by itself as a CC / when should we query to get to documented in the chart?
    Are there any other clinical parameters we should be looking at when evaluating whether we should query such as the anion gap?
    Is there a specific treatment for metabolic acidosis?
    Thank you,
    Christine Butka RN MSN
    CDI Lead
    CentraState Medical Center
    Freehold, NJ

  2. What a timely comment. Recently, our coding auditor suggested that we should always keep an eye out for the cc "acidosis". It seems to me that lactic acidosis could be inherent to the disease process of sepsis and therefore should not be captured. Any thoughts?
    Yvonne B RN CDI Salinas, CA.

  3. Hello all! I agree, I believe lactic acidosis is inherent to sepsis. It is one of the most important indicators that gives the clnician a clue that sepsis may be present. Our fluid administration policy was actually developed on the lactic acid result: the higher the number, the more fluid we bolused (in non-CHF patients, of course). In cases were Sepsis is determined not to be present, we will query the provider, providing they treated or monitored the acidosis in some manner
    Shiloh

  4. -> Continue reading
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What is CLINICAL PATHWAY? What does CLINICAL PATHWAY mean? CLINICAL PATHWAY meaning - CLINICAL PATHWAY definition - CLINICAL PATHWAY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. SUBSCRIBE to our Google Earth flights channel - https://www.youtube.com/channel/UC6Uu... A clinical pathway, also known as care pathway, integrated care pathway, critical pathway, or care map, is one of the main tools used to manage the quality in healthcare concerning the standardisation of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes. Clinical pathways aim to promote organised and efficient patient care based on evidence-based medicine, and aim to optimise outcomes in settings such as acute care and home care. A single clinical pathway may refer to multiple clinical guidelines on several topics in a well specified context. A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the pa

Metabolic Acidosis | Pathway Medicine

Metabolic Acidosis is a pathophysiological category of acidosis that refers to any cause of decreased ECF pH not due to a ventilatory defect (i.e. Respiratory Acidosis). Although the primary metabolic disturbance can cause a significant decrease in blood pH, respiratory compensatory mechanisms can largely correct the pH over several hours. The fundamental primary disturbance in a metabolic acidosis is a decrease in the levels of ECF bicarbonate concentration ([HCO3-]). Decreased bicarbonate results in an misalignment of the Henderson-Hasselbalch Equation for the bicarbonate buffer which largely determines the pH of the extracellular fluid. Mathematically, the reduced ECF pH results from an increase in the ratio between the partial pressure of arterial carbon dioxide (PaCO2) relative to the ECF concentration of bicarbonate ([HCO3-]). More colloquially, metabolic acidoses are caused by a pathologic consumption of the weak base form of the bicarbonate buffer, that is bicarbonate (HCO3-), resulting in a decrease in ECF pH. Metabolic Acidoses can be compensated by the actions of the lungs which serve to realign the bicarbonate buffer Henderson-Hasselbalch Equation over a period of hour Continue reading >>

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  1. One of our CDI noted an elevated lactic acid and queried the physician for a diagnosis. The patient did not have Sepsis. Our physician advisor said not to do that because the next lactic acid was normal. She said we should also be looking for the underlying cause of the lactic acidosis and not querying for the diagnosis. A diagnosis of lactic acidosis will give us a CC. Other CDI's have said that if the elevated lactic acid was treated, monitored or evaluated we should be querying for the diagnosis. Does anyone have any direction on how this should be handled?
    Is lactic acidosis always inherent in other conditions and that's what we should focus on?
    What can we pick up the diagnosis by itself as a CC / when should we query to get to documented in the chart?
    Are there any other clinical parameters we should be looking at when evaluating whether we should query such as the anion gap?
    Is there a specific treatment for metabolic acidosis?
    Thank you,
    Christine Butka RN MSN
    CDI Lead
    CentraState Medical Center
    Freehold, NJ

  2. What a timely comment. Recently, our coding auditor suggested that we should always keep an eye out for the cc "acidosis". It seems to me that lactic acidosis could be inherent to the disease process of sepsis and therefore should not be captured. Any thoughts?
    Yvonne B RN CDI Salinas, CA.

  3. Hello all! I agree, I believe lactic acidosis is inherent to sepsis. It is one of the most important indicators that gives the clnician a clue that sepsis may be present. Our fluid administration policy was actually developed on the lactic acid result: the higher the number, the more fluid we bolused (in non-CHF patients, of course). In cases were Sepsis is determined not to be present, we will query the provider, providing they treated or monitored the acidosis in some manner
    Shiloh

  4. -> Continue reading
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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mamma

Metabolic Acidosis

Diabetic Ketoacidosis (DKA), Alcohol ic ketoacidosis or starvation ketosis Paraldehyde, Phenformin (neither used in U.S. now) Propofol Infusion Syndrome has been proposed as a replacement in mnemonic Salicylate s (do not miss Chronic Salicylate Poisoning ) IV. Causes: Metabolic Acidosis and Normal Anion Gap (Hyperchloremia) Renal Tubular Acidosis (proximal or distal) V. Causes: Metabolic Acidosis and Elevated Osmolal Gap PaCO2 drops 1.2 mmHg per 1 meq/L bicarbonate fall Calculated PaCO2 = 1.5 x HCO3 + 8 (+/- 2) Useful in High Anion Gap Metabolic Acidosis Measured PaCO2 discrepancy: respiratory disorder Investigate normal Anion Gap Metabolic Acidosis Elevated in normal Anion Gap Metabolic Acidosis VII. Labs: Consider in Metabolic Acidosis with Increased Anion Gap Basic chemistry panel as above ( Serum Glucose , Blood Urea Nitrogen ) Rutecki (Dec 1997) Consultant, p. 3067-74 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Metabolic Acidosis." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New W Continue reading >>

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Popular Questions

  1. One of our CDI noted an elevated lactic acid and queried the physician for a diagnosis. The patient did not have Sepsis. Our physician advisor said not to do that because the next lactic acid was normal. She said we should also be looking for the underlying cause of the lactic acidosis and not querying for the diagnosis. A diagnosis of lactic acidosis will give us a CC. Other CDI's have said that if the elevated lactic acid was treated, monitored or evaluated we should be querying for the diagnosis. Does anyone have any direction on how this should be handled?
    Is lactic acidosis always inherent in other conditions and that's what we should focus on?
    What can we pick up the diagnosis by itself as a CC / when should we query to get to documented in the chart?
    Are there any other clinical parameters we should be looking at when evaluating whether we should query such as the anion gap?
    Is there a specific treatment for metabolic acidosis?
    Thank you,
    Christine Butka RN MSN
    CDI Lead
    CentraState Medical Center
    Freehold, NJ

  2. What a timely comment. Recently, our coding auditor suggested that we should always keep an eye out for the cc "acidosis". It seems to me that lactic acidosis could be inherent to the disease process of sepsis and therefore should not be captured. Any thoughts?
    Yvonne B RN CDI Salinas, CA.

  3. Hello all! I agree, I believe lactic acidosis is inherent to sepsis. It is one of the most important indicators that gives the clnician a clue that sepsis may be present. Our fluid administration policy was actually developed on the lactic acid result: the higher the number, the more fluid we bolused (in non-CHF patients, of course). In cases were Sepsis is determined not to be present, we will query the provider, providing they treated or monitored the acidosis in some manner
    Shiloh

  4. -> Continue reading
read more

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  • What Does Metabolic Acidosis Mean?

    Symptoms of acidosis can be alarming for any person who is unaware of its existence in their body or do not understand the disorder. The symptoms of acidosis can be different depend on its cause. Acidosis disrupts proper cellular function and activity, leading to various disease and sickness. Common causes of acidosis include an existence of an underlying illness, diabetes, smoking, poor diet, kidney disorders, genetic factors or excessive use of ...

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  • Metabolic Acidosis And Metabolic Alkalosis Ppt

    Acidemia: Arterial blood pH below the normal range (<7.36) Alkalemia: Arterial bloodpH above the normal range (>7.44) Acidosis: a processthat tends to lower the pH (can be caused by fall in serum bicarbonate or a rise in PCO2 Alkalosis: a processthat tends to raise the pH (can be caused by increase in serum bicarbonate or a decrease in PCO2 Base Excess: the amount of strong acid needed to bring a solution back to a pH of 7.4 while keeping PCO2 a ...

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  • Respiratory Acidosis And Metabolic Acidosis At The Same Time

    The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis. Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through bre ...

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  • What Does Hyperchloremic Metabolic Acidosis Mean?

    Strong ions are cations and anions that exist as charged particles dissociated from their partner ions at physiologic pH. The SID (Strong Ion Difference) is the difference between the positively- and negatively-charged strong ions in plasma. This method of evaluating acid-base disorders was developed to help determine the mechanism of the disorder rather than simply categorizing them into metabolic vs. respiratory acidosis/alkalosis as with the ...

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  • Which Metabolic Rate Resulted In Metabolic Acidosis?

    Acidosis is caused by an overproduction of acid in the blood or an excessive loss of bicarbonate from the blood (metabolic acidosis) or by a buildup of carbon dioxide in the blood that results from poor lung function or depressed breathing (respiratory acidosis). If an increase in acid overwhelms the body's acid-base control systems, the blood will become acidic. As blood pH drops (becomes more acidic), the parts of the brain that regulate breath ...

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  • Respiratory Acidosis Vs Metabolic Acidosis

    Respiratory acidosis is an acid-base balance disturbance due to alveolar hypoventilation. Production of carbon dioxide occurs rapidly and failure of ventilation promptly increases the partial pressure of arterial carbon dioxide (PaCO2). [ 1 ] The normal reference range for PaCO2 is 35-45 mm Hg. Alveolar hypoventilation leads to an increased PaCO2 (ie, hypercapnia). The increase in PaCO2, in turn, decreases the bicarbonate (HCO3)/PaCO2 ratio, the ...

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