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Acidosis and Alkalosis

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Acidosis may not cause any symptoms or it may be associated with nonspecific symptoms such as fatigue, nausea, and vomiting. Acute acidosis may also cause an increased rate and depth of breathing, confusion, and headaches, and it can lead to seizures, coma, and in some cases death.

Symptoms of alkalosis are often due to associated potassium (K+) loss and may include irritability, weakness, and cramping.

Common Causes of Acid-Base Disorders

Respiratory acidosis
Reduced CO2 elimination

  • Decreased breathing rate (respiratory drive) due to drugs or central nervous system disorders
  • Impaired breathing and lung movement (respiratory mechanics) due, for example, to trauma or abnormal presence of air between the lung and the wall of the chest (pneumothorax)
  • Respiratory muscle/nerve disease (myasthenia gravis, botulism, amyotrophic lateral sclerosis (ALS), Guillain-Barre syndrome)
  • Airway obstruction (food or foreign object)
  • Lung disease

Respiratory alkalosis
Increased CO2 elimination

Metabolic acidosis
Decreased HCO3-, due to increased acid or loss of bicarbonate

  • Alcoholic ketoacidosis
  • Diabetic ketoacidosis
  • Kidney failure
  • Lactic acidosis
  • Toxins – overdose of salicylates (aspirin), methanol, ethylene glycol
  • Gastrointestinal bicarbonate loss, such as from prolonged diarrhea
  • Renal bicarbonate loss

Metabolic alkalosis
Increased HCO3-, due to loss of acid or gain of bicarbonate

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