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Acidosis/Alkalosis

High base = high pH


Carbonic acid

H20 + CO2 H2CO3

OH-

Bicarbonate

+ HCO3water

High Acid = low pH

H+

Acidosis

Alkalosis

H+ = CO2 = HCO3-

H+ = CO2 = HCO3-

Expected
Compensations

Increased
breathing
rate

Increased
absorption and
creation of
bicarbonate

Expected
Compensations

Failures
to Compensate

If breathing
is slow =
increased CO2 =
Respiratory
Acidosis

If HCO3- is
low =
Metabolic
Acidosis

Failures
to Compensate

100 90 80

70

Decreased
breathing
rate

Secretion\excretion
of bicarbonate
by kidneys

If HCO3- is
high =
Metabolic
Alkalosis

If breathing
is rapid =
decreased CO2 =
Respiratory
Alkalosis

Arterial blood [H+] (nmol/L)


50
40
30
60

60

120 110 100 90 80

56

20

70

60

50

52

pH < 7.35

pH > 7.45

Acidosis

Alkalosis

CO2 = HCO3CO2 >


45 mmHg

Arterial plasma [HCO3-] (mmol/L)

pH

HCO3 <
20 mmol/L

CO2 =
CO2 <
35 mmHg

HCO3-

HCO3 >
27 mmol/L

44

Patient would
breathe slowly

Metabolic
Acidosis
Patient would
breathe rapidly

Respiratory
Alkalosis

Metabolic
Alkalosis

Patient would
breathe rapidly

Patient would
breathe slowly

Metabolic
Alkalosis

Chronic
Respiratory
Acidosis

40

30
25

36
32
28

Acute R
e

spirato

24

20

ry Acid

osis

20

Normal
Chronic
Respiratory
Alkalosis

16
12
8

Respiratory
Acidosis

35

PC
O
2 (m
mH
g)

48

40

Acute
Respiratory
Alkalosis

15
10

Hg)
(mm
O
2
C
P

Metabolic
Acidosis

4
0
7.0

7.1

7.2

7.3

7.4

7.5

Arterial blood pH

7.6

7.7

7.8