Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Decreased serum pH (< 7.35)• Decreased serum HCO3 +++ Epidemiology + • Etiologies include:-Diarrhea-Diuretics-Renal tubular disease-Ureterosigmoidostomy-Lactic acidosis-Diabetic ketoacidosis-Uremia +++ Laboratory Findings + • Decreased serum pH (< 7.35)• Decreased serum HCO3 + • Differentiate between anion gap or hyperchloremic causes + • Serum electrolytes• ABG measurements• Calculate anion gap: Na - (Cl + HCO3)• Anion gap > 15: H+ excess, lactic acidosis, diabetic ketoacidosis, uremia, methanol ingestion, salicylate intoxication, ethylene glycol ingestion• Anion gap < 15: HCO3 loss, diarrhea, renal tubular disease, ureterosigmoidostomy, acetazolamide, NH4 Cl administration + • Treat underlying condition• Conservative HCO3 administration: Estimate need by multiplying base deficit by one half total body water +++ Medications + • Sodium bicarbonate as needed +++ Treatment Monitoring + • Serial ABG measurements +++ Complications + • Hypotension• Death +++ Prognosis + • Varies with etiology +++ References ++Adrogue HJ et al. Management of life-threatening acid-base disorders. (Two parts.) N Engl J Med. 1998;338:26, 107. ++Ishihara K et al. Anion gap acidosis. Semin Nephrol. 1998;18:83. [PubMed: 9459291] Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth