Sections View Full Chapter Figures Tables Videos 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] GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessSurgery 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessSurgery Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options