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 select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process 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 Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.