1. Metabolic Acidosis Sana Javed UG-3 Section-A

2. What is Metabolic Acidosis? A pH imbalance in which the body has accumulated too much acid due to metabolism and does not have enough bicarbonate to effectively neutralize the effects of the acid Characterized by: Reduction in serum bicarbonate (HCO 3 − ) concentration Decrease in the arterial partial pressure of carbon dioxide (PaCO 2 ) Reduction in blood pH <7.35

3. Normal body Compensation Maintenance of slightly basic pH is manifested by HCO 3 - in blood Acidic pH: ultimate CO 2 + H 2 O + H + excretion under normal conditions

4. Causes & Types 1. Myocardial Infarction- Lactic Acidosis 2. Renal failure- Renal Acidosis 3. Excessive fat metabolism in the absence of carbohydrates:  Type 1 diabetes (Diabetic ketoacidosis), malnutrition, low-carbohydrate, high-fat diet

5. Symptoms Headache & lethargy Drowsiness Hyperventilation (as the lungs attempt to compensate by “blowing off” carbon dioxide) Nausea Vomiting Stupor, coma & death

6. Diagnosis Arterial Blood Gas: A snapshot of the blood's pH, PaO 2, & PaCO 2 (>45mmHg)  HCO 3 - (<24mM/L) Serum electrolytes: Na +, K +, Cl -, & HCO 3 - levels Urine pH levels: pH<6

7. Treatment Sodium bicarbonate I.V. Evaluation and correction of electrolyte imbalances  Food  Injections  Supplements Correction of the underlying cause

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