clinical approach to acid-base disorders

1. look at pH
if pH < {{c1::7.35}} then acidemia
if pH > {{c1::7.45}} then alkalemia

2. acidemia
if {{c5::low HCO3-}} then metabolic acidosis
if {{c5::high Pco2}} then respiratory acidosis

3. alkalemia
if {{c6::high HCO3-}} then metabolic alkalosis
if {{c6::low Pco2}} then respiratory alkalosis

4. metabolic acidosis
calculate the anion gap
if Pco2 decreases by 1 for every 1 of HCO3- rises, then compensated metabolic acidosis
if Pco2 is higher than this, then metabolic acidosis + {{c2::respiratory acidosis}}
if Pco2 is lower than this, then metabolic acidosis + {{c2::respiratory alkalosis}}

5. respiratory acidosis
divide ΔpH by ΔPco2 to determine if acute or chronic:
if = 0.8 then acute respiratory acidosis
if = 0.33 then chronic respiratory acidosis
if 0.33 - 0.8 then acute exacerbation of chronic condition
if > 0.8 then respiratory acidosis + metabolic acidosis
if < 0.33 then respiratory acidosis + metabolic alkalosis

6. metabolic alkalosis
divide ΔPco2 by ΔHCO3
if < 0.7 then metabolic alkalosis + {{c3::respiratory alkalosis}}
if ~ 0.7 then compensated metabolic alkalosis
if > 0.7 then metabolic alkalosis + {{c3::respiratory acidosis}}

7. respiratory alkalosis
similar to respiratory acidosis to determine acute vs chronic (not typing all this out lol)

8. {{c4::mixed acid base disorder::what is it called}}
normal pH can be associated with abnormal Pco2, HCO3-, or anion gap as these things can cancel one another out

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