- See ABG
- See Diff Dx: Anion Gap / Non Anion Gap
- By definition: primary decrease HCO3 concentration.
- Simple Met acidosis, Stimulates Ventilation, Decreasing pCO2
- Base Deficit:
- indicator of blood loss, resuscitation, and mortality in trauma patients, and it is a more sensitive marker of hypovolemia than vital signs;
- base deficit and base excess are the same term;
- normal base deficit is 0 to 3 mmol/L
- Must distinguish from compensatory decr in HCO3 due to Resp Alk.
- Predicted pCO2 Decrease (vs. HCO3) after Full Resp. Compensation.
- HCO3: 10 12 14 16 18 20 22 24
- pCO2: 21-25 24-28 27-31 30-34 33-37 36-40 39-43 42-46 * if pCO2 = approx predicted value, then Respiratory Compensation. * if pCO2 > than predicted, then concomitant Resp. Acidosis * if pCO2 < than predicted, then concomitant Met. Alkalosis
- Respiratory compensation (pCO2) for Metabolic acidosis will not be < 10.
- After Full Compensation: pCO2 = 1.5(HCO3) + 8 (+/- 2)
- Hypervent, lethargy, HTN/Hypoten, Arrhythmia, HyperCa
- See Diff Dx for Management: Anion Gap / Non Anion Gap
- Order: toxin screen, serum lactate, and serum ketone levels.