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ACIDOSIS
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8
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- Human physiology dictates that a runner's near-top speed cannot be maintained for more than 30–35 seconds due to the depletion of phosphocreatine stores in muscles, and perhaps secondarily to excessive metabolic acidosis as a result of anaerobic glycolysis.
- Lactic acidosis can also be the result of illnesses, medications, poisonings or inborn errors of metabolism that interfere directly with oxygen utilization by cells.
- Clinical presentation of iron poisoning in the absence of treatment progresses in five stages: the gastrointestinal phase, latent phase, metabolic acidosis and shock phase, hepatotoxicity phase, and bowel obstruction due to scarring.
- Analysis of paired arterial and venous specimens can give insights into the aetiology of acidosis in the newborn.
- Signs and symptoms that may be seen in acidosis include headaches, confusion, feeling tired, tremors, sleepiness, flapping tremor, and dysfunction of the cerebrum of the brain which may progress to coma if there is no intervention.
- Ketoacidosis is a metabolic state caused by uncontrolled production of ketone bodies that cause a metabolic acidosis.
- Symptoms include poor feeding, vomiting, dehydration, acidosis, low muscle tone (hypotonia), seizures, and lethargy.
- The typical signs of malignant hyperthermia are due to a hypercatabolic state, which presents as a very high temperature, an increased heart rate and abnormally rapid breathing, increased carbon dioxide production, increased oxygen consumption, mixed acidosis, rigid muscles, and rhabdomyolysis.
- Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure.
- Other conditions that may present similarly include other causes of high anion gap metabolic acidosis including diabetic ketoacidosis.
- Hyperchloremia should not be mistaken for hyperchloremic metabolic acidosis as hyperchloremic metabolic acidosis is characterized by two major changes: a decrease in blood pH and bicarbonate levels, as well as an increase in blood chloride levels.
- The US boxed warning cautions potential onset of lactic acidosis or liver damage due to use of tenofovir disoproxil.
- Rapid and deeper respirations (hyperventilation) due to sympathetic nervous system stimulation and acidosis.
- Acute metabolic acidosis, lasting from minutes to several days, often occurs during serious illnesses or hospitalizations, and is generally caused when the body produces an excess amount of organic acids (ketoacids in ketoacidosis, or lactic acid in lactic acidosis).
- In accordance with WHO, perinatal asphyxia is characterised by: profound metabolic acidosis, with a pH less than 7.
- It works as glucose increases the uptake of sodium and thus water by the intestines, and the potassium chloride and sodium citrate help prevent hypokalemia and acidosis, respectively, which are both common side effects of diarrhea.
- Hypoxemia, hypertension, pulmonary hypertension, respiratory acidosis and increased intracranial pressure may supervene.
- Laboratory results include higher plasma/serum transaminase activity, hyperammonemia, acidosis, hypoglycemia, and an increased anion gap.
- It also results from other causes such as hypoxia, acidosis, hypokalemia, hyperkalemia, hypovolemia, toxins, pulmonary thrombosis, and coronary thrombosis.
- In acidotic states, such as in acute kidney failure, Ringer's lactate solution may be advantageous as the byproducts of lactate metabolism in the liver counteract the acidosis.
- Glycolate and oxalate are the primary toxins responsible for the metabolic acidosis, and for the renal damage, seen in ethylene glycol poisoning.
- The permissive hypercapnia leads to respiratory acidosis which might have negative side effects, but given that the patient is in ARDS, improving ventilatory function is more important.
- Kidney failure, causes high anion gap acidosis by decreased acid excretion and decreased HCO reabsorption.
- Hypoaldosteronism causes low sodium (hyponatremia), high potassium (hyperkalemia), and metabolic acidosis, a condition in which the body produces excess acid.
- Proximal muscle weakness, exercise intolerance, lactic acidosis, high serum lactate/pyruvate ratio, normal to elevated serum CK, dyspnea, exaggerated cardiorespiratory response to exercise are common symptoms.
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