Biochemical Approach of Acid-Base Disturbances
PDF
xml (Español)

Keywords

metabolic acidosis
respiratory acidosis
metabolic alkalosis
respiratory alkalosis
Acid-base equilibrium
alkalemia
acidemia
alkalosis
acidosis
critical care
blood gas analysis
cellular respiration

How to Cite

1.
Nitsch Prado A. Biochemical Approach of Acid-Base Disturbances. Rev. Colomb. Nefrol. [Internet]. 2023 Jul. 25 [cited 2024 Oct. 6];10(3). Available from: https://revistanefrologia.org/index.php/rcn/article/view/612

Abstract

Background: The current paradigms in arterial blood gas analysis are based on mathematical or physicochemical models that require complex algorithms for interpretation. This leads to avoidance or dislike from health care professionals.

Purpose: To formulate a new approach to the analysis and classification of acid base disturbances.

Methodology: we conducted a systematic review of the related literature and a paradigm shift for data interpretation.

Results: Acid-base disorders can be grouped and managed according to the underlying biochemical processes.

Conclusions: This proposal represents a new classification, which groups acid base disorders according to the underlying causal biochemical process. Disorders with an elevated anion gap relate to alterations in cellular respiration (energy/ATP production)- All disturbances with  normal anion gap relate to transmembrane ion exchange.

https://doi.org/10.22265/acnef.10.3.612
PDF
xml (Español)

References

Berend K. Diagnostic Use of Base Excess in Acid-Base Disorders. NEJM. 2018 ;378(15):1419-1428. https://doi.org/10.1056/NEJMra1711860

Dzierba AL, Abraham P. A Practical Approach to Understanding Acid-Base Abnormalities in Critical illness. J Pharm Practice. 2011;24(1):17-26. https://doi.org/10.1177/0897190010388153

Ahmad M, Wolberg A, Kahwaji C. Biochemistry, Electron Transport Chain.. [Online]. StatPearls; 2021 [cited 2022]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526105/#_NBK526105_pubdet_

Anesthesia Education Website. Acid-base physiology. [Online]. [cited 2022] Available from: https://www.anaesthesiamcq.com/AcidBaseBook/ab2_1.php

United states environmental Protection Agency. Technical Overview of Volatile Organic Compounds. [Online].; 2021. Available from: https://www.epa.gov/indoor-air-quality-iaq/technical-overview-volatile-organic-compounds#conclusion

Kaufman DA. Interpretation of ABgs. [Online]. American Thoracic Asociation. [cited 2022] Available from: https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-education/abgs.php

Saha A, Bhattacharya M, Sharma G, Lee SS, Chakraborty C. Probable Molecular Mechanism of Remdesivir for the Treatment of COVID-19: Need to Know More. J. ARCMED. 2020;51(6):585-586. https://doi.org/10.1016/j.arcmed.2020.05.001

Blough B, Moreland A, Mora A. Metformin-induced lactic acidosis with emphasis on the anion gap. Proc (Bayl Univ Md Cent). 2015;28(1):31-33. https://doi.org/10.1080/08998280.2015.11929178

Palmer BF, Clegg DJ. Salicylate Toxicity. NEJM. 2020;382:2544-2555. https://doi.org/10.1056/NEJMra2010852

DuBose TD. Metabolic and respiratory acidosis. In Wilcox CS. Therapy in Nephrology and Hypertension.: Saunders Elsevier. 2008:368-380. https://doi.org/10.1016/B978-141605484-9.50033-2

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Dimensions


PlumX


Downloads

Download data is not yet available.