Determining the cause

Do not forget to integrate clinical and laboratory findings.

Make use of all the available blood parameters when assessing acid-base status:

• [H⁺]
• [HCO₃^-]
• pCO₂
• Anion gap

The anion gap assesses the accumulation of acids other than HCl and H₂CO₃.

It is equal to  ([Na⁺]  -  [Cl^-]  -  [HCO₃^-])  and should be 12 + 2 Eq/l.

Using [H⁺] and [HCO₃^-] it should be possible to identify the primary disorder and whether there is a mixed picture.

Further assessment depends on the primary disorder:

• Metabolic acidosis

• Metabolic alkalosis

• Respiratory acidosis

• Respiratory alkalosis

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