What is Metabolic Acidosis ?
Metabolic acidosis-marked by excess acid accumulation and deficient base bicarbonate-is produced by an underlying disorder. Symptoms result from the body's attempts to correct the acidotic condition through compensatory mechanisms in the lungs, kidneys, and cells.
Metabolic acidosis is more prevalent among children, who are vulnerable to acid-base imbalance because their metabolic rates are faster and their ratios of water to total body weight are lower. Severe or untreated metabolic acidosis can be fatal.
Causes of Metabolic Acidosis
Metabolic acidosis usually results from excessive burning of fats in the absence of usable carbohydrates. Diabetic ketoacidosis, chronic alcoholism, malnutrition, or a low-carbohydrate, high-fat diet-all of which produce more keto acids than the metabolic process can handle-can cause this. Other causes include:
Signs & Symptoms of Metabolic Acidosis
If metabolic acidosis becomes severe, the person may develop:
Exteme acidosis leads to neurological and cardiac complications:
Arterial blood gas analysis reveals a pH less than 7.35 to confirm metabolic acidosis, decreased partial pressure of carbon dioxide as part of the compensatory mechanism, and bicarbonate levels less than 24 mEq/L in acute metabolic acidosis.
Urine pH is 4.5 in the absence of renal disease.
Serum potassium levels are usually elevated, as hydrogen ions move into the cells and potassium moves out of the cells to maintain lectroneutrality.
Blood glucose levels increase in diabetes. Serum ketone body levels increase in diabetes mellitus.
Plasma lactic acid levels are elevated in lactic acidosis.Anion gap values more than 14 mEq/L indicate metabolic acidosis. These values result from increased acid production or renal insufficiency.
For acute metabolic acidosis, treatment may include I.V. administration of sodium bicarbonate (when arterial pH is less than 7.2) to neutralize blood acidity. For chronic metabolic acidosis, oral bicarbonate may be given. Other treatment measures include careful evaluation and correction of electrolyte imbalances and, ultimately, correction of the underlying cause. For example, diabetic ketoacidosis requires insulin administration and fluid replacement.Mechanical ventilation may be required to ensure adequate respiratory compensation.
Keeping diabetes mellitus type I under control can avoid many cases of metabolic acidosis. Avoid ingesting toxic materials.
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