Different Interpretation Approaches To Acid Base Disturbances

Abstract

Management of acidbase disorders begins with accurate diagnosis, a process requiring two tasks: First, reliable measurement of acidbase variables in the blood. Second, proper interpretation of the data in relation to human health and disease allowing definition of the patients acidbase status.

In this essay we have assessed 3 approaches for interpretati on of acid base dis­ turbance, physiological approach which based on Henderson Hasselbalch equa­ tion , Base excess approach , based on work done by Ole Sigaard-Andersen , and physiochemical approach based on work done by Peter Stewart.

physiological approach considers acid as hydrogen ion donor and base as hydrogen ion acceptor. pH is determined by level of carbonic acid "PaC02, controlled by respiratory system " and bicarbonate concentration as metabolic component. The physiological approach determined four situations of distur­ bance of acid base status

1. Respiratory acidosis" due to increase of PaC02"

2. Respiratory alkalosis "due to decrease of PaC02"

3. Metabolic acidosis" presented by decrease in HC03- concentration" 4. Metabolic alkalosis " presented by increase in HC03- concentration" Secondary response to the primary disorder is produced to minimize its effect on pH, this secondary response called "Compensatory" , absence of secondary response indicates presence of another co-existing acid base disorder "Mixed Disorder" .