A simple minded clinician's approach to interpretation of acid base balance.
Jon Palmer, VMD, Associate Professor, New Bolton Center, University of Pennsylvania
Last edited: February 1998
Neonatology
A simple minded clinician's approach to interpretation of acid base balance.
Jon Palmer, VMD, Associate Professor, New Bolton Center, University of Pennsylvania
Last edited: February 1998
The following is a simple method of determining the acid base status of an animal by analyzing an arterial blood gas result.
1. Is there an acidosis or alkalosis?
2. If there is an acidosis, is it metabolic or respiratory?
a. If the Paco2 is higher than normal, it's a respiratory acidosis.
b. If the base excess is negative, it's a metabolic acidosis.
c. If both the Paco2 is high and the base excess is negative it's a mixed respiratory and metabolic acidosis.
3. If there is an alkalosis, is it metabolic or respiratory?
a. If the Paco2 is lower than normal, it's a respiratory alkalosis.
b. If the base excess is positive, it's a metabolic alkalosis.
c. If both the Paco2 is low and the base excess is positive it's a mixed respiratory and metabolic alkalosis.
4. Is there any compensation?
a. In the case of an acidosis if the Paco2 is low there is respiratory compensation or if the BE is high there is metabolic compensation.
b. In the case of an alkalosis if the Paco2 is high there is respiratory compensation or if the BE is low there is metabolic compensation.
5. These guidelines do not always work in cases of complex acid/base balance where the respiratory and metabolic changes may be independent of each other.