Respiratory = problems in lung , in H2CO3

Metabolic = problems in HCO3

Respiratory Metabolic

Acidosis Alkalosis Acidosis Alkalosis

( Trapped Co2) (wash C02) Loss of HCO3- High HCO3-
High H2CO3 Low H2CO3 Gain of H+ Loss of H+
‫)يزيد انتاج االحماض‬
HCO3 ‫فالجسم يستهلك‬
)‫في معادلتها‬

ratio 𝐻𝐶𝑂3 𝐻𝐶𝑂3 ↓𝐻𝐶𝑂3 ↑𝐻𝐶𝑂3

= low ratio = High ratio = low ratio = High ratio
↑𝐻2𝐶𝑂3 ↓𝐻2𝐶𝑂3 𝐻2𝐶𝑂3 𝐻2𝐶𝑂3

Causes • ↓Respiratory • Hyperventilatio Renal failure: • Loss of

Centre → n due to decrease ability of gastric HCI:
morphia. Exercise the kidneys to Repeated
• Extensive ,anxiety, pain, remove excess vomiting,
lung diseases shock. acids formed inside Gastric
as in extensive • Infection and the body. suction.
emphysema fever Increased • Bicarbonate
& massive • Drugs (aspirin) production of retention
pneumonia • CNS tumor, acids :Severe NaHCO3
• Obstructive: trauma. muscular exercise, administration
severe High protein diet, Milk alkali
bronchial Ketosis: severe syndrome
asthma and in uncontrolled • Hypokalemia
asphyxia. diabetes mellitus, in case of
starvation diuretics
Excessive loss of
bases: diarrhea.

Lung No Lung Compensation RC is stimulated by hypoventilation

compensatio ‫الرئة أصال بايظة‬ acidosis causing
n deep rapid
breathing, the
hyperventilation
results in CO2 loss
and reduction of
H2CO3
Kidney by increasing by increasing excretion increasing increasing excretion
Compensation
excretion of H+ ions of HCO3- ions in urine excretion of H+ of HCO3- ions in
in urine and and reabsorption of H+ ions in urine and urine and
reabsorption of into the blood reabsorption of reabsorption of H+
HCO3- into the blood HCO3- into the into the blood
blood
 PCO2 HCO3 PH
35-45 22-26 7.35-7.45
Respiratory Uncompensated ↑ N ↓
Acidosis
Compensated ↑ ↑ Near 7.35

Metabolic Uncompensated N ↓ ↓
Acidosis
Compensated ↓ ↓ Near 7.35

Respiratory Uncompensated ↓ N ↑
Alkalosis
Compensated ↓ ↓ Near 7.45

Metabolic Uncompensated N ↑ ↑
Alkalosis
Compensated ↑ ↑ Near 7.45

Examples :
 1. pH= 7.28, PCO2= 40, HCO3= 18

Acidosis

Metabolic

No compensation

Not compensated metabolic acidosis.

2. pH= 7.33, PCO2= 60, HCO3= 34

Acidosis

Respiratory

Partial compensation

Partially compensated respiratory acidosis

3. pH= 7.5, PCO2= 29, HCO3= 24

Alkalosis

Respiratory

No compensation

Not compensated respiratory alkalosis

4. pH= 7.48, PCO2= 28, HCO3= 20

Alkalosis

Respiratory

Partial compensation

Partially compensated respiratory alkalosis