ABG

Metabolic acidosis Respiratory acidosis Metabolic alkalosis Respiratory alkalosis

Renal Failure
When the kidneys fail to excrete acids or reabsorb
bicarbonate effectively
Diabetic Ketoacidosis (DKA):
insufficient insulin leads to increased production of ketones
Lactic Acidosis:
Conditions such as sepsis, shock, or certain medications can
lead to the production and accumulation of lactic acid in the
body
Severe Diarrhea:
Excessive loss of bicarbonate through diarrhea
Starvation or Fasting:
breakdown of fats and proteins, resulting in the production of
ketones
Salicylate Poisoning:
Ingestion of aspirin or other salicylate-containing drugs by
interfering with cellular respiration.
Hyperchloremic Acidosis:
Conditions such as severe dehydration or excessive loss of
sodium bicarbonate can cause an increase in chloride ions
Inborn Errors of Metabolism:
Genetic disorders affecting enzymes involved in metabolism,
such as organic acidemias, can result in the accumulation of
acidic byproducts.
Excessive Alcohol Ingestion:
Alcohol metabolism produces acidic compounds, and
excessive alcohol intake can overwhelm the body's ability to
buffer and eliminate these acids, contributing to metabolic
acidosis.
Carbon Monoxide Poisoning:
Inhaled carbon monoxide can bind to hemoglobin, reducing
oxygen delivery to tissues and leading to lactic acidosis as cells
switch to anaerobic metabolism.
Chronic Obstructive Pulmonary Disease
(COPD):
inadequate removal of carbon dioxide from the lungs and
resulting in respiratory acidosis.
Atelectasis (Collapsed Lung):
Atelectasis reduces the surface area available for gas
exchange in the lungs, causing an imbalance in the
elimination of carbon dioxide and contributing
Drug Overdose (e.g., Opioids):
Some drugs, particularly opioids, can depress respiratory
function, leading to hypoventilation and the retention of
carbon dioxide
Neuromuscular Disorders:
Conditions that weaken the respiratory muscles, such as
myasthenia gravis or amyotrophic lateral sclerosis (ALS),
can result in insufficient ventilation and respiratory
acidosis.
Chest Wall Abnormalities:
Structural abnormalities in the chest wall, such as severe
kyphoscoliosis, can limit lung expansion and compromise
effective breathing, leading to respiratory acidosis.
Severe Pneumonia:
Infections in the lungs, particularly those causing
significant inflammation and consolidation, can impair gas
exchange and contribute to respiratory acidosis.
Central Nervous System Depression (e.g.,
Stroke, Brain Injury):
Conditions affecting the central respiratory centers in the
brain, such as strokes or traumatic brain injuries, can lead
to inadequate control of breathing and respiratory
acidosis.
Obesity Hypoventilation Syndrome:
Obesity-related changes in respiratory mechanics,
combined with the effects of excess weight on respiratory
muscles, can lead to hypoventilation and respiratory
acidosis.
Airway Obstruction (e.g., Foreign Body):
Blockage of the airways by a foreign body or other
obstructions can impede airflow, leading to inadequate
carbon dioxide elimination and respiratory acidosis.
Acute Respiratory Distress Syndrome
(ARDS):
ARDS is a severe lung condition characterized by
inflammation and damage to the alveoli.
Vomiting:
Prolonged or severe vomiting results in the loss of
stomach acid (hydrochloric acid), leading to an increase in
bicarbonate concentration and metabolic alkalosis.
Diuretic Use:
Certain diuretic medications, especially loop diuretics, can
cause excessive loss of chloride and sodium, leading to an
increase in bicarbonate levels and metabolic alkalosis.
Excessive Antacid Consumption:
Antacids containing bicarbonate or citrate can contribute
to metabolic alkalosis when consumed in excess, as they
introduce additional bicarbonate ions into the system.
Hyperaldosteronism:
Conditions such as Conn's syndrome, characterized by
overproduction of aldosterone, can lead to increased
sodium reabsorption in the kidneys, resulting in metabolic
alkalosis.
Cushing's Syndrome:
Overproduction of cortisol, as seen in Cushing's syndrome,
can increase renal bicarbonate reabsorption, contributing
to metabolic alkalosis.
Hypokalemia:
Low levels of potassium in the blood (hypokalemia) can
stimulate hydrogen ion secretion in the kidneys, leading to
an increase in bicarbonate and metabolic alkalosis.
Excessive Alkali Ingestion
Ingesting substances with high alkalinity, such as
bicarbonate-rich medications or baking soda, can lead to
metabolic alkalosis.
Bartter Syndrome:
Bartter syndrome is a rare genetic disorder that affects the
kidneys' ability to reabsorb sodium, resulting in excessive
renal loss of sodium and chloride, and subsequent
metabolic alkalosis.
Chronic Potassium Depletion:
Conditions causing chronic depletion of potassium, such as
chronic laxative abuse, can lead to increased bicarbonate
reabsorption in the kidneys and metabolic alkalosis.
Excessive Adrenal Steroid Use:
Prolonged use of certain steroids, like glucocorticoids, can
increase renal bicarbonate reabsorption and contribute to
metabolic alkalosis.
Hyperventilation (Psychogenic or Anxiety-
Induced):
Emotional stress or anxiety can lead to hyperventilation,
causing excessive removal of carbon dioxide and resulting in
respiratory alkalosis.
Pulmonary Embolism:
A sudden blockage of the pulmonary arteries by a blood clot
can cause rapid and shallow breathing, leading to
hyperventilation and respiratory alkalosis.
High Altitude:
At higher altitudes, there is a lower partial pressure of oxygen,
stimulating increased ventilation and potentially leading to
respiratory alkalosis.
Fever:
Elevated body temperature can increase respiratory rate,
promoting hyperventilation and contributing to respiratory
alkalosis.
Hypoxemia:
Conditions such as pneumonia, asthma, or acute respiratory
distress syndrome (ARDS) can cause low oxygen levels,
prompting increased ventilation and respiratory alkalosis.
Liver Disease (Hepatic Encephalopathy):
in severe liver disease, accumulation of toxic substances like
ammonia can affect the brain's respiratory centers, leading to
hyperventilation and respiratory alkalosis.
Pregnancy:
Hormonal changes during pregnancy, such as increased
progesterone levels, can stimulate respiratory centers, causing
hyperventilation and respiratory alkalosis.
Salicylate Poisoning (Aspirin):
Toxic levels of salicylates, as seen in aspirin poisoning, can
stimulate the respiratory center, leading to increased
ventilation and respiratory alkalosis.
Sepsis:
Severe infections, particularly those progressing to sepsis, can
trigger an exaggerated respiratory response, resulting in
hyperventilation and respiratory alkalosis.
Mechanical Ventilation:
inappropriately high ventilator settings during mechanical
ventilation can lead to excessive removal of carbon dioxide,
causing respiratory alkalosis.