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The amount of respiratory compensation in metabolic acidosis can be estimated using Winters' formula. [2] Hyperventilation due to the compensation for metabolic acidosis persists for 24 to 48 hours after correction of the acidosis, and can lead to respiratory alkalosis. [3] This compensation process can occur within minutes. [4]
There are four primary acid-base derangements that can occur in the human body - metabolic acidosis, metabolic alkalosis, respiratory acidosis, and respiratory alkalosis. These are characterized by a serum pH below 7.4 (acidosis) or above 7.4 (alkalosis), and whether the cause is from a metabolic process or respiratory process.
Respiratory alkalosis is very rarely life-threatening, though pH level should not be 7.5 or greater. The aim in treatment is to detect the underlying cause. When PaCO2 is adjusted rapidly in individuals with chronic respiratory alkalosis, metabolic acidosis may occur. [ 3 ]
Compensation for metabolic alkalosis occurs mainly in the lungs, which retain carbon dioxide (CO 2) through slower breathing, or hypoventilation (respiratory compensation). CO 2 is then consumed toward the formation of the carbonic acid intermediate, thus decreasing pH. Respiratory compensation, though, is incomplete.
metabolic acidosis, or respiratory alkalosis with renal compensation if too low (less than −2 mEq/L) Blood pH is determined by both a metabolic component, measured by base excess, and a respiratory component, measured by PaCO 2 (partial pressure of carbon dioxide). Often a disturbance in one triggers a partial compensation in the other.
Rapid deep breaths increase the amount of carbon dioxide exhaled, thus lowering the serum carbon dioxide levels, resulting in some degree of compensation. Overcompensation via respiratory alkalosis to form an alkalemia does not occur. [citation needed] Extreme acidemia can also lead to neurological and cardiac complications: [citation needed]
Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, [2] a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and vice versa, a delicate balance is created between these two conditions.
Four fundamental changes may occur that affect acid-base balance in the body: respiratory acidosis, respiratory alkalosis, metabolic acidosis and metabolic alkalosis. Additionally, a respiratory and a metabolic disturbance may occur simultaneously, such as respiratory acidosis followed by a compensatory shift towards metabolic alkalosis.