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Such a disturbance is called a metabolic alkalosis (Fig. 12). Alternatively, if protons are added to the bloodstream in the form of acidic metabolites, as occurs during diabetic ketoacidosis, then pH will fall, along with bicarbonate concentration. This type of disturbance is called a metabolic acidosis.
Metabolic alkalosis is an acid-base disorder in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate ( HCO − 3 ), or alternatively a direct result of increased bicarbonate concentrations.
An excess of acid is called acidosis or acidemia, while an excess in bases is called alkalosis or alkalemia. The process that causes the imbalance is classified based on the cause of the disturbance (respiratory or metabolic) and the direction of change in pH (acidosis or alkalosis). This yields the following four basic processes:
Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5] Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35. [6]
Similarly, an alkalosis would cause an alkalemia on its own. [24] In medical terminology, the terms acidosis and alkalosis should always be qualified by an adjective to indicate the etiology of the disturbance: respiratory (indicating a change in the partial pressure of carbon dioxide), [25] or metabolic (indicating a change in the Base Excess ...
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.
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. If the body experiences one of these derangements, the body will try to compensate by inducing an opposite process (e.g. induced respiratory alkalosis for a primary metabolic acidosis). [7]
It can also occur as a compensatory response to chronic metabolic alkalosis. [citation needed] One key to distinguish between respiratory and metabolic acidosis is that in respiratory acidosis, the CO 2 is increased while the bicarbonate is either normal (uncompensated) or increased (compensated). Compensation occurs if respiratory acidosis is ...