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Metabolic acidosis


Metabolic acidosis is caused by increased production of hydrogen ions from metabolic causes or from excessive bicarbonate loss (pH ↓, HCO 3 − ↓).

Compensatory mechanisms are:

  • ■

    ↓ pCO 2 by hyperventilation

  • ■

    ↓ H + by kidneys (unless in renal failure).

Causes (all causes of metabolic acidosis require urgent assessment)

Excessive production of h +

  • ●

    Diabetic ketoacidosis

  • ●

    Lactic acidosis secondary to hypoxia, e.g. shock, ischaemic gut

  • ●

    Septicaemia

  • ●

    Starvation

  • ●

    Drugs, e.g. ethanol, paracetamol, salicylates

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