|Written by Dr.Md.Redwanul Huq (Masum)|
|Sunday, 15 January 2012 16:24|
It is a clinical condition which is developed due to accumulation of an acid other than carbonic acid in the body that causes reduction in the plasma bicarbonate.
Causes of metabolic acidosis:
- Accumulation of excessive acids in plasma:
i) Lactic acidosis
ii) Ketoacidosis (e.g. Diabetic ketoacidosis)
iii) Salicylate poisoning
iv) Methanol poisoning
2. Decreased excretion of acids from plasma:
i) Acute renal failure
ii) Chronic renal failure
iii) Distal renal tubular acidosis
3. Bicarbonate loss:
iii) Intestinal fistula.
Symptoms of metabolic acidosis are-
i) Respiratory distress
viii) Muscle pain due to cramp.
- Deep sighing breathing (Kussmaul respiration)
- Dryness of mouth
- Pulse rate – increased
- Blood pressure- decreased
- Postural hypotension
- Low JVP
- Reduced urine output
- Reflexes- depressed
Treatment of metabolic acidosis:
i) Identification and treatment of the underlying cause (if possible)
ii) If there is association with sodium and water depletion – correction accordingly
iii) IV infusion of Bicarbonate (1.26% NaHCO3) can be given if-
- Underlying cause cannot be corrected readily
- Severe acidosis (H+ concentration is more than 70 nmol/l, pH is less than 7.15)
- There is evidence of tissue dysfunction.
iv) Haemodialysis- is done as a part of treatment of metabolic acidosis in case of renal failure.