Corrected by:
Metabolische AzidoseDtsch Med Wochenschr 2020; 145(22): e138-e138
DOI: 10.1055/a-1311-2530
Störungen des Säure-Basen-Haushalts (SBH) unterschiedlicher Ätiologie kommen im klinischen
Alltag sehr häufig vor. Jeder klinisch tätige Arzt sollte daher die Erkennung und
Therapie von Störungen im SBH beherrschen, um Patienten mit diesen Störungen optimal
zu behandeln.
Abstract
Acid-base disorders due to different etiologies are frequently encountered in daily
clinical practice and may result in life-threatening situations. Basic knowledge of
the diagnostic and therapeutic approach of acid-base disorders is therefore essential
for every clinician. Acid-base disorders should be treated according to their underlying
etiology. Therefore, diagnosis of the underlying etiology is the critical step in
the process of care for patients with acid-base disorders. Undirected buffering with
HCO3
– should be avoided, since the application of HCO3
– might lead to severe side effects. A strict diagnostic pathway for the diagnosis
of acid-base disorders is required, which should be vigorously applied:
– analysis of the pH to classify acidemia or alkalemia
– analysis of pCO2 and HCO3
– to classify the primary acid base disorder
– analysis of the adequate regulation in order to detect additional acid-base disorders
– analysis of the anion gap and the relationship of the anion gap vs. the change in
HCO3
– to detect further metabolic disorders
Metabolic acidosis can be divided into two main etiologies:
– acidosis with addition of acid with increased anion gap,
– acidosis with loss of HCO3
– with normal anion gap.
Schlüsselwörter
Säure-Basen-Störung - metabolische Azidose - metabolische Alkalose - Anionenlücke
Key words
acid base disorders - metabolic acidosis - metabolic alkalosis - anion gap
