Metabolische Azidose

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

Publication History

Article published online:
03 November 2020

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