Metabolic acidosis

Metabolic acidosis is a decrease in blood pH caused by a primary reduction in bicarbonate or an increase in nonvolatile acids. It is distinguished from respiratory acidosis by its primary metabolic disturbance.

Anion gap: A calculated difference between measured serum cations and anions, used to identify unmeasured ions. A raised gap can reveal acids whose anions are not included in routine electrolyte measurements.
Ketoacidosis: Metabolic acidosis caused by accumulation of ketone bodies during inadequate carbohydrate availability or insulin deficiency. Ketones add unmeasured acids and commonly raise the anion gap.
Respiratory acidosis: A decrease in blood pH caused by primary carbon dioxide retention from inadequate alveolar ventilation. Its primary disturbance is elevated carbon dioxide rather than reduced bicarbonate or added nonvolatile acid.
Henderson–Hasselbalch equation: An equation relating pH to the ratio of a weak acid’s concentration and its conjugate base. It expresses how bicarbonate and dissolved carbon dioxide jointly determine blood pH.
Hyperkalemia: An abnormally high concentration of potassium in the blood. Some acid–base disturbances and their causes can accompany elevated potassium, affecting cardiac risk.
Bicarbonate: A major blood buffer that binds hydrogen ions and helps regulate acid–base balance. Its reduction is the defining primary disturbance in many cases.
Lactic acidosis: Metabolic acidosis associated with elevated lactate, often from impaired oxygen delivery, altered metabolism, or reduced clearance. Lactate accumulation is a frequent cause of high-anion-gap acidosis.
Metabolic alkalosis: A primary increase in blood bicarbonate or loss of hydrogen ions that raises blood pH. It is the opposite direction of primary metabolic change.
Arterial blood gas: A measurement of arterial pH, carbon dioxide pressure, and oxygenation used to assess gas exchange and acid–base status. Its pH and carbon dioxide values help identify the primary acid–base disturbance.
Cardiac arrhythmia: An abnormality in the rate or rhythm of the heartbeat caused by altered electrical activity. Severe acidemia can impair cardiac function and increase susceptibility to rhythm disturbances.

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