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Common causes of acid-base disorders

Respiratory acidosis
Reduced CO2 elimination

  • Decreased respiratory drive (due to drugs or central nervous system disorders)
  • Hypoventilation
  • Lung disease
  • Respiratory muscle/nerve disease (myasthenia gravis, botulism, amyotrophic lateral sclerosis, Guillain-Barré syndrome)

Respiratory alkalosis
Increased CO2 elimination

  • Hyperventilation (due to anxiety, pain, shock)
  • Severe infection or fever
  • Liver failure
  • Pneumonia, pulmonary congestion or embolism

Metabolic acidosis
Decreased HCO3-, due to loss or to increased acid

  • Alcoholic ketoacidosis
  • Diabetic ketoacidosis
  • Kidney failure
  • Lactic acidosis
  • Toxins (overdose of salicylates [aspirin], methanol, ethylene glycol, toluene)
  • Gastrointestinal bicarbonate loss, such as from prolonged diarrhoea

Metabolic alkalosis
Increased HCO3-, due to gain, or to loss of acid

  • Diuretics
  • Prolonged vomiting
  • Severe dehydration

Last Review Date: April 5, 2017