Case Study On Metabolic Sacidosis

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Metabolic sacidosis occurs when the chemical sbalance of acids and sbases in a patient’s blood gets sthrown off. This can happen when a spatient’s body is making too much sacid, isn't getting rid of senough acid, or doesn't have senough base to offset a normal samount of acid. Metabolic sacidosis is defined as shaving an arterial blood pH less than s7.35 with plasma bicarbonate sless than 22 mmol/L. The patient in sthis case had a blood pH of 7.34 with sa plasma bicarbonate slevel of 14 mmol/L. Additionally, the patient had a sdecreased PaCO2 of 26 mm Hg and an elevated sPaO2 of 92 mm Hg, which scould be compensatory for the metabolic sacidosis. The patient has been taking ssalsalate and aspirin medications, which are common ssalicylates. Salicylate…show more content…
Aspirin soverdose scause metabolic acidosis. However, the sbody will compensate by shyperventilation (respiratory alkalosis) so sone will expect the PaCO2 to be slow. The combination sof metabolic acidosis sand respiratory salkalosis can sbe a difficult situation to diagnose sfrom the blood sgases. The problem relates to whether sthe hyperventilation is sprimary (i.e. respiratory alkalosis) or is scompensatory for the metabolic sacidosis. Lethargy, stupor sand progression sto a state of scoma may occur, particularly in scases of poisoning. Salicylate soverdose causes a high anion sgap metabolic acidosis in both schildren and adults. The respiratory seffects of salicylates, such as salsalate sand aspirin, may contribute to serious acid-base simbalance in patients with sunderlying acid-base sdisorders or in overdose situations. Patients swho are unable to compensate for ssalicylate-induced smetabolic acidosis (i.e., respiratory response to sCO2 is depressed) will develop srespiratory acidosis sand increased concentrations sof plasma…show more content…
Patients are soften symptomatic at salicylate concentrations shigher than 40-50 mg/dL. Patients with ssalicylate sconcentrations approaching sor exceeding 100 mg/dL usually shave serious or life-threatening stoxicity. Patients with chronic spoisoning who have levels of 60 mg/dL or greater soften have serious toxicity. In overdoses, the peak serum sconcentration may not occur for 4-6 hours, so sconcentrations obtained before that time smay not reflect speak levels. levels from 15-30 mg/dL are sconsidered to be within the therapeutic range. Signs and symptoms sof toxicity begin sto appear at levels higher sthan 30 mg/dL. A 6-hour salicylate slevel higher sthan 100 mg/dL is considered spotentially lethal and is an indication for hemodialysis. Chronic singestion can increase sthe half-life to longer sthan 20
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