Clinical Consequences of Acid-Base Disorders
System | Acidemia | Alkalemia |
|---|---|---|
Cardiovascular | Impaired cardiac contractility Arteriolar dilation Venoconstriction Centralization of blood volume Increased pulmonary vascular resistance Decreased cardiac output Decreased systemic blood pressure Decreased hepatorenal blood flow Decreased threshold for cardiac arrhythmias Attenuation of responsiveness to catecholamines | Arteriolar constriction Reduced coronary blood flow Reduced anginal threshold Decreased threshold for cardiac arrhythmias |
Metabolic | Insulin resistance Inhibition of anaerobic glycolysis Reduction in ATP (adenosine triphosphate) synthesis Protein degradation Bone demineralization (chronic) | Stimulation of anaerobic glycolysis Formation of organic acids Decreased oxyhemoglobin dissociation Decreased ionized calcium |
Neurologic | Inhibition of metabolism and cell-volume regulation Obtundation and coma | Tetany Seizures Lethargy Delirium Stupor |
Respiratory | Compensatory hyperventilation with possible respiratory muscle fatigue | Compensatory hypoventilation with hypercapnia and hypoxemia |