Description
Thorough investigation of complex cases of acid-base disturbances indudes verification of pH, determination of respiratory and metabolic components, calculation of the anion gap, assessment of the degree of compensation; and analysis of the relationship among anions in the blood. In patients with suspected metabolic alkolosis, use the urinary chloride level to help differentiate between a saline-responsive and saline-resistant condition. In the evaluation of normal union gap metabolic acidemia, urinary electrolytes and the calculation of the urine delta gap may help differentiate between renal and stool biocarbonate wasting. In cases of severe acidemia, knowledge of the patient's serum potassium level is critical to formulation of the appropriate treatment strategy.