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x=

Anion Gap = (Na + K) - (CI + HCOr) Nornral =

10

o
@

o
7
--t

- l8mmol/l

If the precise acid-base derangement is not immediately clear (e.g. middle column) then remember the
following points:
Always cotrsicler tlre clinical context when irrterpreting
acid-base status.
Metabolic co{-npensation takes days to occtlr, re$.Piratory
compensation takes minutes.
Overcompensation does not occur.
An apparent compensatory resPonse cor.rld represent an opposing

o
z

(,

BE (-2 to +2)

(22-28 mmol/l)

pH (7.3$-7.a5)

Note that with a very mild acidaemia or alkalaemia both PaCO2 and
HCO, may be just within the "normal range" (considered to be a mild
mixed acid-base disturbance).

H' (35-45 nmoll)

lF'

z --'

i ) f r,
rlLL

n
!
n

m
i

PaCO2: 4.7-6.0 kFb

or 3F-45 mmHg

HCO3 st

C,v,

Normal values

prinrary process.

Use the flow chart opposite to broadly classify acid-base status.

If the patient has a metabolic acidosis, calcr-rlate the anion gap to narrow down the differential diagnosis.

/+

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tArst

Normal pH
7 -35-7.45

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n
m
+

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lt\^-i (9{

Ery

q*g.:
Figure 22 Acid-bose

less-0rar 7.1?

1ft4

pttnafy
alllosb

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</1

stotus.

55