Carbonic Acid / Bicarbonate Buffer System
CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3
Metabolic Acidosis and DKA
Includes the following:
Decreased pH
Low HCO3 levels
This condition occurs when acids other than carbonic acid accumulate in ECF or when there is a loss of HCO3.
Rarely occurs spontaneously but in is with other problems
(starvation, shock, trauma... but the answer you're looking for is.......
ANSWER
Diabetic Ketoacidosis (DKA)
Key Points (Information Below MerekManual Professional Version)
- Metabolic acidosis can be caused by acid accumulation due to
increased acid production or acid ingestion; decreased acid
excretion; or GI or renal HCO3− loss.
- Metabolic acidoses are categorized based on whether the anion gap is
high or normal.
- High anion gap acidoses are most often due to ketoacidosis, lactic
acidosis, renal failure, or certain toxic ingestions
- Normal anion gap acidoses are most often due to GI or renal HCO3−
loss
- Calculate delta gap to identify concomitant metabolic alkalosis, and
apply Winters formula to see whether respiratory compensation is
appropriate or reflects a 2nd acid-base disorder.
- Treat the underlying cause
- NaHCO3 is indicated when acidosis is due to a change in HCO3− (normal
anion gap acidosis)
- Intravenous NaHCO3 is controversial in high anion gap acidosis (but
may be considered when pH < 7.00, with a target pH of ≤ 7.10).
Sources:
http://www.webmd.com/diabetes/tc/diabetic-ketoacidosis-dka-topic-overview#1
http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/acid-base-regulation-and-disorders/metabolic-acidosis
