Acidemia
| Acidosis | |
|---|---|
| Classification and external resources | |
| Specialty | Critical care medicine |
| ICD-10 | E87.2 |
| ICD-9-CM | 276.2 |
| DiseasesDB | 87 |
| MedlinePlus | 001181 |
Acidosis is an increased acidity in the blood and other body tissue (i.e. an increased hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma.
Acidosis is said to occur when arterial pH falls below 7.35 (except in the fetus - see below), while its counterpart (alkalosis) occurs at a pH over 7.45. Arterial blood gas analysis and other tests are required to separate the main causes.
The term acidemia describes the state of low blood pH, while acidosis is used to describe the processes leading to these states. Nevertheless, the terms are sometimes used interchangeably. The distinction may be relevant where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high or a low pH.
The rate of cellular metabolic activity affects and, at the same time, is affected by the pH of the body fluids. In mammals, the normal pH of arterial blood lies between 7.35 and 7.50 depending on the species (e.g. healthy human-arterial blood pH varies between 7.35 and 7.45). Blood pH values compatible with life in mammals are limited to a pH range between 6.8 and 7.8. Changes in the pH of arterial blood (and therefore the extracellular fluid) outside this range result in irreversible cell damage.
Nervous system involvement may be seen with acidosis and occurs more often with respiratory acidosis than with metabolic acidosis. Signs and symptoms that may be seen in acidosis include headaches, confusion, feeling tired, tremors, sleepiness, flapping tremor, and dysfunction of the cerebrum of the brain which may progress to coma if there is no intervention.
Metabolic acidosis may result from either increased production of metabolic acids, such as lactic acid, or disturbances in the ability to excrete acid via the kidneys, such as either renal tubular acidosis or the renal acidosis of renal failure, which is associated with an accumulation of urea and creatinine as well as metabolic acid residues of protein catabolism.
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