Quantitative Displacement of Acid-Base Equilibrium in Metabolic Acidosis

Article1 February 1967Quantitative Displacement of Acid-Base Equilibrium in Metabolic AcidosisMORRIS S. ALBERT, M.D., RALPH B. DELL, M.D., ROBERT W. WINTERS, M.D.MORRIS S. ALBERT, M.D., RALPH B. DELL, M.D., ROBERT W. WINTERS, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-2-312 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMetabolic acidosis is commonly encountered in a variety of disorders, all of which are characterized either by the gain of strong acid or by loss of bicarbonate from the extracellular fluid (1). In either case, the primary effect upon the acid-base composition of blood is a fall in the concentration of the metabolic component, and this can be measured either by a change in the concentration of whole blood buffer base (that is, the base excess, which in this case assumes a negative value) or by a fall in the concentration of bicarbonate in the plasma or both. Given this...References1. WINTERS RW: Terminology of acid-base disorders. Ann. Intern. Med. 63: 873, 1965. LinkGoogle Scholar2. MITCHELLCARMANSEVERINGHAUSRICHARDSONSINGERSHNIDER RACTJWBWMMS: Stability of cerebrospinal fluid pH in chronic acid-base disturbances in blood. J. Appl. Physiol. 20: 443, 1965. CrossrefMedlineGoogle Scholar3. MITCHELLSINGER RAMM: Respiration and cerebrospinal fluid pH in metabolic acidosis and alkalosis. Ibid., p. 905. Google Scholar4. ALBERTWINTERS MSRW: Acid-base equilibrium of blood in normal infants. Pediatrics 37: 728, 1966. MedlineGoogle Scholar5. SIGGAARD-ANDERSEN O: The Acid-Base Status of the Blood, 2nd ed. The Williams & Wilkins Co., Baltimore, 1964. Google Scholar6. FINBERG L: Pathogenesis of lesion in the nervous system in hypernatremic states. I. Clinical observations of infants. Pediatrics 23: 40, 1959. MedlineGoogle Scholar7. WINKLERELKINTONHOPPERHOFF AWJRJHE: Experimental hypertonicity: alterations in the distribution of body water and the cause of death. J. Clin. Invest. 23: 109, 1944. CrossrefGoogle Scholar8. KETYPOLISNADLERSCHMIDT SSBDCSCF: The blood flow and the oxygen consumption of the human brain in diabetic acidosis and coma. J. Clin. Invest. 27: 500, 1948. CrossrefGoogle Scholar9. STEELJORRIE RGJH: Principles and Procedures of Statistics. McGraw Hill Book Co., New York, 1960. Google Scholar10. POPPELLVANAMEEROBERTSRANDALL JWPKEHT: The effect of ventilatory insufficiency on respiratory compensation in metabolic acidosis and alkalosis. J. Lab. Clin. Med. 47: 885, 1956. MedlineGoogle Scholar11. MØLLER B: Hydrogen ion concentration in arterial blood. A clinical study of patients with diabetes mellitus and diseases of the kidneys, lungs, and heart. Acta Med. Scand. 165 (suppl. 348): 1, 1959. MedlineGoogle Scholar12. LENNONLEMANN EJJ: Defense of hydrogen ion concentration in chronic metabolic acidosis. A new evaluation of an old approach. Ann. Intern. Med. 65: 265, 1966. LinkGoogle Scholar13. ELKINTON JR: Clinical disorders of acid-base regulation. A survey of seventeen years' diagnostic experience. Med. Clin. N. Amer. 50: 1325, 1966. CrossrefMedlineGoogle Scholar14. KILDEBERG P: Clinical Acid-Base Physiology Studies in Neonates, Infants, and Young Children. In preparation. Google Scholar15. WINTERSLOWDERORDWAY RWJANK: Observations on carbon dioxide tension during recovery from metabolic acidosis. J. Clin. Invest. 37: 640, 1958. CrossrefMedlineGoogle Scholar16. ALBERTRAHILLVEGAWINTERS MSWJLRW: Acid-base changes in cerebrospinal fluid of infants with metabolic acidosis. New Eng. J. Med. 274: 719, 1966. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New YorkFrom the Department of Pediatrics, Columbia University, College of Physicians and Surgeons, and the Babies Hospital, Columbia-Presbyterian Medical Center, New York, N. Y.This study was supported by grants HD 00117, the National Institute of Human Development, National Institutes of Health, Bethesda, Md., and by grant U 1127, the Health Research Council of the City of New York.Drs. Albert and Dell were Postdoctoral Fellows supported by grants 1-F2-HE20, 281 and 1-F2-AM-19, 779, respectively, the National Institutes of Health, Bethesda, Md. Dr. Winters is a Career Scientist, supported by grant I-309, the Health Research Council of the City of New York.Requests for reprints should be addressed to Morris S. Albert, M.D., Babies Hospital, 3975 Broadway, New York, N. Y. 10032. 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