Metabolic acidosis

Dr.Vijula.A, junior resident ,MD general medicine, Thoothukudi Medical College And Hospital

Abstract

The ability of early life began with its capability to carry its internal ocean with them. To
maintain life an organism must maintain the constancy of internal ocean despite diet, fluid
intake, and other environmental condition. Acid base balance, water balance, osmolarity,
electrolytes are maintained in constancy by internal chemistries. Though commonly faced,
metabolic derangements are misinterpreted and poorly managed. Step wise and schematic
approach of acid base helps us to manage acid base disorders in a better way. Patients
rarely present with the complaint of “I have acidosis”. Hence, interpretation and foreseeing
the complications of each condition causing metabolic acidosis is necessary for prompt
treatment. Putting simply, the body’s goal is to eliminate the large burden of acid generated
in the creation and storage of energy required for cellular metabolism. Acid base
metabolism is a process by which proton synthesis during normal energy production is
eliminated. The pH is maintained between 7.35 and 7.45 by several intricate processes
between the renal and respiratory systems. Instead thinking acid base disorder as numbers,
arrows and charts, cause should be considered as a process, traced, and treated. The
following steps must be followed while treating metabolic acidosis like history ,drug / toxin
intake, physical examination, interpretation, finding associated acid base derangements
with anion gap, and delta anion gap, diagnosis and treatment of the same.