Disturbances in acid-base metabolism. Recognition in the office setting

Determination of the appropriateness of the compensatory response is essential in evaluation of any acid-base disturbance. Adequate compensation supports the presence of a single acid-base event. Inadequate compensation may indicate that a second primary acid-base event is present or, in some circumstances, that time has been inadequate for maximal physiologic compensation. When acid-base disturbances are mixed, treatment of one disorder may unmask the full pH-altering potential of the second disorder. Close monitoring of patients at risk for the development of acid-base disorders permits detection of problems at a time when intervention may prevent serious complications. Relatively inexpensive and easy-to-use chemical analytic systems to assist early diagnosis are now present in many office-based laboratories.