Acid-base imbalance: a review with proposed unified diagnostic algorithm

Abstract

Introduction: Alterations in the acid-base balance are studied in all medical specialties. Although most cases derive from a preexisting pathology, they can also manifest themselves in a primary context. The proper identification of the acid-base disorder allows the pathological process to be characterized. The correct interpretation of the blood gasometry as a technique for monitoring the ventilatory status, oxygenation and acid-base balance of a patient requires the integration of various physicochemical approaches in order to specify a diagnosis, quantify a therapeutic response, and monitor the severity or the progression of a pathological process. Methodology: A literature review was conducted in the PubMed, Scopus and Science Direct databases. The articles were selected according to the title and the abstract and sorted by topics relevant by pathophysiology, divergences, clinical approach, diagnosis, and management. Results: A guide the clinical correlation of the critical patient with the blood gasometry parameters to characterize the acid-base disorder through the proposition of a diagnostic algorithm. Conclusion: The incorporation of the three theories in a diagnostic algorithm facilitates a greater understanding of the pathophysiological mechanisms and allows us to identify a more precise therapeutic objective to correct the underlying disorder in the different clinical contexts of the patient.

Keywords

• Acid-base imbalance, blood gas analysis, diagnosis, algorithms.