Acidosis is a condition characterized by an excessive acidic state in body fluids, leading to a blood pH below 7.35, which can cause irreversible cellular damage. There are two main causes of acidosis: respiratory acidosis due to carbon dioxide accumulation and metabolic acidosis resulting from the body's inability to filter fixed acids or excessive acid production. Treatment varies based on the type of acidosis and may include bronchodilators, bicarbonate infusions, and specific drugs for conditions like opioid overdose.

1. Acid-Base Disorders:
a Look into Balance and Imbalance
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2. What is Acidosis?
Acidosis can be characterized as an unreasonable corrosive state of the body liquids
or tissues when the blood vessel pH falls beneath 7.35. This can be achieved either by
acid accumulation or loss of alkali. Acidemia is a condition of low blood pH, while
acidosis is the procedure which causes acidemia.
This can prompt to irreversible cell harm in outrageous cases and influence the related
organs by augmentation, achieving a scope of signs and side effects.
Since we have comprehended the nuts and bolts of Acid Base Regulation in our body,
there are two boss pathways through which acidemia happens.
- Exorbitant accumulation of carbon dioxide in the blood
- Inability of the kidney to discharge 'Fixed acids' out of the body, or the creation of
extra acid in the body, for example, lactic acid

3. What are the Sources of Acid in
the Body?
Preparing (digestion system) of starches and fats – The final product of digestion system of
carbs and fats produces energy, water and some measure of carbon dioxide. Carbon
dioxide is additionally a result of breath. Within the sight of compound carbonic
anhydrase, this CO2 consolidates with water to frame carbonic acid(H2CO3) and later on
separates to give hydrogen particle (H+) and bicarbonate (HCO3-). The H+ delivered will
tie itself to red blood cells (RBC), go to lung alveoli and again within the sight of carbonic
anhydrase, will change over to carbon dioxide gas to be discharged from the lungs.
Lactic acids and ketoacids which are created accordingly of incomplete
metabolism(without oxygen)
Breakdown of phosphates in the diet in the presence of water (hydrolysis)
Sulfuric acid, which is created after metabolism of sulfur containing acids (cysteine,
methionine)
Metabolism of cationic amino acids (arginine, lysine)

4. Classification
According to the cause, acidosis can be classified into
• Respiratory acidosis
• Metabolic acidosis

5. Respiratory acidosis will happen if the lungs are unable to expel
carbon dioxide from the body properly. This will cause a buildup
of carbon dioxide in the blood, a condition known as hypercapnia.
What is respiratory
acidosis?

6. Causes of Respiratory Acidosis
• Any condition hampering the lung function – Obstructive lung disorders such as
emphysema (damage to lung alveoli), chronic bronchitis (inflammation of bronchi),
pneumothorax (abnormal collection of air in lung space causing lung collapse), asthma
and severe pneumonia.
• Breathing disorders in sleep such as sleep apnea
• Depression of respiratory centre due to head injury
• As a compensatory response to increased alkali levels in the body
• Overdose of drugs such as opioids and sedatives
• Disorders of nerves and muscles which can result in chest compression and impaired
breathing, as amyotrophic lateral sclerosis
• Pulmonary edema
• Scoliosis

7. Treatment- Respiratory Acidosis
• Bronchodilators are used to reverse some types of
airway obstructions
• Oxygen supply should be adequate
• Non-invasive positive pressure ventilation
• Acetazolamide (for bicarbonate excretion) can
be used, but with caution
• Drug antagonists such as naloxone (for opioid
overdose) in cases of poisoning

8. Metabolic Acidosis
When there is a reduction in the amount of bicarbonate (HCO3-)
in the blood due to production of excessive acid or when the
kidneys are unable to filter out the ‘fixed’ acids, acidemia occurs
and this condition is termed as metabolic acidosis.

9. The causes of metabolic acidosis
•
• Ketoacidosis
• Lactic acidosis
• Lactic acidosis due to toxins
• Toxins converted to acids in the body
• Normal anion gap
• Bicarbonate loss from the gastro-intestinal tract – diarrhea, colostomy, enteric fistulas, use
of ion-exchange resins, excess of Calcium chloride intake, etc.
• Urologic procedures – ureteroileal conduit, ureterosigmoidostomy
• Bicarbonate loss from kidneys – hyperparathyroidism, renal tubular acidosis,
acetazolamide
• Parenteral infusions – arginine, rapid sodium chloride infusions, lysine
• Other causes – hypoaldosteronism, hyperkalemia
High anion
gap

10. Treatment-Metabolic Acidosis
• Bicarbonate infusions
• ACE inhibitors are used to lower the levels of
potassium (type 4 tubular renal acidosis)
• Insulin is given intravenously for diabetic
ketoacidosis, starvation.
• Restoration of tissue oxygen in lactic acidosis
• Drugs to counteract in cases of methanol
poisoning or salicylate poisoning

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