A patient has mild metabolic acidosis from a not-too-severe diabetic decompensation leading to keto-acidosis. The patient's...

A patient has mild metabolic acidosis from a not-too-severe diabetic decompensation leading to keto-acidosis. The patient's pH is 7.49 with a bicarbonate = 16mM. What is the most likely explanation for these data?

a) this is compatible with a single acid-base

b)diabetic ketoacidosis, with appropriate respiratory compensation

c) solely from this data, you can determine that there is a simultaneous metabolic alkalosis

d) these numbers can be explained by a simultaneous respiratory alkalosis

e) the patient's respirations are probably about 7 per minute and shallow, with the smell of acetone

Solutions

Expert Solution

Option B- diabetic ketoacidosis, with appropriate respiratory compensation .

The body initially buffers the change with the bicarbonate buffering system, but this system is quickly overwhelmed and other mechanisms must work to compensate for the acidosis. One such mechanism is hyperventilation to lower the blood carbon dioxide levels (a form of compensatory respiratory alkalosis).

The respiratory compensation for metabolic acidosis involves a decrease in PCO2.

The normal blood pH is tightly regulated between 7.35 and 7.45.

Normal bicarbonate levels are: 23 to 30 mEq/L in adults.

in the given condition ph is maintained normally,but the bicarbonate level falls this indicates that the compensation is by respiration and not by buffer system.

The deep and rapid sighing respiration, called Kussmaul's respiration, in patients suffering DKA provides clinical evidence of this compensatory mechanism. The patient is said to be either fully compensated if pH is within the normal range, or partially compensated if pH remains below the lower limit of normal.

Sydney Mullin answered 11 months ago

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