acid base problems
case 1 metabolic acidosis. HCO3 = 6
Treatment of metabolic acidosis with THAM buffer
http://ajrccm.atsjournals.org/cgi/content/full/161/4/1149
interesting case from 1993 NEJM:
http://www.nejm.org/doi/full/10.1056/NEJM199302183280717
Note survival of pH 6.46!
A simple tool for deciding if small acid base disturbances are compendated or not is shown below. For a respiratory disturbance if the PCO2 is changed by 12 (from 40 to 52) (from 40 to 28) and there is no compensation by kidneys, then the pH will be changed by 0.1 (from 7.4 to 7.3) (from 7.4 to 7.5). For a purely metabolic disturbance, if the HCO3 is changed by 6 (from 24 to 18) (from 24 to 30) and there is no respiratory compensation then the pH will be changed by 0.1 (from 7.4 to 7.3) (from 7.4 to 7.5)
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