by "Grog" (Alan W. Grogono), Professor Emeritus, Tulane University Department of Anesthesiology
Diagram Index: Diagram   Examples   Test Yourself   Report Structure   Large Diagram 

Classical Acid-Base Examples

Blue Bar

Fully load this page before selecting the cases below.

Classical Examples:

Acute Respiratory
1. Acidosis || 2. Alkalosis

Chronic Respiratory
3. Acidosis || 4. Alkalosis

Metabolic
5. Acidosis || 6. Alkalosis

Combined
7. Acidosis || 8. Alkalosis

Complex Examples
    Case 9   ||   Case 10  

  Case 11   ||   Case 12  


Instructions:

Click on an example above
to see the position on the
diagram and description below.
Note: This diagram is
locked and does not respond.

  Your browser does not support Java, so nothing is displayed.
10. Chronic Respiratory Alkalosis with Acute Metabolic Alkalosis.

This woman lives at an altitude of two miles in Cusco, Peru. In response to hypoxemia she normally hyperventilates with a PCO2 of 28 mmHg. In partial compensation for this chronic respiratory alkalosis she normally maintains a compensatory metabolic acidosis with SBE = -4 mMol/L.

When she develops upper gastro-intestinal obstruction she vomits and, in losing gastric acid, develops a metabolic alkalosis which alters the SBE from her normal value of -4 mMol/L to zero.

If these results were reviewed with no knowledge of the patient's history, they would be mistaken for someone with an acute disturbance, e.g., acute voluntary hyperventilation, or a healthy individual being hyperventilated during minor surgery.

Acid-Base Zones

Classical Zones

The diagram shows the position of the principal zones. These zones are based on the review of the literature described by Schlichtig, Grogono, and Severinghaus. The arrows indicate typical acidosis and alkalosis. The labels in the black circles correspond to the legend in the table below.

Blue Bar

Acidosis  Slope
AR   Acute Respiratory Acidosis:  Delta SBE = 0 
CR   Chronic Respiratory Acidosis:   Delta SBE = 0.4 x Delta PCO2
M   Metabolic Acidosis:  Delta PCO2 = 1.0 x Delta SBE
Blue Bar
Alkalosis  Slope
AR   Acute Respiratory Alkalosis:  Delta SBE = 0 
CR   Chronic Respiratory Alkalosis:     Delta SBE = 0.4 x Delta PCO2
M   Metabolic Alkalosis:   Delta PCO2 = 0.6 x Delta SBE



Blue Bar
Acid-Base Tutorial
Alan W. Grogono
Small Logo Copyright Oct 2016.
All Rights Reserved
Blue Bar