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Disease states classified according to the Stewart approach |
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| Acid–base disturbance |
Disease state |
Examples |
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| Metabolic alkalosis |
Low serum albumin |
Nephrotic syndrome, hepatic cirrhosis |
| High SID+ |
Chloride loss: vomiting, gastric drainage, diuretics, post-hypercapnea, Cl- wasting diarrhea due to villous adenoma, mineralocorticoid excess, Cushing's syndrome, Liddle's syndrome, Bartter's syndrome, exogenous corticosteroids, licorice Na2+ load (such as acetate, citrate, lactate): Ringer's solution, TPN, blood transfusion |
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| Metabolic acidosis |
Low SID+ and high SIG |
Ketoacids, lactic acid, salicylate, formate, methanol |
| Low SID+ and low SIG |
RTA, TPN, saline, anion exchange resins, diarrhea, pancreatic losses |
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RTA, renal tubular acidosis; SIG, strong ion gap; SID+, strong ion difference; TPN, total parenteral nutrition. | ||
Corey Critical Care 2005 9:184 doi:10.1186/cc2985 |
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