Mixed Acid-Base Disorders

  • John T. Harrington
  • Nicolaos E. Madias


Virtually all recent discussions of the diagnosis and management of mixed acid-base disturbances have focused exclusively on the acid-base disorders per se and have relegated the patient and the clinical setting to a subordinate position. In the 1980s several excellent reviews utilizing primarily a laboratory approach have appeared (1–3). In this laboratory-dominated approach, the acid-base data first are examined to determine whether they are consistent with any of the simple acid-base disorders; if the acid-base data do not fit, and assuming that they reflect a steady state, one can confidently conclude that a mixed acid-base disturbance is present (4). For instance, in a patient with a plasma bicarbonate concentration of 8mEq/l, the finding of a PaCO2 level substantially greater than the value anticipated for simple metabolic acidosis establishes the presence of a concomitant element of respiratory acidosis and thus the presence of a mixed acid-base disorder.


Metabolic Acidosis Lactic Acidosis Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis 
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© Kluwer Academic Publishers 1991

Authors and Affiliations

  • John T. Harrington
  • Nicolaos E. Madias

There are no affiliations available

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