Metabolic acidosis

If the metabolism of the organism is out of balance, this can lead in untreated cases to coma and general poisoning, which can even be fatal. A metabolic acidosis is therefore a complication that should be treated promptly.

What is Metabolic Acidosis?

Acidosis is a well-known condition in which the pH value shifts in such a way that there is an increase in the acidic components.

For this reason, over-acidification is achieved within the metabolism, which leads to damage to individual organs. Will the pH level in the blood during a metabolic acidosis measured, results below 7.36 due to an increase in the concentration of hydrogen ions are not uncommon.

This parameter is extremely worrying and indicates an increase in the acid content in the metabolism. This has to do with a derailment of the so-called acid-base balance.

causes

As a causal trigger for a metabolic acidosis several criteria come into question. The balance between acids and bases in the body's own metabolism can shift if people with diabetes mellitus have too high a sugar concentration as part of hyperglycaemia or if fewer hydrogen ions can be excreted due to a loss of kidney function.

Other causes of metabolic acidosis are urea poisoning, persistent hunger and persistent high-grade diarrhea. Diseases such as Addison's disease, extensive burns, poisoning with methanol (alcohol) or fistulas that are in the stomach can also trigger metabolic acidosis.

In all causes of metabolic acidosis, there is either an increased accumulation of hydrogen ions, an additional excretion of bicarbonates or a "build-up" of hydrogen ions.

Typical symptoms & signs

• Shortness of breath
• Hyperventilation
• Frequent urination
• Bad breath
• a headache
• Low resilience
• Cardiac arrhythmias
• Low blood pressure (hypotension)

Diagnosis & course

A metabolic acidosis triggers an increased breathing rate (hyperventilation) in order to rebalance the metabolism through increased exhalation of hydrocarbon ions. This special kind of breathing is called Kussmaul's breathing in medicine.

It usually occurs when there is a metabolic imbalance caused by diabetes mellitus. Another side effect of metabolic acidosis is the fruity odor from the mouth and urine of those affected. Clinically, metabolic acidosis also comes to the fore as a result of decreased blood pressure. Heart rhythm disturbances are also noteworthy in metabolic acidosis. Deep unconsciousness can also occur.

The diagnosis of metabolic acidosis relates to clinical abnormalities and deficits in general well-being on the values ​​of the laboratory measurements. In metabolic acidosis, these include parameters such as creatinine and urea nitrogen in the serum, bicarbonate in the serum and urine, and primarily the pH of the urine. A further diagnosis can be carried out in the case of metabolic acidosis by means of the carbon dioxide partial pressure.

Complications

In the worst case, this disease leads to the death of the patient. It must therefore be treated by a doctor, so that there are no consequential damage or other complications. As a rule, those affected suffer from severe shortness of breath and also from hyperventilation. The shortness of breath can also lead to a loss of consciousness, which can lead to a fall and possibly injuries.

The internal organs may also be undersupplied and damaged due to the shortness of breath. Furthermore, there is a very bad breath of breath, which can be very unpleasant for those affected and for outsiders. This can lead to social tension. Furthermore, the patient's resilience drops significantly as a result of the illness and severe headaches occur.

The heart is also affected by the disease, which leads to disorders of the heart rhythm and low blood pressure in the patient. The patient's quality of life is significantly reduced. Treatment usually takes place with the help of medication. The patient may also need dialysis to prevent death. This disease may reduce the person's life expectancy.

When should you go to the doctor?

A doctor's visit is advisable as soon as there is a feeling of illness or decreased performance. In the case of bad breath, headaches or decreasing physical and mental resilience, a doctor is required. Fatigue, fatigue and rapid fatigue are signs of an existing discrepancy.

If the daily obligations can no longer be fulfilled, the person concerned needs medical help. Disorders of the heart rhythm, strong palpitations or an increased pulse rate should be examined and treated. A sudden low blood pressure is a warning signal from the organism. A doctor visit is necessary so that a diagnosis can be made and treatment initiated. If breathing disorders occur, a doctor should also be consulted.

Hyperventilation, a lack of oxygen, or fear of breathing difficulties should be reported to a doctor. If the skin is blue or the fingers and feet are cold, the organism is insufficiently supplied with oxygen. A medical check-up is therefore necessary as soon as there is a strong sensation of cold or blue lips. In the event of acute respiratory distress, an ambulance must be alerted. Until it arrives, first aid measures must be taken to ensure an adequate supply of oxygen. Since metabolic acidosis can lead to premature death in severe cases, a doctor should be consulted as soon as the first irregularities occur.

Treatment & Therapy

The metabolic acidosis is offset by emergency measures and further treatments. The acute signs of illness that occur with metabolic acidosis are increased by additional ventilation and administration of bicarbonate.

This results in an increased emission of carbon dioxide via the lungs. If metabolic acidosis occurs in patients with diabetes, the insulin level must be increased rapidly to counteract diabetic acidosis. Bicarbonates for oral administration as tablets force the equilibrium of the acid-base balance.

If it is suspected that a failure of kidney function is the original cause of metabolic acidosis, those affected can undergo blood purification and detoxification through dialysis (blood washing). An abundant supply of appropriate fluids also reduces metabolic acidosis when there is no unconsciousness.

Outlook & forecast

Without medical care, the prognosis for metabolic acidosis is extremely poor. Numerous complications, a comatose state and the premature death of the person affected can occur. It is therefore urgently advisable to consult a doctor at the first health impairment. This is the only way to ensure the survival of those affected.

Intensive medical care is required to improve health. The prospect of alleviating the symptoms therefore increases if adequate medical care is initiated at an early stage. Otherwise, a continuous increase in very unpleasant health problems can be expected. Over a long period of time there is a deterioration in quality of life, a decrease in resilience and disturbances in the heart rhythm. If there are other diseases of the heart rhythm system or organic disorders, the prognosis is also worsened. In spite of all efforts and early medical care, these patients in particular often experience long-term health impairments. In these cases, consequential disruptions can occur, which must be taken into account when making the overall prognosis.

The patient is dependent on drug therapy in the long term. They also have to have regular check-ups. Otherwise, the symptoms can relapse at any time and the disease may return.

prevention

To one metabolic acidosis To avoid using suitable prophylaxis, risk groups with a corresponding pre-existing illness should drink a sufficient amount of fluids every day and be physically active.

The amount of fluid should be at least 2500 ml per day. Metabolic acidosis can also be prevented in diabetes mellitus with the right insulin setting. People with bronchial asthma and chronic kidney disease should implement their diet and lifestyle based on their doctor's advice. Excessive consumption of alcoholic beverages and smoking are not recommended in this context as a prevention against metabolic acidosis.

Aftercare

Since a metabolic disorder can have a wide variety of causes, follow-up care must also be tailored to the individual patient. There is therefore no simple direction in follow-up care for metabolic acidosis. It often does not represent an independent clinical picture, but is the symptom or the result of another systemic disease.

Depending on the severity of the metabolic disorder, the specialist must adapt the follow-up care to the patient. In some cases, the causal disease cannot be cured, which means that follow-up care must also be permanent with regular check-ups and doctor's appointments. As a rule, the symptoms can be largely suppressed, this can be done by long-term administration of appropriate medication.

In general, aftercare can aim to alleviate the accompanying symptoms. Those affected should therefore ensure that they drink sufficient fluids in order to avoid renewed acidification.

You can do that yourself

A serious derailment of the so-called acid-base balance is a very serious disorder and potentially life-threatening. Risk groups should therefore know the typical symptoms and consult a doctor as soon as possible. The risk groups particularly include people who suffer from diabetes mellitus, patients with severe diarrhea as well as people who are chronically undernourished and alcoholics.

In addition to a number of unspecific symptoms, metabolic acidosis leads to an idiosyncratic bad breath, often described as tart and fruity. The urine also often takes on a corresponding odor note. A doctor should be sought immediately as soon as these symptoms occur. Patients can also help themselves in this situation by increasing their fluid intake. In the case of acute acidosis, the person affected should drink at least one liter of fluid promptly. Alkaline medicinal waters are particularly recommended, otherwise normal mineral water or unsweetened tea can also be drunk. In the case of incorrectly adjusted diabetics, the insulin level often has to be increased quickly. In addition, the administration of bicarbonates helps to restore the acid-base balance. Bicarbonates can be found in almost all households in the form of soda, baking soda, Bullrich's salt or baking powder.

A sufficient intake of fluids, preferably at least 2.5 liters per day, in conjunction with sufficient exercise, can also prevent acidosis in high-risk patients.