SIRS,
Sepsis, and Lactic Acidosis
Our patient, who has symptoms
indicative of pneumonia, is at a risk to develop a pH disturbance. Respiratory acidosis may result from the lung
infection or lactic acidosis may develop in response to septic shock.
The balance of acids and bases are
important in the human body. The power
of hydrogen (pH) is how we measure the acid base balance. A higher pH reading
is less acidic than a lower pH reading (Huether & McCance, 2008). PH is balanced in several ways by our bodies
and measured in the blood. The main
organs that regulate blood pH are the lungs and kidneys according to T.L.Bland
(personal communication, Feb.13, 2008).
The body’s normal metabolism generates acids, which
require elimination in order to maintain normal pH. An imbalance may result in acidosis, when the
pH is less than 7.35, or alkalosis when the pH is greater than 7.45. The lungs respond accordingly by retaining
carbon dioxide (CO2) if the alkalosis occurs or breathing out more CO2 if
acidosis occurs. The kidneys respond to
ph changes with bicarbonate which is a base that increases the pH or the
kidneys give off acids in the urine if the pH is acidic. The compensatory lungs improve results in
minutes while the kidney compensatory mechanism requires hours to days although
both responses may occur simultaneously (http://labtestsonline.org/understanding/conditions/acidosis.html).
Acid base disorders are divided into
acidosis (low pH) or alkalosis (high pH).
The disorders are identified as respiratory or metabolic according to
the factor that has changed. For example
CO2 concentration changes indicate respiratory while bicarbonate concentration
(HCO3-) changes indicate metabolic changes.
The respiratory and metabolic entities may compensate each other in
order for the body to work in harmony (http://labtestsonline.org/understanding/conditions/acidosis.html).
According to T.L. Bland, the
arterial blood gasses (ABG’s) respond to severe pneumonia with low pH resulting
in acidosis with slightly elevated HCO3 and partial pressure of CO2 in arterial
blood (Paco2) when tissue hypoxia is severe enough to produce lactic acid. Lactic acidosis can also occur with septic
shock (Huether & McCance 2008). Tissue hypoxia results when the body’s
demand for oxygen is higher than the supply.
Anaerobic metabolism creates lactic acid build up resulting in lactic
acidosis.
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