Respiratory Changes and Acid–Base Compensation: Watch the Salt

Editorial| January 2024 Respiratory Changes and Acid–Base Compensation: Watch the Salt This article has an Audio Podcast David A. Story, M.D., F.A.N.Z.C.A. David A. Story, M.D., F.A.N.Z.C.A. 1Department of Critical Care; Melbourne Medical School, The University of Melbourne, Melbourne, Australia. https://orcid.org/0000-0002-6479-1310 Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information This editorial accompanies the article on p. 116. Accepted for publication September 10, 2023. Address correspondence to Dr. Story: Anesthesiology January 2024, Vol. 140, 1–3. https://doi.org/10.1097/ALN.0000000000004762 Connected Content Article: Combining the Physical–Chemical Approach with Standard Base Excess to Understand the Compensation of Respiratory Acid–Base Derangements: An Individual Participant Meta-analysis Approach to Data from Multiple Canine and Human Experiments Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation David A. Story; Respiratory Changes and Acid–Base Compensation: Watch the Salt. Anesthesiology 2024; 140:1–3 doi: https://doi.org/10.1097/ALN.0000000000004762 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: dietary sodium chloride, salts, sodium chloride, base excess, carbon dioxide measurement, partial pressure Imagine you are asked to assess this room air arterial blood gas (ABG): Pao2 25 mmHg, Spo2 50%, pH 7.53, Paco2 13 mmHg, bicarbonate 11 mM, base excess −6.9 mM. Apart from thinking “My goodness!,” or similar thoughts, you will likely diagnosis life- threatening hypoxemia, alkalemia with a mixed picture of respiratory alkalosis and metabolic acidosis, as you look to ensure that the patient is being resuscitated. However, the ABG is the summary results from very fit and fully conscious people, and although this ABG is on “room air,” it was taken on Mount Everest at 8,400 m (27,500 feet) as climbers safely descended from the nearby summit.2 This high-altitude ABG is an extreme example of chronic respiratory alkalosis and associated metabolic (nonrespiratory) compensation. In this issue of Anesthesiology, Zadek et al.3 report a sophisticated individual participant meta-analysis of physiologic... You do not currently have access to this content.