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Copyright ©The Author(s) 2018.
World J Diabetes. Nov 15, 2018; 9(11): 199-205
Published online Nov 15, 2018. doi: 10.4239/wjd.v9.i11.199
Table 1 Clinical effects of metabolic acidosis[27,28]
SystemClinical effects
CardiovascularDepressed myocardium contractility
Changes in SVR
Acidosis-aided catecholamine release opposes acidosis-mediated vasodilation.
Net SVR depends on the sum of both effects
Conduction defects and dysrhythmias
Impaired response to exogenous vasopressors
PulmonaryIncreased work of breathing and respiratory failure
Compensatory alveolar hyperventilation
Dyspnea (Kussmaul’s breathing)
Acute decrease in hemoglobin oxygen affinity (Bohr Effect)
Temporary: Affinity rises after 36 h due to depletion of RBC 2,3-DPG
RenalPseudo-hyperkalemia
Hyperuricemia
Hypercalcemia
Hematological effectImpaired coagulation
Thrombocytopenia
Reduced fibrinogen and thrombin formation
Impaired clotting factor function
Factor Va
Factor VIIa
Factor VIIa/tissue factor complex
EndocrineInsulin resistance
Catecholamine, cortisol, PTH and aldosterone stimulation
Bone demineralization
Protein wasting
Free radical formation
Musculoskeletal systemAnti-anabolic effect on the bone growth centers in chronic metabolic acidosis
Muscle fatigue
Central nerve systemCerebral edema
Depressed sensorium
Immune systemImpaired leukocyte function
Increased susceptibility to infections