1/21 Acid–base interpretation often feels like a maze. But there’s a simple way to make sense of it at the bedside. It starts with pH, strong ions, and base excess.
2/21 First: what is pH? pH = the concentration of hydrogen ions, which come from water splitting into H⁺ and OH⁻. Anything that changes how much water dissociates changes pH.
Wonderful @icmteaching , thank you. I have a question about base excess: As far as I understood, BE by itself does not provide information about the underlying condition and could be perfectly normal in the case of multiple conditions acting in opposite directions. So, as you stated, it only size quantitatively the metabolic acidosis. In case of profound negative BE, does a relation exist with AG in order to "estimate" the numbers of triggers involved? Otherwise does It make sense comparing "residual negative" with lactacidemia to sort out the presence of other multiple masked unmeasured anions (urea, phosphates, ketones ecc)? For example very high AG and very negative BE in a patient with profound pure high AG acidosis, hyperlactacidemia and AKI (⬆️urea). I cannot dose serum ketones where I work so it's tricky sometimes (es. Euglycemic DKA)
@icmteaching One of your Best Threads! Thank you so much!
@icmteaching Terrific tutorial. Thank you for breaking SID in simple terms
@icmteaching What a wonderful discussion… loved it 👌
