What is Metabolic Acidosis ?

Metabolic Acidosis is excessive blood acidity, which is characterized by low levels of bicarbonate in the blood. When the increase in acidity exceeded pH buffering system, the blood will actually become acidic. Along with decreasing pH of the blood, breathing becomes deeper and more rapid as the body's effort to reduce excess acid in the blood by lowering the amount of carbon dioxide. In the end, the kidneys also try to compensate this situation by issuing more acid in the urine.

But both of these mechanisms could be exceeded if the body constantly produces too much acid, resulting in severe acidosis and end up with a coma.


CAUSE
Causes of metabolic acidosis can be grouped into three main groups:

The amount of acid in the body may increase if consuming an acid or a substance that is converted into acid. Most of the material that causes acidosis is considered toxic when eaten. Examples are methanol (wood alcohol) and an anti-freeze (ethylene glycol). An overdose of aspirin can cause metabolic acidosis.
The body can produce more acid through metabolism. The body can produce excessive acid as a result of some disease; one of them is diabetes mellitus type I. If diabetes is not well controlled, your body will break down fat and produces acids called ketones. Excessive acid is also found in advanced stages of shock, in which lactic acid is formed from the metabolism of sugar.
Metabolic acidosis can occur if the kidneys are not able to throw acid in the proper amount. Even a normal amount of acid that can cause acidosis if the kidneys are not functioning normally. Abnormalities of renal function is known as renal tubular acidosis, which can occur in patients with renal failure or patients with disorders that affect the kidney's ability to dispose of acid.

The main cause of metabolic asidois:

Renal failure
Renal tubular acidosis (renal deformities)
Diabetic ketoacidosis
Lactic acidosis (increase in lactic acid)
Toxic materials such as ethylene glycol, salicylate overdose, methanol, paraldehid, asetazolamid or ammonium chloride
Loss of base (eg bicarbonate) through the digestive tract due to diarrhea, ileostomy or colostomy.


SYMPTOMS
Mild metabolic acidosis may produce no symptoms, but usually the patient felt nausea, vomiting and fatigue. Breathing becomes deeper or slightly faster, but most patients do not pay attention to this. In line with worsening acidosis, the patient began to feel fatigue, drowsiness, nausea and experiencing more confusion. If acidosis worsens, blood pressure may fall, causing shock, coma and death.


Diagnosis
Acidosis diagnosis is usually made based on the results of pH measurement of blood taken from arterial blood (radial artery in the wrist). Arterial blood is used as an example because venous blood is not accurate for measuring blood pH. To find out the cause, made measurements of carbon dioxide and bicarbonate levels in the blood.

It may take additional tests to help determine the cause. For example, high blood sugar levels and the presence of ketones in the urine usually indicates an uncontrolled diabetes. Presence of toxic materials in the blood indicate that the metabolic acidosis that occurs due to poisoning or overdose. Sometimes done by microscopic examination of urine and measurement of urine pH.


TREATMENT
Treatment depends on the cause of metabolic acidosis. For example, diabetes controlled with insulin or poisoning treated with toxic wastes from the blood. Sometimes it is necessary to dialysis to treat severe overdose or poisoning.

Metabolic acidosis can be treated directly. In the event of a mild acidosis, which required only intravenous fluids and treatment for the cause. In the event of severe acidosis, bicarbonate may be given intravenously, but bicarbonate only provide temporary relief and may be harmful.