Acidosis is a condition in which there is either a production in the body of two abnormal acids – beta-hydroxybutyric and acetoacetic acids; or a diminution in the alkali reserve of the blood.
Causes The condition is usually due to faulty metabolism of fat, resulting in the production of beta-hydroxybutyric and acetoacetic acids. It occurs in DIABETES MELLITUS when this is either untreated or inadequately treated, as well as in starvation, persistent vomiting, and delayed anaesthetic vomiting. It also occurs in the terminal stages of glomerulonephritis (see KIDNEYS, DISEASES OF), when it is due to failure of the kidneys. A milder form of it may occur in severe fevers, particularly in children. (See also ACETONE.)
Symptoms General lassitude, vomiting, thirst, restlessness, and the presence of acetone in the urine form the earliest manifestations of the condition. In diabetes a state of COMA may ensue and the disease end fatally.
Treatment The underlying condition must always be treated: for example, if the acidosis is due to diabetes mellitus then insulin must be given. Sodium bicarbonate (see SODIUM) is rarely necessary for diabetic ketoacidosis; if it is used, it is invariably now given intravenously. Acidosis might be treated with oral sodium bicarbonate in cases of chronic renal failure. Anaesthetists dislike the administration of bicarbonate to acidotic patients, since there is some evidence that it can make intracellular acidosis worse. They almost always use HYPERVENTILATION of the artiﬁcially ventilated patient to correct acidosis.