Na+ mEq/L pH
Cl- mEq/L pCO2 mmHg
HCO3- mEq/L Albumin g/dL
Metabolic Acidosis (Anion Gap) Metabolic Acidosis (Non-Gap) Metabolic Alkalosis Respiratory Acidosis Respiratory Alkalosis
MUDPILES
  • Methanol
  • Uremia
  • Diabetic Ketoacidosis (check serum ketones)
  • Propylene Glycol (in BZD drips) or Paraldehydes
  • Isoniazid
  • Lactic Acidosis (check serum lactate)
  • Ethylene Glycol (anti-freeze)
  • Salycylates
GOLDMARK
  • Glycols (ethylene or propylene)
  • Oxoporin (reflects fatty liver damage from glutathione consumption, e.g. acetaminophen toxicity)
  • L-Lactate
  • D-Lactate (bacterial form)
  • Methanol
  • Aspirin (salycylate)
  • Renal Failure (BUN uremia)
  • Ketoacidosis
GI Loss
  • Diarrhea / Laxatives
  • Fistula, (pancreatic, biliary)
  • Uretero-intestinal diversion (ileal conduit)
Renal Loss
  • Renal Tubular Acidosis (Type 1 Distal or Type 2 Proximal)
  • Renal Failure
  • Hyper-kalemia
Exogenous Acid
  • HCl
  • Amino Acids
FUSED CARS
  • Fistula (pancreatic, biliary)
  • Uretero-gastric conduit
  • Saline admin (dilutional acidosis)
  • Endocrine (hyper-PTH)
  • Diarrhea
  • Carbonic anhydrase inhibitor (acetazolamide)
  • Ammonium chloride
  • Renal tubular acidosis
  • Spironolactone
Alkaline Input
  • Bicarbonate Infusion
  • Hemodialysis
  • Calcium Carbonate
  • Parenteral Nutrition
Proton Loss
  • GI Loss (vomiting, NG suction)
  • Renal loss
  • Diuretics
  • Mineralocorticoids
Airway Obstruction
  • Foreign body, aspiration
  • OSA (obstructive sleep apnea)
  • Laryngo- or broncho-spasm
Neuromuscular
  • Myasthenia gravis
  • Hypokalemic periodic paralysis
  • Guillain-Barre
  • Botulism, Tetanus
  • Hypo-kalemia, hypo-phosphatemia
  • Cervical spine injury
  • Morbid obesity
  • Polio, MS, ALS
Central
  • Drugs (opiates, sedatives)
  • Oxygen treatment in acute hypercapnia
  • Brain trauma or stroke
Pulmonary
  • Pulmonary edema
  • Asthma
  • Pneumonia
  • ARDS
  • COPD
  • Pulmonary Fibrosis
Mechanical Ventilation
Hypoxia
  • High altitude
  • CHF
  • Pulmonary Embolism
Lung Disease
  • Pulmonary fibrosis
  • Pulmonary edema
  • Pneumonia
Drugs
  • Progesterone
  • Nicotine
Stimulation of Respiratory Drive
  • Psychogenic
  • Neurologic (pontine tumor)
  • Sepsis
  • Pregnancy
  • Mechanical ventilation