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Simple acid-base disturbance is a primary pathophysiologic process that is either acidosis
or alkalosis and it is an appropriate compensatory mechanism. There are several things that take
place in simple acid-base disturbance (Adrogué et al., 2009). First, there is a primary
pathophysiologic process and then there is a compensatory mechanism. A combined acid-base
disturbance on the other hand is a situation where one has more than one primary process taking
place accompanied by several compensatory mechanisms. There are several examples of the
simple acid-base disturbance. For instance, if a patient who has diabetic ketoacidosis stops using
insulin will start breathing very fast. In this case, the person will have diabetic ketoacidosis and
the compensatory respiratory alkalosis that accompanies it.
On the other hand, combined acid-base disturbance will occur if the same patient stops
taking the insulin, develops gastro-paresis that is very severe, and starts vomiting. The person
will end up having diabetic ketoacidosis together with the kind of compensatory mechanism that
it entails. In addition to this, the patient will have a metabolic alkalosis that comes from
vomiting. The major difference between simple and combined acid-base disturbance is that the
simple acid-base disturbance only involves the first or initial disturbance of the status of acid-
base which is accompanied by the appropriate compensation level. Contrary, combined acid-base
disturbance entails a concurrent manifestation of acid-base disturbance that occurs more than
once. The only thing that helps in differentiating the two acid-base disturbances is their pH
(Berend et al., 2014). For instance, the patient is always either acidemic or alkalinic. If the
patient is acidemic then acidosis would be taking place and if the same patient is alkalinic then
alkalosis would be automatically taking place.
3
References
Adrogué, H. J., Gennari, F. J., Galla, J. H., & Madias, N. E. (2009). Assessing acid–base
disorders.
Kidney international
,
76
(12), 1239-1247.
Berend, K., de Vries, A. P., & Gans, R. O. (2014). Physiological approach to assessment of acid–
base disturbances.
New England Journal of Medicine
,
371
(15), 1434-1445.
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