Biochemical Approach of Acid-Base Disturbances

Background: The current paradigms in arterial blood gas analysis are based on mathematical or physicochemical models that require complex algorithms for interpretation. This leads to avoidance or dislike from health care professionals. Purpose: To formulate a new approach to the analysis and classification of acid base disturbances. Methodology: we conducted a systematic review of the related literature and a paradigm shift for data interpretation. Results: Acid-base disorders can be grouped and managed according to the underlying biochemical processes. Conclusions: This proposal represents a new classification, which groups acid base disorders according to the underlying causal biochemical process. Disorders with an elevated anion gap relate to alterations in cellular respiration (energy/ATP production)- All disturbances with  normal anion gap relate to transmembrane ion exchange.