STEPWISE ALGORITHM: ACID–BASE DISORDER INTERPRETATION

START → CHECK pH

↓

pH < 7.35 → ACIDEMIA

pH > 7.45 → ALKALEMIA

↓

CHECK PRIMARY CHANGE

• PaCO₂ abnormal → RESPIRATORY

• HCO₃⁻ abnormal → METABOLIC

↓

ASSESS COMPENSATION

• Metabolic acidosis → Winter’s formula

• Metabolic alkalosis → Expected PaCO₂ rise

• Respiratory disorders → Acute vs chronic pattern

↓

IF METABOLIC ACIDOSIS → CALCULATE ANION GAP

AG = Na⁺ − (Cl⁻ + HCO₃⁻)

• AG 8–12 → Normal AG acidosis

• AG >12 → High AG acidosis

↓

CHECK FOR MIXED DISORDERS

• Normal pH with abnormal PaCO₂ & HCO₃⁻

• Compensation inappropriate

• Use delta gap if needed

END → CORRELATE WITH CLINICAL CONTEXT

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