Acid Base Calculator

Interpret arterial blood gas values and calculate anion gap for acid-base analysis

Acid-Base Analysis Calculator

CRITICAL CARE ASSESSMENT

FOR HEALTHCARE PROFESSIONALS ONLY

Acid-base disorders can be life-threatening. This tool aids interpretation but cannot replace clinical judgment and immediate medical intervention.

Arterial Blood Gas (ABG) Values

Normal: 7.35-7.45

mmHg

Normal: 35-45 mmHg

mEq/L

Normal: 22-26 mEq/L

Anion Gap Calculation

mEq/L

Normal: 135-145 mEq/L

mEq/L

Normal: 95-105 mEq/L

g/dL

Normal: 3.5-5.0 g/dL

Clinical Example

Case: COPD Patient with Shortness of Breath

Patient: 86-year-old male with severe COPD

Presentation: Fatigue and shortness of breath

ABG Results: pH 7.10, pCO₂ 56 mmHg, HCO₃⁻ 24 mEq/L

Electrolytes: Na⁺ 140, Cl⁻ 108, Albumin 3.3 g/dL

Interpretation

Primary Disorder: Severe respiratory acidosis

Compensation: No metabolic compensation (HCO₃⁻ normal)

Anion Gap: 8 mEq/L (normal)

Clinical Action: Improve ventilation, consider BiPAP or intubation

Normal ABG Values

pH7.35-7.45
pCO₂35-45 mmHg
HCO₃⁻22-26 mEq/L
Anion Gap8-16 mEq/L

Primary Disorders

Metabolic Acidosis

↓ HCO₃⁻, ↓ pH

DKA, lactic acidosis, uremia

Metabolic Alkalosis

↑ HCO₃⁻, ↑ pH

Vomiting, diuretics, hyperaldosteronism

Respiratory Acidosis

↑ pCO₂, ↓ pH

COPD, respiratory failure

Respiratory Alkalosis

↓ pCO₂, ↑ pH

Hyperventilation, anxiety

Compensation Rules

Winter's Formula

Expected pCO₂ = 1.5 × (HCO₃⁻) + 8 (±2)

Metabolic Alkalosis

Expected pCO₂ = 0.7 × (HCO₃⁻) + 21 (±2)

Respiratory Disorders

HCO₃⁻ changes 1-4 mEq/L per 10 mmHg pCO₂

Understanding Acid-Base Balance

Acid-Base Physiology

The body maintains acid-base balance through three systems: chemical buffers, respiratory system (controlling CO₂), and renal system (controlling HCO₃⁻). When one system fails, the others compensate to maintain pH homeostasis.

Henderson-Hasselbalch Equation

pH = 6.1 + log([HCO₃⁻] / (0.03 × pCO₂))

  • pH depends on the ratio of HCO₃⁻ to CO₂
  • Normal ratio is 20:1 (HCO₃⁻:CO₂)

Anion Gap Significance

The anion gap represents unmeasured anions in serum. An elevated anion gap suggests the presence of organic acids (ketoacids, lactate) or ingested toxins, helping differentiate causes of metabolic acidosis.

Clinical Applications

  • Rapid diagnosis of acid-base disorders
  • Assessment of respiratory/metabolic compensation
  • Detection of mixed acid-base disorders
  • Monitoring treatment effectiveness

Systematic ABG Interpretation

Step 1: pH

Determine if acidemia (<7.35), alkalemia (>7.45), or normal

Step 2: Primary

Identify if metabolic (HCO₃⁻) or respiratory (pCO₂) cause

Step 3: Compensation

Check if appropriate compensation is present

Step 4: Anion Gap

Calculate gap to determine cause of acidosis

⚠️ CRITICAL CLINICAL DISCLAIMER

FOR HEALTHCARE PROFESSIONALS ONLY. This acid-base calculator is designed for educational purposes and clinical decision support. It cannot replace comprehensive clinical assessment, laboratory correlation, and medical expertise.

EMERGENCY SITUATIONS: Severe acid-base disorders (pH <7.20 or >7.60) represent medical emergencies requiring immediate intervention. Always correlate with clinical presentation and repeat laboratory values.

Healthcare providers must independently verify all calculations and consider patient-specific factors, comorbidities, and clinical context. Complex mixed disorders may not be fully characterized by automated interpretation.

ALWAYS CONSULT with intensivist, pulmonologist, or nephrologist for complex cases or when clinical picture doesn't match calculated interpretation.