What is Acidemia?

Acidemia refers to a condition in which the blood becomes too acidic, meaning its pH level drops below the normal range (7.35 – 7.45). This can disrupt normal bodily functions and lead to serious health issues. Acidemia is often a sign of an underlying metabolic or respiratory disorder and requires immediate medical attention in severe cases.

What Causes Acidemia?

Acidemia occurs when the body produces too much acid or fails to eliminate excess acid. The main types of acidemia include:

1. Metabolic Acidemia

Caused by a buildup of acidic substances in the blood due to:

• Lactic acidosis – From intense exercise, shock, or infections
• Diabetic ketoacidosis (DKA) – A complication of uncontrolled diabetes
• Renal (kidney) failure – Impairs acid removal
• Poisoning or drug overdose – From substances like aspirin, methanol, or antifreeze
• Inherited metabolic disorders – Such as propionic acidemia, methylmalonic acidemia, or isovaleric acidemia

2. Respiratory Acidemia

Occurs when the lungs fail to remove enough carbon dioxide (CO₂), leading to excess acidity. Causes include:

• Chronic obstructive pulmonary disease (COPD)
• Asthma or severe pneumonia
• Sleep apnea
• Neuromuscular disorders affecting breathing

What Are the Symptoms of Acidemia?

Symptoms depend on the severity and underlying cause but can include:

• Rapid breathing (hyperventilation) – The body tries to expel excess acid
• Fatigue and weakness – Due to impaired cellular function
• Confusion or difficulty thinking – Resulting from brain effects
• Nausea and vomiting – Common in metabolic acidemia
• Headaches – Due to increased acidity in the blood
• Irregular heartbeat (arrhythmia) – In severe cases
• Coma or seizures – In extreme acidemia cases

How Is Acidemia Diagnosed?

A doctor may perform several tests to confirm acidemia and its cause:

• Arterial blood gas (ABG) test – Measures pH, CO₂, and oxygen levels
• Serum electrolyte test – Checks bicarbonate (HCO₃⁻) levels
• Lactate test – Detects lactic acidosis
• Urinalysis – Measures acid levels in urine
• Genetic testing – For inherited metabolic disorders

What Are the Treatment Options for Acidemia?

Treatment depends on the underlying cause and severity of the acid buildup.

1. Metabolic Acidemia Treatment

• Sodium bicarbonate (baking soda IV) – To neutralize acid in severe cases
• IV fluids and electrolyte replacement – For hydration and balance
• Dialysis – If caused by kidney failure
• Insulin therapy – For diabetic ketoacidosis (DKA)
• Vitamin B12 or special diets – For inherited metabolic disorders

2. Respiratory Acidemia Treatment

• Oxygen therapy – Helps remove excess CO₂
• Ventilator support (mechanical ventilation) – For severe lung failure
• Bronchodilators and steroids – For COPD or asthma-related acidemia

Can Acidemia Cause Complications?

If left untreated, acidemia can lead to:

• Organ failure – Due to prolonged acid damage
• Shock or coma – In severe metabolic cases
• Irreversible brain damage – From extreme pH imbalances
• Cardiac arrhythmias – Leading to heart complications