Acid-base disturbances can be separated by type (acidosis, alkalosis) and origin (respiratory, metabolic). in this flow chart, we have broken it down by type and then by origin, providing examples of different causes. Acidosis is due to accumulation of a respiratory acid (carbon dioxide) or metabolic acid, which can contain chloride as an anion with the hydrogen, resulting in a hyperchloremic metabolic acidosis, or a non-chloride-containing anion for the hydrogen (e.g. lactate) resulting in a high anion gap metabolic acidosis. A hyperchloremic metabolic acidosis can also be caused by loss of a base (bicarbonate). An alkalosis is caused by the converse situations; respiratory alkalosis is due to a loss of carbon dioxide in the lungs with hyperventilation) whereas metabolic acidosis is due to loss of a chloride-containing acid or gain of a base.
