Fig. 2.
Schematic (non-proportional) development of acid-base status using the Stewart-Fencl approach. a Day 0: admission, severe metabolic acidosis due to ethylene glycol and its metabolites. Low bicarbonate is partly caused by renal failure. b Day 16: admission to tertiary centre, severe metabolic alkalosis, high SID made by markedly elevated bicarbonate level. c Day 19: normal pH achieved by dialysis removal of abundant bicarbonate and by rising hyperproteinemia. d Day 22: restoration of normal conditions. Atot–, weak acids; Pi–, inorganic phosphate; SID, strong ion difference; XA–, unmeasured anions, i.e., lactate; Cl–, measured chloride.