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Review
. 2025 Aug;40(4):774-792.
doi: 10.1002/ncp.11328. Epub 2025 Jun 8.

Breathing and balance: Clinical insights and management strategies of respiratory acid-base disorders

Anne M Tucker  1 , Tami N Johnson  1
Affiliations
Review

Breathing and balance: Clinical insights and management strategies of respiratory acid-base disorders

Anne M Tucker et al. Nutr Clin Pract. 2025 Aug.

Abstract

Respiratory acidosis and alkalosis are two of the four main acid-base processes encountered in clinical practice. These two processes are tightly balanced by breathing. Identification and management of respiratory acid-base disorders are important for clinicians, particularly when caring for patients with underlying pulmonary and neurological conditions. Basic knowledge of respiratory function, alveolar gas exchange, and innate compensation concepts can provide clinicians with the tools to design safe and effective nutrition care plans. These concepts will also aid in monitoring response to medical interventions and drug therapy. An overview of these ideas and management strategies is provided in this review.

Keywords: acidosis; acid‐base balance; acid‐base disorders; alkalosis; respiratory.

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Conflict of interest statement

Anne M. Tucker serves as a paid consultant for Up to Date, Inc. Tami N. Johnson declares no conflict of interests.

Figures

Figure 1
Figure 1
Carbonic acid and bicarbonate buffer system.
See this image and copyright information in PMC

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