Compensation Rules Cheat-Sheet

Basics

Use to detect mixed disorders.

Metabolic acidosis

Expected PaCO₂ = 1.5 × HCO₃ + 8 ± 2 (Winters)

Metabolic alkalosis

Expected PaCO₂ ≈ 0.7 × ΔHCO₃ above 24

Acute respiratory acidosis

HCO₃ rises 1 per 10 ↑PaCO₂

Chronic respiratory acidosis

HCO₃ rises 3.5 per 10 ↑PaCO₂

Acute respiratory alkalosis

HCO₃ falls 2 per 10 ↓PaCO₂

Chronic respiratory alkalosis

HCO₃ falls 5 per 10 ↓PaCO₂

WardRound

WardRound

Clinical Decisions in Seconds