Diagnosis | Acidosis


An acidosis is determined by a so-called blood gas analysis. For this purpose, an arterial blood sample is taken (usually from an artery in the forearm) or a few drops of blood are taken from the earlobe after the application of a vasodilating ointment. A detailed anamnesis interview should reveal possible causes.

In order to further determine the cause, various values are determined in the blood and urine. The blood sugar level can also be determined. If the cause is respiration-related, an X-ray examination of the lungs is often carried out, as well as various lung function tests. An examination in a sleep laboratory can also be useful.

Can you smell acidosis?

In principle, acidosis is a disease of the blood, which can be accompanied by serious consequences for the organs. Only when the metabolic processes involved in the acid-base balance are adapted to produce products that are breathed out or otherwise excreted, acidosis can also cause odours. This process typically occurs in diabetics.

Due to the insulin deficiency, an apparent lack of energy occurs in this clinical picture despite an increased glucose level in the blood, since the glucose cannot be absorbed into the cells. As a consequence, as in severe periods of fasting and hunger, fat is burned and so-called “ketone bodies” are formed to provide the cells with alternative energy. The ketone bodies can cause a typical acetone smell in the air we breathe, which can smell like nail polish remover or fermented fruit. Unconscious persons with a strong smell of acetone may suffer from a severe diabetic derailment with acidosis and coma.

Consequences of acidosis

Acidosis can be accompanied by many metabolic changes and noticeable symptoms. It can be accompanied by severe life-threatening consequences, which is why the body tries to compensate for acidosis by means of various compensatory mechanisms. Direct consequences can be shortness of breath, deep breathing, blue lips, fatigue, fainting or coma.

Due to metabolic processes that lead to the excretion of the acid, the amount of urine may be increased, weakness, muscle cramps and fatigue may occur and severe cardiac arrhythmia may occur. All these are dangerous direct consequences of acidosis. In extreme cases, if the acidosis cannot be compensated quickly, life-threatening consequences such as shock, cardiac arrest or coma can occur.


The prognosis for acidosis depends strongly on the causative disease. Severe acidosis is an emergency situation and should therefore be clarified immediately by a doctor. Some acute illnesses can disappear completely with therapy, in some chronic lung diseases only an improvement can be achieved.


Since acidosis is a symptom of various diseases there is no general prophylaxis. The underlying disease should be treated and controlled (e.g. cessation of sugar disease diabetes). Many of the lung-dependent causes have nicotine as their main cause (especially in COPD). Therefore, complete nicotine abstinence is the most important preventive measure for these diseases.