Secondary or compensatory responses should NOT be designated as acidosis or alkalosis.
The committee recommended the use of the adjectives secondary or compensatory to describe the change in the composition of the blood or the process (eg ventilation) but not to modify the nouns acidosis or alkalosis. This is the practice adopted here.
Many published articles refer to compensatory processes as though they were primary processes. This lazy and incorrect use of these terms is extremely confusing so caution must be exercised and ultimately one should not be too pedantic in insisting on correct terminology in others as the practice is widespread in the clinical literature.
For example: A patient with diabetic ketoacidosis and compensatory Kussmaul respirations should be described as having a 'metabolic acidosis with compensatory hyperventilation'.
The use of the term secondary respiratory alkalosis in this case would be wrong as the change is a compensatory one and not a primary process and so by definition then it cannot be an alkalosis.
It is possible that a patient such as this could have a mixed disorder with a respiratory acid-base disorder as well as the metabolic acidosis. The interpretation of these more complicated cases is discussed in Section 8.4.
The terms acidaemia and alkalaemia may be used to describe the net pH deviation in the blood but the Ad-Hoc Committee recommended the reporting of the actual pH value or the use of the terms low, high and normal as preferable.