Metabolic acidosis in the critically ill: lessons from physical chemistry.
There is growing interest in quantitative physical chemical analysis of acid-base physiology among intensivists. Acid-base dilemmas seen in the intensive care unit are not always well addressed by the traditional approaches. Quantitative physical chemical analysis also allows for the exploration of unexplained anion-induced acidosis where the familiar anion gap is insufficient or inaccurate. This approach emphasizes the application of accepted physical chemical principles and identification of independent and dependent acid-base variables. In aqueous solutions, water dissociation is the major source of free hydrogen ions.
Kellum
J A
JA
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh Medical Center, Pennsylvania, USA. Kellum@smtp.anes.upmc.edu
D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000378:metabolism* / Q000628:therapy; D000140:Acidosis, Lactic / Q000378:metabolism / Q000628:therapy; D002245:Carbon Dioxide / Q000378:metabolism; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D016638:Critical Illness; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000378:metabolism; D012996:Solutions; D014867:Water
D012996:Solutions; D014867:Water; D002245:Carbon Dioxide; D019344:Lactic Acid