Bench-to-bedside review: treating acid-base abnormalities in the intensive care unit - the role of buffers.
The recognition and management of acid-base disorders is a commonplace activity for intensivists. Despite the frequency with which non-bicarbonate-losing forms of metabolic acidosis such as lactic acidosis occurs in critically ill patients, treatment is controversial. This article describes the properties of several buffering agents and reviews the evidence for their clinical efficacy. The evidence supporting and refuting attempts to correct arterial pH through the administration of currently available buffers is presented.
Section of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois, USA.
Brian K
BK
Gehlbach
Gregory A
GA
Schmidt
D000137:Acid-Base Imbalance / Q000188:drug therapy*; D000138:Acidosis / Q000188:drug therapy*; D002021:Buffers; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D003999:Dichloroacetic Acid / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D017693:Sodium Bicarbonate / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome; D014325:Tromethamine / Q000494:pharmacology / Q000627:therapeutic use
D002021:Buffers; D014325:Tromethamine; D017693:Sodium Bicarbonate; D003999:Dichloroacetic Acid