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Review
. 2005 Apr;9(2):198-203.
doi: 10.1186/cc2912. Epub 2004 Oct 20.

Clinical review: Acid-base abnormalities in the intensive care unit -- part II

Lewis J Kaplan  1 , Spiros Frangos
Affiliations
Review

Clinical review: Acid-base abnormalities in the intensive care unit -- part II

Lewis J Kaplan et al. Crit Care. 2005 Apr.

Abstract

Acid-base abnormalities are common in the critically ill. The traditional classification of acid-base abnormalities and a modern physico-chemical method of categorizing them will be explored. Specific disorders relating to mortality prediction in the intensive care unit are examined in detail. Lactic acidosis, base excess, and a strong ion gap are highlighted as markers for increased risk of death.

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Figures

Figure 1
Figure 1
Charge balance in human plasma. SIDa, apparent strong ion difference; SIDe, effective strong ion difference; SIG, strong ion gap. Reproduced with permission from [1].
Figure 2
Figure 2
Charge interaction in human plasma. The equations demonstrate the charge interactions in human plasma that serve as independent control mechanisms for pH determination (pCO2, sum of weak acids and proteins in human plasma [ATOT], and strong ion difference).
See this image and copyright information in PMC

References

    1. Gunnerson K, Kellum JA. Acid–base and electrolyte analysis in critically ill patients: are we ready for the new millennium? Curr Opin Crit Care. 2003;9:468–473. doi: 10.1097/00075198-200312000-00002. - DOI - PubMed
    1. Stewart PA. Modern quantitative acid–base chemistry. Can J Physiol Pharm. 1983;61:1444–1461. - PubMed
    1. Miller L, Waters JH. Mechanism of hyperchloremic nonanion gap acidosis. Anesthesiology. 1997;87:1009–1010. doi: 10.1097/00000542-199710000-00050. - DOI - PubMed
    1. Fencl V, Jabor A, Kazda A, Figge J. Diagnosis of metabolic acid–base disturbances in critically ill patients. Am J Respir Crit Care Med. 2000;162:2246–2251. - PubMed
    1. Abramson D, Scalea TM, Hitchcock R, Trooskin SZ, Henry SM, Greenspan J. Lactate clearance and survival following injury. J Trauma. 1993;35:584–589. - PubMed

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