RT Book, Section A1 Kaufman, David A1 Kitching, Andrew J. A1 Kellum, John A. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Wood, Lawrence D.H. SR Print(0) ID 2295454 T1 Chapter 77. Acid-Base Balance T2 Principles of Critical Care, 3e YR 2005 FD 2005 PB The McGraw-Hill Companies PP New York, NY SN 9780071416405 LK accessanesthesiology.mhmedical.com/content.aspx?aid=2295454 RD 2023/01/28 AB The blood [H+] and pH are determined by the strong ion difference (SID), the PCO2, and the total concentration of weak acids, mostly consisting of phosphate and albumin.Both acidemia and alkalemia have potentially harmful physiologic effects, and the presence of either is related to mortality.Most acid-base derangements do not benefit from specific correction of the abnormal pH; instead, the intensivist should focus on detecting and treating the underlying condition.Acid-base disorders are easily characterized using a stepwise approach.Lactic acidosis is the most important acid-base abnormality in ICU patients. Inadequate tissue oxygenation underlies the lactic acidosis in some patients (acute hemorrhage, critical hypoxemia, cardiogenic shock) but probably does not in others (such as the resuscitated septic patient).