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 2021/10/16
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).