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Endogenous metabolic acid-base abnormalities: lactate and other strong ions

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Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.

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Abstract

Some of the most common clinical problems in critically ill and injured patients are disorders of acid-base equilibrium. Although alkalosis is also common and severe alkalosis may be life-threatening, acidosis appears to be the most frequently encountered acid-base abnormality and has a considerably larger differential diagnosis. Acidosis may occur as a result of increases in arterial partial pressure of carbon dioxide (pCO2) (respiratory acidosis) or from a variety of organic or inorganic, fixed acids (metabolic acidosis). There appears to be a difference in physiological variables and outcomes in patients with either respiratory acidosis or metabolic acidosis [1], [2], leading some investigators to hypothesise that the cause of acidosis rather than the acidosis per se drives the association with clinical outcomes. Although the true cause-effect relationship between acidosis and adverse clinical outcome remains uncertain, metabolic acidosis remains a powerful marker of poor prognosis in critically ill patients [3]–[5].

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Author information

Authors and Affiliations

  1. Reanimation Engineering and Shock Center (VCURES) Laboratory, Departments of Anesthesiology/Critical Care and Emergency Medicine, Virginia Commonwealth University Medical Center, The Virginia Commonwealth University, Richmond, Virginia, USA

    K. J. Gunnerson

  2. The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    J. A. Kellum

Authors
  1. K. J. Gunnerson
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  2. J. A. Kellum
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Editor information

Editors and Affiliations

  1. Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

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© 2006 Springer-Verlag Italia

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Gunnerson, K.J., Kellum, J.A. (2006). Endogenous metabolic acid-base abnormalities: lactate and other strong ions. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/88-470-0407-1_38

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  • DOI: https://doi.org/10.1007/88-470-0407-1_38

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0406-1

  • Online ISBN: 978-88-470-0407-8

  • eBook Packages: MedicineMedicine (R0)

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