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Bench-to-bedside review: treating acid-base abnormalities in the intensive care unit - the role of buffers

Brian K Gehlbach, Gregory A Schmidt
Critical Care: the Official Journal of the Critical Care Forum 2004, 8 (4): 259-65
15312208
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.

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Ettienne Coetzee

When referring to lactic acidosis, do you mean lactate as the cause of the acidosis or hyperlactataemia with concomitant acidosis? As far as I understand, the term "lactic acidosis" can be misleading and that hyperlactataemia is merely a way of getting rid of pyruvate to enable glycolysis to continue in an environment where the mitochondria are dysfunctional. Please see Curr Opin Crit Care 12:315-321 2006.

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Jose Antonio Flores

Great article. Useful

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