Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical review: Acid–base abnormalities in the intensive care unit. | Critical Care April 2005 Vol 9 No 2 Kaplan and Frangos Review Clinical review Acid-base abnormalities in the intensive care unit Lewis J Kaplan and Spiros Frangos Yale University School of Medicine Department of Surgery Section of Trauma Surgical Critical Care and Surgical Emergencies New Haven Connecticut USA Corresponding author Lewis J Kaplan Published online 20 October 2004 This article is online at http content 9 2 198 2004 BioMed Central Ltd Critical Care 2005 9 198-203 DOI cc2912 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. Introduction Deranged acid-base physiology drives admission to a critical care arena for vast numbers of patients. Management of diverse disorders ranging from diabetic ketoacidosis to hypoperfusion with lactic acidosis from hemorrhagic or septic shock shares a variety of common therapies for disordered acid-base balance. It is encumbent upon the intensivist to decode the deranged physiology and to categorize the disorder in a meaningful fashion to direct effective repair strategies 1 . Besides the traditional classification of respiratory versus metabolic acidosis versus alkalosis and gap versus nongap normal gap the intensivist benefits from classifying acidbase disorders into three discrete groups iatrogenically induced . hyperchloremic metabolic acidosis a fixed feature of a pre-existing disease process . chronic renal failure hyperlactatemia or a labile feature of an evolving disease process . lactic acidosis from hemorrhage shock of any cause . The therapy for and the outcome from each of these three categories may be .
