Document Detail


Acid-base and electrolyte analysis in critically ill patients: are we ready for the new millennium?
MedLine Citation:
PMID:  14639065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Disorders of acid-base and electrolytes are commonly seen in critically ill patients. The presence of these disorders typically signals the development of an underlying pathology. These disturbances can be severe and are often associated with worse outcome. Indeed, metabolic acidosis is one of the ways we quantify organ failure. Although acid-base and electrolyte disorders may be a result of the underlying pathophysiology (eg, renal failure, respiratory failure, shock), they may also result from the way in which we manage critically ill patients. RECENT FINDINGS: The application of the physical-chemical approach to acid-base analysis has led to recent developments in the identification and quantification and understanding of mechanisms for acid-base disorders commonly found in critically ill patients. Examples include a better understanding of the role of electrolytes (especially sodium and chloride) and weak acids in the pathophysiology of acid-base disorders, the implication of acid-base derangements on the inflammatory process and organ perfusion, and the importance of resuscitation fluid composition. SUMMARY: By adopting a physical-chemical approach to acid-base analysis we are gaining insight to the complexities of acid-base disorders and how their treatments may affect outcome.
Authors:
Kyle J Gunnerson; John A Kellum
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  9     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-11-25     Completed Date:  2004-01-29     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  468-73     Citation Subset:  IM    
Affiliation:
Virginia Commonwealth University Reanimation Engineering Shock Center, Department of Anesthesiology, Virginia Commonwealth University/Medical College of Virginia, Richmond, Virginia, USA.
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Imbalance / diagnosis,  etiology,  physiopathology*,  prevention & control*
Acidosis / diagnosis,  etiology,  physiopathology,  prevention & control
Critical Care / methods*
Fluid Therapy / methods
Glucose / metabolism
Humans
Insulin / therapeutic use
Renal Replacement Therapy / adverse effects
Respiration, Artificial / adverse effects
Water-Electrolyte Balance / physiology*
Chemical
Reg. No./Substance:
11061-68-0/Insulin; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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