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Acid-base disorders in critical care medicine
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Annual Review of Medicine
|January 1, 1989
Summary
Metabolic alkalosis is common in critically ill patients, often stemming from low chloride or protein levels. Assessing plasma protein concentration is crucial for accurate acid-base status evaluation in these individuals.
Area of Science:
- Critical care medicine
- Nephrology
- Internal medicine
Background:
- Nonrespiratory (metabolic) alkalosis is a frequent acid-base disorder in critically ill patients.
- This condition is commonly linked to hypochloremia (low chloride levels) and/or hypoproteinemia (low plasma protein levels).
Purpose of the Study:
- To highlight the prevalence of metabolic alkalosis in critically ill patients.
- To emphasize the role of hypochloremia and hypoproteinemia in its development.
- To underscore the importance of measuring plasma protein concentration in acid-base status assessment.
Main Methods:
- Review of existing literature on acid-base balance in critical care.
- Analysis of common causes of metabolic alkalosis in hospitalized patients.
- Discussion of diagnostic parameters for acid-base disturbances.
Main Results:
- Metabolic alkalosis is the most prevalent acid-base disturbance in critically ill populations.
- Hypochloremia and hypoproteinemia are identified as primary contributors to metabolic alkalosis.
- Plasma protein concentration significantly influences the interpretation of acid-base status.
Conclusions:
- Accurate evaluation of acid-base status in critically ill patients requires consideration of plasma protein levels.
- Clinicians should routinely assess both electrolytes and proteins to manage metabolic alkalosis effectively.
- Integrating plasma protein data can improve diagnostic accuracy and therapeutic strategies for acid-base disorders.
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