Metabolic acidosis is a frequent and potentially serious aspect of critical illness. Acidosis increases hydrogen ion concentration [H +], which compromises cellular protein function (Schmjdtii1992). Clinical assessment of acid-base disorders is based on measurable alterations in the extracellular compartment; inferred changes in intracellular acid-base balance may be inaccurate ( Schmidti1992; TMnessen 1995). Acidosis and acidemia are not synonymous. Acidemia refers to an abnormally low blood pH (e.g. pH < Z.36), while acidosis refers to the underlying process which causes acidemia ( BarnĀ® Schmidt 1992; Schmidt.1992). Understanding the pathophysiology of metabolic acidosis is fundamental to management.

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