Management of specific forms of metabolic acidosis

The four steps of management of metabolic acidosis are primary resuscitation, assuring adequate ventilation, correction of the underlying cause of acidosis, and finally consideration of alkali therapy. Primary resuscitation (assurance of airway, breathing, circulation, etc.) is fundamental to managing critically ill patients who have metabolic acidosis. Then, assurance of adequacy of ventilation is paramount. Once the correct diagnosis has been established, management is directed to correcting the underlying cause of the acidosis. Finally, exogenous HCO 3- has a role in some forms of acidosis. However, in others, bicarbonate is not beneficial and may be potentially harmful.

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