Normal anion gap metabolic acidosis

These conditions are less common and less life-threatening in the ICU setting. In general, they are best treated by reversal of underlying processes. Where this is not possible, and particularly with severe acidemia, bicarbonate is often indicated, especially for renal tubular acidosis ( Emmetteia/ 1992). Correction of hyperkalemia is more important in hyperkalemic distal renal tubular acidosis. Exogenous bicarbonate may also be indicated in hyperchloremic acidosis associated with gastrointestinal HCO3- loss, particularly that due to pancreaticobiliary fistulas and ureteroenterostomies ( Emmettefa/ 1992). Acetazolamide, nicotinic acid, and citrate may also be of use.

York.

Halperin, M.L. and Goldstein, M.B. (1988). Metabolic acidosis. In Fluid, electrolyte and acid-base emergencies, pp. 40-96. W.B. Saunders, Philadelphia, PA. Stacpoole, P. (1993). Lactic acidosis. Endocrinology and Metabolism Clinics of North America, 22, 221-45.

York.

Halperin, M.L. and Goldstein, M.B. (1988). Metabolic acidosis. In Fluid, electrolyte and acid-base emergencies, pp. 40-96. W.B. Saunders, Philadelphia, PA. Stacpoole, P. (1993). Lactic acidosis. Endocrinology and Metabolism Clinics of North America, 22, 221-45.

8.4.1 Pathophysiology and causes

S. Brimioullexs, R. J. Kahn

Introduction

Definitions

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C!inica|..mani.festati.Ons Diagnosis

Chapter references

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