Disorders of acid-base balance.

Abstract

Intensivists spend much of their time managing problems related to fluids, electrolytes, and blood pH. Recent advances in the understanding of acid-base physiology have resulted from the application of basic physical-chemical principles of aqueous solutions to blood plasma. All changes in blood pH, in health and in disease, occur through changes in three variables: carbon dioxide, relative electrolyte concentrations, and total weak acid concentrations. However, while this quantitative approach has enjoyed widespread use among researchers, clinicians are reluctant to employ it. Recent advances have brought a measure of parity between the newer and the older, descriptive approach to acid-base physiology. Case-based review of the literature. Both quantitative and traditional approaches can be easily combined to result in a powerful tool for bedside acid-base analysis.