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Acid–Base Balance in the Context of Critical Care

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Diet and Nutrition in Critical Care

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Abstract

Acid–base homeostasis of the body requires the lungs, kidneys, and a complex system of buffers. The maintenance of a normal pH of 7.35–7.45 of arterial blood is ideal for optimal organ function. This chapter will describe the role of the lungs, kidneys, and complex buffers in acid–base balance. The chapter will review the diagnosis, sources, and treatment of metabolic and respiratory acidosis and alkalosis. Mixed disorders and compensatory mechanisms will be discussed in this text. The chapter will conclude with the influence of nutrition on acid–base balance (Roberts 2013; Ayers and Dixon 2012; Madias 2002).

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Abbreviations

ABG:

Arterial blood gas

ADP:

Adenosine triphosphate

AKA:

Alcoholic ketoacidosis

BDZ:

Benzodiazepines

BE/BD:

Base excess/base deficit

Cl− :

Chloride

CNS:

Central nervous system

CPOD:

Chronic obstructive pulmonary diseases

CVA:

Cerebrovascular accident

D5NS:

5 % dextrose in 0.9 % sodium chloride

DKA:

Diabetic ketoacidosis

ECF:

Extracellular fluid

HCO3 :

Bicarbonate

Kg:

Kilogram

L:

Liter

mEq:

Milliequivalent

Na+ :

Sodium

NH4+:

Ammonia

NM:

Neuromuscular

PaCO2 :

Arterial pressure of carbon dioxide

RTA:

Renal tubular acidosis

References

  • Ayers P, Dixon C. Simple acid–base tutorial. J Parenter Enteral Nutr. 2012;36:18–23.

    Article  CAS  Google Scholar 

  • Barrett KE, Barman SM, Boitano S, Brooks HL. Acidification of urine & bicarbonate excretion. In: Barrett KE, Barman SM, Boitano S, Brooks HL, editors. Ganong’s review of medical physiology. 24th ed. New York: McGraw-Hill; 2012. http://www.accesspharmacy.com/content.aspx?aID=56266144. Accessed 16 May 2013.

  • Constable P. Clinical acid–base chemistry. In: Ronco C, Bellomo R, Kellum J, editors. Critical care nephrology. 2nd ed. Philadelphia: Elsevier; 2009. p. 581–614.

    Google Scholar 

  • Devlin JW, Matzke GR. Acid–base disorders. In: Talbert RL, DiPiro JT, Matzke GR, Poser LM, Wells BG, Yee GC, editors. Pharmacotherapy: a pathophysiologic approach. 8th ed. New York: McGraw-Hill; 2011. p. 923–42.

    Google Scholar 

  • DuBose TD. Acidosis and alkalosis. In: Fauci AS, Kasper DL, Jameson JL, Longo DL, Hauser SL, editors. Harrison’s principles of internal medicine. 18th ed. New York: McGraw-Hill; 2012. p. 363–73.

    Google Scholar 

  • DuBose TD, Hamm L. Diagnosis of simple and mixed disorders. In: Emmett M, editor. Acid base and electrolyte disorders: a companion to Brenner & Rector’s the kidney. 1st ed. Philadelphia: Elsevier; 2002. p. 41–53.

    Google Scholar 

  • Kamel KS, Davids MR, Lin SH, Halperin ML. Interpretation of electrolyte and acid–base parameters in blood and urine. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, editors. Brenner and Rector's the Kidney. 9th ed. Philadelphia: Saunders; 2011. p. 897–928.

    Google Scholar 

  • Laski ME, Wesson DE. Lactic acidosis. In: DuBose TD, Hamm LL, editors. Acid–base and electrolyte disorders-a companion to Brenner and Rector’s the kidney. Philadelphia: Saunders; 2002. p. 83–107.

    Google Scholar 

  • Madias NE. Respiratory alkalosis. In: DuBose TD, Hamm LL, editors. Acid–base and electrolyte disorders-a companion to Brenner and Rector’s the Kidney. Philadelphia: Saunders; 2002. p. 147–64.

    Google Scholar 

  • McClave SA, Martindale RG, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically Ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Neteral Nutr. 2009;33(3):277–316.

    Article  Google Scholar 

  • Roberts AL. Arterial blood gases and acid base balance. In: Lee M, editor. Interpreting laboratory data. Bethesda: American Society of Health-System Pharmacists Inc; 2013. p. 193–205.

    Google Scholar 

  • Stewart PA. Goals, definitions and basic principles. In: Kellum JA, Ebers PWG, editors. Stewart’s textbook of acid–base. 2nd ed. Amsterdam: Elsevier; 2007. p. 36–62.

    Google Scholar 

  • White JV, Guenter P, Jensen G, et al. Consensus statement: academy of nutrition and dietetics and american society for parenteral and enteral nutrition: characteristics recommended for the identification and documentation and adult malnutrition (undernutrition). J Parenter Enteral Nutr. 2012;36(3):275–83.

    Article  Google Scholar 

  • Wooley JA, Frakenfield MS. In: Muller CM, editor. The A.S.P.E.N. Adult nutrition support core curriculum. 2nd ed. Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 2012. p. 22–35.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pharmacy, Mississippi Baptist Medical Center, 1225 North State Street, 39202-2002, Jackson, MS, USA

    Phil Ayers

  2. Mississippi Baptist Medical Center, 1225 North State Street, 39202-2002, Jackson, MS, USA

    Carman Dixon & Andrew Mays

  3. Jackson Pulmonary Associates, 501 Marshall Street, Suite 200, 39202-2002, Jackson, MS, USA

    D. Timothy Cannon

Authors
  1. Phil Ayers
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  2. Carman Dixon
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  3. Andrew Mays
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  4. D. Timothy Cannon
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Corresponding author

Correspondence to Phil Ayers .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King's College London, London, United Kingdom

    Rajkumar Rajendram

  2. School of Medicine, King's College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Ayers, P., Dixon, C., Mays, A., Cannon, D.T. (2014). Acid–Base Balance in the Context of Critical Care. In: Rajendram, R., Preedy, V., Patel, V. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8503-2_100-1

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  • DOI: https://doi.org/10.1007/978-1-4614-8503-2_100-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-8503-2

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