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A Systematic Approach to Understanding Acid-Base Disorders in the Critically Ill

A Systematic Approach to Understanding Acid-Base Disorders in the Critically Ill Objective:The objective of this review is to discuss acid-base physiology, describe the essential steps for interpreting an arterial blood gas and relevant laboratory tests, and review the 4 distinct types of acid-base disorders.Data Sources:A comprehensive literature search and resultant bibliography review of PubMed from inception through March 7, 2023.Study Selection and Data Extraction:Relevant English-language articles were extracted and evaluated.Data Synthesis:Critically ill patients are prone to significant acid-base disorders that can adversely affect clinical outcomes. Assessing these acid-base abnormalities can be complex because of dynamic aberrations in plasma proteins, electrolytes, extracellular volume, concomitant therapies, and use of mechanical ventilation. This article provides a systematic approach to acid-base abnormalities which is necessary to facilitate prompt identification of acid-base disturbances and prevent untoward morbidity and mortality.Relevance to Patient Care and Clinical Practice:Many acid-base disorders result from medication therapy or are treated with medications. Pharmacists are uniquely poised as the medication experts on the multidisciplinary team to assist with acid-base assessments in the context of pharmacotherapy.Conclusion:The use of a systematic approach to address acid-base disorders can be performed by all pharmacists to improve pharmacotherapy and optimize patient outcomes. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Pharmacotherapy SAGE

A Systematic Approach to Understanding Acid-Base Disorders in the Critically Ill

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References (20)

Publisher
SAGE
Copyright
© The Author(s) 2023
ISSN
1060-0280
eISSN
1542-6270
DOI
10.1177/10600280231165787
Publisher site
See Article on Publisher Site

Abstract

Objective:The objective of this review is to discuss acid-base physiology, describe the essential steps for interpreting an arterial blood gas and relevant laboratory tests, and review the 4 distinct types of acid-base disorders.Data Sources:A comprehensive literature search and resultant bibliography review of PubMed from inception through March 7, 2023.Study Selection and Data Extraction:Relevant English-language articles were extracted and evaluated.Data Synthesis:Critically ill patients are prone to significant acid-base disorders that can adversely affect clinical outcomes. Assessing these acid-base abnormalities can be complex because of dynamic aberrations in plasma proteins, electrolytes, extracellular volume, concomitant therapies, and use of mechanical ventilation. This article provides a systematic approach to acid-base abnormalities which is necessary to facilitate prompt identification of acid-base disturbances and prevent untoward morbidity and mortality.Relevance to Patient Care and Clinical Practice:Many acid-base disorders result from medication therapy or are treated with medications. Pharmacists are uniquely poised as the medication experts on the multidisciplinary team to assist with acid-base assessments in the context of pharmacotherapy.Conclusion:The use of a systematic approach to address acid-base disorders can be performed by all pharmacists to improve pharmacotherapy and optimize patient outcomes.

Journal

Annals of PharmacotherapySAGE

Published: Jan 1, 2024

Keywords: acid-base; arterial blood gas; acidosis; alkalosis; critically ill; intensive care

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