Abstract
A fundamental change in the way we think about acid-base homeostasis has been on the horizon for some time. Modern advances in cell biology and physiology now permit us to explain the inconsistencies in the traditional approaches to acid-base that have been identified by physical chemistry for decades. Furthermore, the widespread availability of personal computers has permitted the application of these principles to clinical medicine. In the ICU, patients frequently manifest extreme examples of acid-base imbalance. The understanding of the genesis of many these abnormalities as well as the approach to treatment are profoundly affected by this new paradigm. Common disorders such as suction alkalosis, dilutional acidosis, and lactic acidosis are among the best examples.
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