The focus of this review will be to examine the subject of metabolic a
cidosis in the alcoholic, emphasing intracellular events. In this rega
rd, two points shall be highlighted: first, ''metabolic'' aspects of m
etabolic acidosis and their quantitative implications; and second, we
will highlight factors that impact on the severity of intracellular ac
idosis and the titration of intracellular proteins. This approach shou
ld provide a better understanding of the pathophysiology of the metabo
lic acid-base disorders in these patients, and could indicate where le
verage should be exerted in therapy.