METABOLIC-ACIDOSIS IN THE CRITICALLY ILL - LESSONS FROM PHYSICAL-CHEMISTRY

There is growing interest in quantitative physical chemical analysis o f acid-base physiology among intensivists. Acid-base dilemmas seen in the intensive care unit are not always well addressed by the tradition al approaches. Quantitative physical chemical analysis also allows for the exploration of unexplained anion-induced acidosis where the famil iar anion gap is insufficient or inaccurate. This approach emphasizes the application of accepted physical chemical principles and identific ation of independent and dependent acid-base variables. In aqueous sol utions, water dissociation is the major source of free hydrogen ions.