Hyperchloremic acidosis in the critically ill: One of the strong-ion acidoses?

David A. Story, Hiroshi Morimatsu, Rinaldo Bellomo

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Decreases in plasma bicarbonate are associated with hyperchloremic acidosis and lactic acidosis. According to the Stewart approach to acid-base physiology, the strong-ion difference regulates plasma bicarbonate, with chloride and lactate being the only strong anions routinely measured in clinical chemistry. We hypothesized that the plasma strong-ion difference, both with and without lactate, would have a stronger association with plasma bicarbonate than plasma chloride alone would have with bicarbonate. We used plasma acid-base data from 300 critically ill patients. The correlation with bicarbonate became progressively weaker (P <0.001): all measured strong ions, r = 0.60; measured strong ions without lactate, r = 0.42; chloride alone, r = -0.27. In a subgroup of 26 patients with traditional hyperchloremic acidosis (base excess <-2mmol/L and anion gap

Original languageEnglish
Pages (from-to)144-148
Number of pages5
JournalAnesthesia and Analgesia
Volume103
Issue number1
DOIs
Publication statusPublished - Jul 2006
Externally publishedYes

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Acidosis
Critical Illness
Bicarbonates
Ions
Chlorides
Lactic Acid
Lactic Acidosis
Clinical Chemistry
Acids
Acid-Base Equilibrium
Anions

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Hyperchloremic acidosis in the critically ill : One of the strong-ion acidoses? / Story, David A.; Morimatsu, Hiroshi; Bellomo, Rinaldo.

In: Anesthesia and Analgesia, Vol. 103, No. 1, 07.2006, p. 144-148.

Research output: Contribution to journalArticle

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