Publications

A review on “Metabolic acidosis in the critically ill and continuous renal replacement therapy”

Metabolic acidosis is common in critically ill patients in intensive care units with or without acute kidney injury. Metabolic acidosis is usually of multifactorial etiology. Often these patients have lactic acidosis. The routine use of intravenous sodium bicarbonate to manage acidemia is debatable. Continuous renal replacement therapy (CRRT) is often indicated in the management of these oliguric, catabolic sick patients with metabolic acidosis. The extent of acid base changes in CRRT is governed by the intensity of plasma water exchange / dialysis and by the buffer content of the replacement fluid/dialy sate used. Bicarbonate containing replacement fluid is the preferred choice over lactate containing fluid as buffering agentinm any centers. However, lactate containing replacement fluid can be used in most patients for managing acidemia in CRRT, as it is easily available and less costly