Maciel Alexandre Toledo, Noritomi Danilo Teixeira, Park Marcelo
Intensive Care Unit, Emergency Department, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Endocr Metab Immune Disord Drug Targets. 2010 Sep;10(3):252-7. doi: 10.2174/187153010791936900.
Metabolic acidosis is very common in critically ill septic patients. Acidosis may be a result of the underlying pathophysiology, but it also may be the result of the way in which those patients are managed. Chloride-associated acidosis is frequent and is potentially aggravated during fluid resuscitation. The severity of metabolic acidosis is associated with poor clinical outcomes; however, it remains uncertain whether or not there is a causal relationship between acidosis and the pathophysiology of septic syndromes. Several experimental findings have demonstrated the impact of acidosis modulation on the release of inflammatory mediators and cardiovascular function. Treatment of metabolic acidosis is based on control of the underlying process and support of organ dysfunction, although the use of intravenous chloride-poor balanced solutions seems an attractive option to prevent the worsening of metabolic acidosis during fluid resuscitation.
代谢性酸中毒在重症脓毒症患者中非常常见。酸中毒可能是潜在病理生理学的结果，但也可能是这些患者治疗方式的结果。与氯相关的酸中毒很常见，并且在液体复苏期间可能会加重。代谢性酸中毒的严重程度与不良临床结局相关；然而，酸中毒与脓毒症综合征的病理生理学之间是否存在因果关系仍不确定。一些实验结果表明了酸中毒调节对炎症介质释放和心血管功能的影响。代谢性酸中毒的治疗基于对潜在病因的控制和对器官功能障碍的支持，尽管使用静脉输注低氯平衡溶液似乎是预防液体复苏期间代谢性酸中毒恶化的一个有吸引力的选择。
