Acute non-anion gap metabolic acidosis is now recognized to be as a common cause of metabolic acidosis, particularly in the ICU. Further examination of its impact on cellular function and clinical outcome are needed. Most important, controlled studies in humans to determine at what level of serum should base therapy be initiated, and what level of serum should be targeted are needed. The potential of other modalities of treatment should also be explored. This research should facilitate the generation of evidence-based guidelines for the treatment of patients with this important and increasingly common form of acute metabolic acidosis.

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