Tag: acidosis
Metabolic Acidosis Worsens Cardiac Function and Vasopressor Needs in Septic Shock
In a prospective observational study conducted from January to December 2024 at Hospital de Especialidades No. 14, IMSS, in Veracruz, Mexico, researchers examined the cardiovascular effects of acute metabolic acidemia in... read more
BICARICU-2: Bicarb Infusions Curb Dialysis Needs in Acidotic AKI
The BICARICU-2 trial investigated the use of sodium bicarbonate (NaHCO3) infusions for critically ill patients suffering from severe acidemia and Acute Kidney Injury (AKI), most often due to septic shock. While the trial,... read more
The Double Danger: Electrolyte Chaos in AKI Drives Worse Outcomes
Electrolyte imbalances and metabolic acidosis are highly prevalent complications in Acute Kidney Injury (AKI) and are directly linked to adverse patient outcomes, including death and a greater need for intensive care. The... read more
Lung-protective Ventilation Strategies for Mechanical Ventilation
This study is an important step toward optimizing mechanical ventilation strategies, addressing the interplay between mechanical power, gas exchange and long-term respiratory outcomes could further refine lung-protective... read more
Code Sepsis – Early Decompensation and Predictors
Early recognition and management of sepsis within the first hour of a sepsis alert is critical for patient survival, requiring healthcare providers to be trained to identify "red flag" symptoms like rapid breathing (tachypnea)... read more
Lactic Acidosis with Metformin Accumulation in the ICU
Metformin-associated lactic acidosis (MALA) in ICUs often follow acute dehydration or infection, and these high-risk situations must be signals to prevent this serious ADR. Specific education programs for physicians and... read more
Misunderstanding Buffering in Critical Illness
It is was disappointing to read the recent review in Intensive Care Medicine on buffering in metabolic acidosis. I consider this a "pre-Copernican" approach to acid–base that does not respect basic physical–chemical principles. The... read more
Feeding Challenges in the ICU
For critically ill patients, timely nutritional support can aid recovery and reduce mortality risk. But what about a patient in septic shock who is receiving vasopressor therapy, or one who requires prone positioning or extracorporeal... read more
Early sodium bicarbonate therapy for critically ill patients with septic shock and acute moderate metabolic acidosis
In recent decades, septic shock has continued to be a life-threatening health problem around the world. Meanwhile, metabolic acidosis (MA) is also well known in critically ill patients, and even moderate metabolic acidosis... read more
Outcomes of Different Steroid Dosing Regimens in Critical Covid-19 Pneumonia
The study found that high-dose steroids in the treatment of critically ill patients with COVID-19 pneumonia did not confer any mortality benefit and were associated with an increased risk of dysglycemia and superimposed infections. A... read more
Hemodialysis as an Effective Treatment for Combined Amlodipine and Metformin Overdose
Introducing emergency dialysis will lead to significant outcomes in mortality and morbidity in patients with combined toxicity of amlodipine and metformin. Moreover, non-ST elevation myocardial infarction is also expected... read more
Effective Treatment for Combined Amlodipine and Metformin Overdose
The combined toxicity of amlodipine and metformin is a rarely reported phenomenon in the literature. The management varies depending on the clinical status of the patient. We present a case that was managed successfully... read more
Acid-Base Disorders in the Critically III Patient
Acid-base disorders are common in the intensive care unit. By utilizing a systematic approach to their diagnosis, it is easy to identify both simple and mixed disturbances. These disorders are divided into four major categories:... read more
Use of ECMO in Acutely Poisoned Pediatric Patients in US
Extracorporeal Membrane Oxygenation (ECMO) may improve the hemodynamic and metabolic status of poisoned pediatric patients. Persistent hypotension, acidemia/acidosis, and elevated Pao2 after 24 hours of ECMO were associated... read more
Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS
Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine. Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive... read more
Endothelial Glycocalyx Degradation Contributes to Metabolic Acidosis in Children After Cardiopulmonary Bypass Surgery
Our data show that metabolic acidosis (increased strong ion gap) is associated with plasma concentration of heparan sulfate, a negatively charged glycosaminoglycan cleaved from the endothelial glycocalyx during cardiopulmonary... read more
Lactated Ringers is Safe in Hyperkalemia, and is Superior to NS
The myth that LR should be avoided in hyperkalemia is not only incorrect, it is probably backwards. For a hyperkalemic patient in renal failure, Lactated Ringers (LR) should be preferred over normal saline (NS). LR has been... read more
Haloperidol, Clonidine and Resolution of Delirium in Critically Ill Patients
Haloperidol and clonidine use in delirious ICU patients may be associated with reduced probability of delirium resolution. This finding, however, merits further investigation given inherent limitations of this observational... read more
Validation of a Point-of-Care Capillary Lactate Measuring Device
Lactate Pro 2 had good agreement with the reference method using arterial blood but poorer agreement using venous blood. Our results show the potential for overestimation of the lactate values in haemodynamically compromised... read more
Preventing Major Airway Complications
Every anaesthetist fears the moment they might become faced with a "can't intubate, can't oxygenate" (CICO) scenario, but thankfully such events are exceedingly rare. They nevertheless receive much attention in the academic... read more
Predicting NIV Failure in Hypoxemic Patients
Non-invasive ventilation (NIV) is applied worldwide to patients with hypoxemic respiratory failure. It is often applied as an attempt to avoid invasive mechanical ventilation. However, the application of NIV is often... read more
Serum Lactate Level and Mortality in Metformin-associated Lactic Acidosis Requiring RRT
This study suggests that predialysis level of serum lactate level is an important marker of mortality in MALA patients requiring renal replacement therapy (RRT) with a linear dose-response relationship. To better evaluate... read more
