RT Book, Section A1 Kaufman, David C. A1 Kitching, Andrew J. A1 Kellum, John A. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107711285 T1 Acid-Base Balance T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accessmedicine.mhmedical.com/content.aspx?aid=1107711285 RD 2024/03/28 AB The blood [H+] and pH are determined by the strong ion difference (SID), the PCO2, and the total concentration of weak acids, mostly consisting of phosphate and albumin.Both acidemia and alkalemia have potentially harmful physiologic effects, and the presence of either is related to mortality.Most acid-base derangements do not benefit from specific correction of the abnormal pH; instead, the intensivist should focus on detecting and treating the underlying condition.Acid-base disorders are easily characterized using a stepwise approach.Lactic acidosis is the most important acid-base abnormality in ICU patients. Inadequate tissue oxygenation underlies the lactic acidosis in some patients (acute hemorrhage, critical hypoxemia, cardiogenic shock) but probably does not in others (such as the resuscitated septic patient).