Etiology, Pathogenesis and Intensive Care of Metabolic Acidosis

V.I. Cherniy, I.P. Shlapak, M.A. Georgiyants, S.G. Tyumentseva, S.Ye. Kugler, B.B. Prokopenko

Abstract


The article presents data on the etiology, pathogenesis, clinical manifestations, principles of diagnosis and treatment of metabolic acidosis: diabetic and nondiabetic ketoacidosis, lactic acidosis in adults and children. The modern directions of infusion therapy for ketoacidosis and lactic acidosis using the latest domestic infusion media are described. In their article, the authors compared the algorithms for the treatment of ketoacidosis and lactic acidosis with the recommendations of the Association of British Clinical Diabetologists and the American Society of Nephrology, making correction for the possibilities of domestic laboratory studies. A characte­ristic feature of some common forms of acid-base imbalance is the entwinement of damaging and adaptive elements, a clear boundary between them does not exist. Multifactoriality and pathogenetic ambiguity of the acid-base homeostasis disorders determine the significant differences in the assessment of the prognostic value and treatment strategies of its complex forms. In clinical practice, this often leads to undue schematization, depersonalization therapy or, even worse, to the desire to take into account the parameters of acid-base status only with the pH shift in the field of life-threatening values.


Keywords


ketoacidosis; lactic acidosis

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DOI: https://doi.org/10.22141/2224-0586.6.77.2016.82183

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