Diagnosis and treatment of severe metabolic acidosis |
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| Institution: | 1. Department of Medicine, Geriatrics Section, University of Padova, Padova, Italy;2. Department of Neurosciences, University of Padova, Padova, Italy;3. National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy;4. Department of Hematological Medicine, Guys and St. Thomas'' NHS Foundation Trust, London, UK;5. Psychiatry Research, The Zucker Hillside Hospital, North Shore – Long Island Jewish Health System, Glen Oaks, NY, USA;6. Hofstra North Shore LIJ School of Medicine, Hempstead, NY, USA;7. The Feinstein Institute for Medical Research, Manhasset, NY, USA;8. Albert Einstein College of Medicine, Bronx, NY, USA;1. Division of Cardiovascular Medicine, Section of Electrophysiology, University of Louisville, Louisville, KY;2. Division of Cardiovascular Medicine, Section of Electrophysiology, University of Iowa Hospitals, Iowa City, IA;1. Oncology and Hematology Department, ABC Medical School, Santo André, SP, Brazil;2. Biological Sciences Department, Federal University of São Paulo, Diadema, SP, Brazil |
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| Abstract: | Severe non-respiratory acidosis is a frequent biochemical finding in sick children. While treatment is usually straightforward and comprises managing the underlying illness and giving supportive care, in some cases the acidosis itself requires specific therapy. The authors provide an approach to the diagnosis, investigation and management of children with severe metabolic acidosis, using the anion gap (adjusted for serum albumin) as a guide to the aetiology. Lactic acidosis, ketosis and organic acids are discussed, as are specific treatments and the general use of sodium bicarbonate as a base. |
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