Acids, bases, and the concept of pH will be defined. After a brief review of respiratory and renal physiology, the intracellular and extracellular buffers that help maintain acid-base homeostasis will be discussed. The prevalent method of arterial blood gas analysis will be reviewed, and the overly “bicarbonate-based” mentality of contemporary acid base management will be brought into question. The underlying physiochemical principles that drive acid-base disturbances will be described. The anesthetic implication of this novel approach will be outlined, including a guide to individualized fluid management, as well as a six-step process to assess the specific etiology of a patient’s metabolic acidosis.
Learning Objectives:
Describe the basics of acid-base physiology in terms of the respiratory system, the renal system, and intracellular and extracellular buffers.
Describe the conventional approach to acidosis diagnosis and management using the Henderson-Hasselbalch method.
Describe the six step process to assessing the specific etiology of a patient's metabolic acidosis using the physiochemical approach.
