Metabolic Acidosis in the ICU

In this episode of Surgery ICU Rounds, Jeff Guy discusses metabolic acidosis, a common issue in the ICU, focusing on its identification, etiology, and management. He explains the processes causing metabolic acidosis, including increased acid accumulation and bicarbonate wasting, and how the body compensates through respiratory ventilation. The discussion covers the importance of arterial blood gases and electrolyte panels, proper blood gas sample collection, and the utility of venous blood gases. Guy elaborates on the anion gap, its calculation, and the impact of factors like albumin levels on its interpretation, while also cautioning against over-reliance on the anion gap alone. The podcast further explores the effects of acidosis on various bodily systems, particularly the cardiovascular system and oxygen delivery, and addresses the complexities of lactic acidosis, including type A and B classifications, and treatment controversies, including the limited benefits of bicarbonate.