In this episode of Critical Care Time, co-hosts Dr. Cyrus Askin and Dr. Nick Mark are joined by nephrologists Dr. Timothy Yau and Dr. Jeffrey Kott to discuss metabolic acidosis in the ICU. The discussion covers a range of topics, including the approach to acid-base derangements, the difference between anion gap and non-anion gap metabolic acidosis, the use of venous vs. arterial blood gases, and the role of renal replacement therapy. The experts share mnemonics, clinical pearls, and practical advice for managing metabolic acidosis in critically ill patients, emphasizing the importance of identifying the underlying cause and tailoring treatment accordingly. They also discuss the limitations and potential downsides of bicarbonate administration, as well as alternative buffering agents.
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