FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 338:26-34 January 1, 1998 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Letters Letters Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article Related Article by Adrogué, H. J. PubMed Citation

Acid–base homeostasis exerts a major influence on protein function, thereby critically affecting tissue and organ performance. Deviations of systemic acidity in either direction can have adverse consequences and, when severe, can be life-threatening. Yet it is the nature of the condition responsible for severe acidemia or alkalemia that largely determines the patient's status and prognosis. Whereas a blood pH of 7.10 can be of little consequence when caused by a transient or easily reversible condition, such as an isolated seizure, it forecasts an ominous outcome if it is the result of methanol intoxication. Similarly, a blood pH of 7.60 seldom . . . [Full Text of this Article]

Adverse Consequences of Severe Acidemia

Management of Life-Threatening Acidoses

Metabolic Acidosis

Alkali Therapy

Risks of Sodium Bicarbonate Therapy

Alternative Alkalinizing Agents

Specific Disorders

            Lactic Acidosis

            Diabetic Ketoacidosis

            Alcoholic Ketoacidosis

            Methanol and Ethylene Glycol Intoxications

            Aspirin Intoxication

            Toluene Exposure

            Bicarbonate Loss

            Renal Failure

            Dilutional Acidosis

Respiratory Acidosis

            Permissive Hypercapnia

            Alkali Therapy

Mixed Acidoses

Source Information

From the Department of Medicine, Baylor College of Medicine and Methodist Hospital, and the Renal Section, Veterans Affairs Medical Center, Houston (H.J.A.); and the Department of Medicine, Tufts University School of Medicine, and the Division of Nephrology and the Tupper Research Institute, New England Medical Center, Boston (N.E.M.).

Address reprint requests to Dr. Madias at the Division of Nephrology, New England Medical Center, Box 172, 750 Washington St., Boston, MA 02111.

References

Related Letters:

Acid–Base Disorders
Marik P., Varon J., Rao R. B., Hoffman R. S., Skorecki K., Bistrian B. R., McCowen K. C., Driscoll D., Adrogué H. J., Madias N. E.
Extract | Full Text  
N Engl J Med 1998; 338:1626-1629, May 28, 1998. Correspondence

More on Acid–Base Disorders
Nahas G. G., Sutin K. M., Fermon C., Turndorf H., Adrogué H. J., Madias N. E.
Extract | Full Text  
N Engl J Med 1998; 339:1005-1006, Oct 1, 1998. Correspondence

Cardiac Contractility during Severe Ketoacidosis
Maury E., Vassal T., Offenstadt G.
Extract | Full Text  
N Engl J Med 1999; 341:1938, Dec 16, 1999. Correspondence

This article has been cited by other articles:

• Zimmerman, J. L. (2009). Acid-Base Disorders. ACCP Pulmonary Med Brd Rev 25: 309-318 [Full Text]  
• Ayers, P., Warrington, L. (2008). Diagnosis and Treatment of Simple Acid-Base Disorders. Nutr Clin Pract 23: 122-127 [Abstract] [Full Text]  
• Han, K.-H., Kim, H.-Y., Croker, B. P., Reungjui, S., Lee, S.-Y., Kim, J., Handlogten, M. E., Adin, C. A., Weiner, I. D. (2007). Effects of ischemia-reperfusion injury on renal ammonia metabolism and the collecting duct. Am. J. Physiol. Renal Physiol. 293: F1342-F1354 [Abstract] [Full Text]  
• Takayesu, J. K., Bazari, H., Linshaw, M. (2006). Case 7-2006 -- A 47-Year-Old Man with Altered Mental Status and Acute Renal Failure. NEJM 354: 1065-1072 [Full Text]  
• Schwaderer, A. L., Schwartz, G. J. (2004). Back to Basics: Acidosis and Alkalosis. Pediatr. Rev. 25: 350-357 [Full Text]  
• Maitland, K., Levin, M., English, M., Mithwani, S., Peshu, N., Marsh, K., Newton, C.R.J.C. (2003). Severe P. falciparum malaria in Kenyan children: evidence for hypovolaemia. QJM 96: 427-434 [Abstract] [Full Text]  
• Bieringer, M., Kettritz, R. (2003). A wretching business: 'how to get the most out of the numbers'. Nephrol Dial Transplant 18: 836-839 [Full Text]  
• Rehm, M., Finsterer, U. (2003). Treating Intraoperative Hyperchloremic Acidosis with Sodium Bicarbonate or Tris-Hydroxymethyl Aminomethane: A Randomized Prospective Study. Anesth. Analg. 96: 1201-1208 [Abstract] [Full Text]  
• Chau, W. K., Yang, C. F., Chou, Y. H., Ho, C. H. (2002). Aggressive Undifferentiated Carcinoma of Unknown Primary Site Complicated by Lactic Acidosis After Bleeding: a Case Report. Jpn J Clin Oncol 32: 210-214 [Abstract] [Full Text]  
• Taniguchi, T., Inagaki, R., Suzuki, F., Muramatsu, I. (2001). Rapid acid extrusion response triggered by {alpha}1 adrenoceptor in CHO cells. J. Physiol. 535: 107-113 [Abstract] [Full Text]  
• Ochnio, J. J., Patrick, D., Ho, M., Talling, D. N., Dobson, S. R. (2001). Past infection with hepatitis A virus among Vancouver street youth, injection drug users and men who have sex with men: implications for vaccination programs. CMAJ 165: 293-297 [Abstract] [Full Text]  
• Tung, A. (2000). Perioperative Ventilation of the Vascular Surgery Patient. SEMIN CARDIOTHORAC VASC ANESTH 4: 265-274 [Abstract]  
• Maury, E., Vassal, T., Offenstadt, G. (1999). Cardiac Contractility during Severe Ketoacidosis. NEJM 341: 1938-1938 [Full Text]  
• Nahas, G. G., Sutin, K. M., Fermon, C., Turndorf, H., Adrogue, H. J., Madias, N. E. (1998). More on Acid-Base Disorders. NEJM 339: 1005-1006 [Full Text]  
• Marik, P., Varon, J., Rao, R. B., Hoffman, R. S., Skorecki, K., Bistrian, B. R., McCowen, K. C., Driscoll, D., Adrogue, H. J., Madias, N. E. (1998). Acid-Base Disorders. NEJM 338: 1626-1629 [Full Text]