Metabolic acidosis is acid accumulation due to increased acid production or acid ingestion, decreased acid excretion or gastrointestinal or renal HCO3− loss. The consequence of this process is a decline in bicarbonate-a major extracellular buffer-and, if unopposed (by compensatory hyperventilation), leads to a decrease in extracellular pH.
Causesof metabolic acidosis include accumulation of ketones and lactic acid, renal failure, and drug or toxic ingestion (high anion gap) and GI or renal HCO3− loss (normal anion gap).
The primary treatment of metabolic acidosis requires correction of the underlying cause. In mild to moderate acidosis, treatment could be limited to . . .
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