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Diagnosis and management of metabolic acidosis: guidelines from a French expert panel

Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the Fren...

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Autores principales: Jung, Boris, Martinez, Mikaël, Claessens, Yann-Erick, Darmon, Michaël, Klouche, Kada, Lautrette, Alexandre, Levraut, Jacques, Maury, Eric, Oberlin, Mathieu, Terzi, Nicolas, Viglino, Damien, Yordanov, Youri, Claret, Pierre-Géraud, Bigé, Naïke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695455/
https://www.ncbi.nlm.nih.gov/pubmed/31418093
http://dx.doi.org/10.1186/s13613-019-0563-2
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author Jung, Boris
Martinez, Mikaël
Claessens, Yann-Erick
Darmon, Michaël
Klouche, Kada
Lautrette, Alexandre
Levraut, Jacques
Maury, Eric
Oberlin, Mathieu
Terzi, Nicolas
Viglino, Damien
Yordanov, Youri
Claret, Pierre-Géraud
Bigé, Naïke
author_facet Jung, Boris
Martinez, Mikaël
Claessens, Yann-Erick
Darmon, Michaël
Klouche, Kada
Lautrette, Alexandre
Levraut, Jacques
Maury, Eric
Oberlin, Mathieu
Terzi, Nicolas
Viglino, Damien
Yordanov, Youri
Claret, Pierre-Géraud
Bigé, Naïke
author_sort Jung, Boris
collection PubMed
description Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Emergency Medicine Society (Société Française de Médecine d’Urgence [SFMU]) have developed formalized recommendations from experts using the GRADE methodology. The fields of diagnostic strategy, patient assessment, and referral and therapeutic management were addressed and 29 recommendations were made: 4 recommendations were strong (Grade 1), 10 were weak (Grade 2), and 15 were experts’ opinions. A strong agreement from voting participants was obtained for all recommendations. The application of Henderson–Hasselbalch and Stewart methods for the diagnosis of the metabolic acidosis mechanism is discussed and a diagnostic algorithm is proposed. The use of ketosis and venous and capillary lactatemia is also treated. The value of pH, lactatemia, and its kinetics for the referral of patients in pre-hospital and emergency departments is considered. Finally, the modalities of insulin therapy during diabetic ketoacidosis, the indications for sodium bicarbonate infusion and extra-renal purification as well as the modalities of mechanical ventilation during severe metabolic acidosis are addressed in therapeutic management.
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spelling pubmed-66954552019-08-29 Diagnosis and management of metabolic acidosis: guidelines from a French expert panel Jung, Boris Martinez, Mikaël Claessens, Yann-Erick Darmon, Michaël Klouche, Kada Lautrette, Alexandre Levraut, Jacques Maury, Eric Oberlin, Mathieu Terzi, Nicolas Viglino, Damien Yordanov, Youri Claret, Pierre-Géraud Bigé, Naïke Ann Intensive Care Review Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Emergency Medicine Society (Société Française de Médecine d’Urgence [SFMU]) have developed formalized recommendations from experts using the GRADE methodology. The fields of diagnostic strategy, patient assessment, and referral and therapeutic management were addressed and 29 recommendations were made: 4 recommendations were strong (Grade 1), 10 were weak (Grade 2), and 15 were experts’ opinions. A strong agreement from voting participants was obtained for all recommendations. The application of Henderson–Hasselbalch and Stewart methods for the diagnosis of the metabolic acidosis mechanism is discussed and a diagnostic algorithm is proposed. The use of ketosis and venous and capillary lactatemia is also treated. The value of pH, lactatemia, and its kinetics for the referral of patients in pre-hospital and emergency departments is considered. Finally, the modalities of insulin therapy during diabetic ketoacidosis, the indications for sodium bicarbonate infusion and extra-renal purification as well as the modalities of mechanical ventilation during severe metabolic acidosis are addressed in therapeutic management. Springer International Publishing 2019-08-15 /pmc/articles/PMC6695455/ /pubmed/31418093 http://dx.doi.org/10.1186/s13613-019-0563-2 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Jung, Boris
Martinez, Mikaël
Claessens, Yann-Erick
Darmon, Michaël
Klouche, Kada
Lautrette, Alexandre
Levraut, Jacques
Maury, Eric
Oberlin, Mathieu
Terzi, Nicolas
Viglino, Damien
Yordanov, Youri
Claret, Pierre-Géraud
Bigé, Naïke
Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title_full Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title_fullStr Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title_full_unstemmed Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title_short Diagnosis and management of metabolic acidosis: guidelines from a French expert panel
title_sort diagnosis and management of metabolic acidosis: guidelines from a french expert panel
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695455/
https://www.ncbi.nlm.nih.gov/pubmed/31418093
http://dx.doi.org/10.1186/s13613-019-0563-2
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