251. Dilutional Acidosis: An Endless Story of Confusion
- Author
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Daniel Doberer, Georg-Christian Funk, and Bruno Schneeweiss
- Subjects
Psychoanalysis ,business.industry ,Bicarbonate ,Critical Care and Intensive Care Medicine ,Chloride ,humanities ,chemistry.chemical_compound ,chemistry ,Biochemistry ,medicine ,medicine.symptom ,business ,Acidosis ,Confusion ,medicine.drug - Abstract
) criticized the classic notion of dilutional acidosis, in which hydrogen carbonate is diluted, and wondered why there is so much controversy about the mechanisms responsible for this phenomenon: Physical chemistry affords a perfectly logical explanation-chloride is increased because a hyperchloremic solution has been administered, and it is the chloride that induces the acidosis. Why such a simple explanation should be so controversial is enigmatic in itself. We agree with his criticism of the classic bicarbonate concept, but the simple explanation for dilutional acidosis Kellum gave is fundamentally flawed as well. He claimed an acidifying effect of chloride itself, because chloride is an acid, especially when it is administered as sodium chloride. This is not correct. Chloride is not an acid, and it cannot
- Published
- 2003