Urgent considerations
See Differentials for more details
Metabolic acidosis is not usually life-threatening unless extremes of pH are achieved (e.g., arterial pH <7.00). Many of the causes of metabolic acidosis are extremely serious. Prompt definitive diagnosis and treatment of the underlying condition is essential.
Giving sodium bicarbonate to raise the extracellular pH is controversial because it does not appear to reduce morbidity or mortality in critically ill patients, and may exacerbate intracellular acidosis.[10][11] There is, however, some evidence to suggest that sodium bicarbonate may improve survival in patients with severe metabolic acidosis and acute kidney injury; research is ongoing.[12][13][14]
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