[Metabolic acidosis in critical care : theoretical and practical aspects].

Acid-base disorders, and metabolic acidosis in particular, are frequently encountered in critical care typically in shock states, metabolic diseases decompensations or intoxications. Their systematic and careful evaluation frequently helps identifying underlying disease and guide clinical management. In most instances, therapy should focus on the underlying disease. Symptomatic treatment of metabolic acidosis is controversial and rarely indicated. This review focuses on the main causes of metabolic acidosis and their diagnostic approach.