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Management of metabolic acidosis: does correction with sodium bicarbonate do more harm than good?

Metabolic acidosis is a very common finding in critically ill patients and is associated with increased morbidity and mortality. Metabolic acidosis in critical care patients is commonly the result of either anaerobic metabolism or failure of excretion of endogenous acid. Other causes include renal or gastrointestinal loss of bicarbonate and the intake of exogenous acids.