Open access peer-reviewed Edited Volume

Metabolic Acidosis

Edward T. Zawada Jr.

University of South Dakota


Anion Gap Delta Gap Ketoacidosis Uremic Acidosis Metanol Ethylene Glycol Metformin Diluent Acidosis Bicarbonate Boluses Bicarbonate Drip Infusions Osteopenia Pathologic Fractures

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About the book

Metabolic acidosis is one of the most common serious disturbances of acid/base balance. It is also one of the most dangerous. Lactic acidosis often accompanies severe sepsis which is the most common cause of death in a non-cardiac intensive care unit. Severe metabolic acidosis can cause poor cardiac function and hypotension, thus contributing to morbidity and mortality in cardiac intensive care units. It can contribute to the poor response after cardiac arrest. Although anion-gap metabolic acidosis is easily diagnosed, the non-anion gap metabolic acidosis is often poorly understood. The definitive treatment requires correcting the underlying cause. The combination of anion-gap and non-anion gap metabolic acidoses can also occur. Correction of one is often insufficient to successfully resuscitate the patient because the other for will remain untreated. The work up to identify these complex metabolic acidoses includes osmolal gap measurements, delta bicarbonate calculations, and urine anion gap measurement. Drug-induced metabolic acidosis can be acute or chronic. Newer medications are being identified each year to cause this clinical problem. Chronic metabolic acidosis accompanies gastrointestinal disturbances, several types of gastrointestinal surgeries, some urologic surgical procedures. Unless anticipated and managed chronic metabolic acidosis is buffered by bone creating and contributing to osteopenic states, hip fractures, vertebral fractures, and disturbed growth of bones in patients before the age of puberty.

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Date completed: October 7th 2019

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Deadline for chapter proposals: October 28th 2019

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Deadline for full chapters: December 27th 2019

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Review results due: March 16th 2020

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Expected publication date: May 15th 2020

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About the editor

Edward T. Zawada Jr.

University of South Dakota

Edward T. Zawada Jr., MD, was born in Chicago, Illinois, in 1947. He graduated with a Bachelor of Science degree summa cum laude from Loyola University Chicago in 1969 and an MD degree summa cum laude from the Loyola Stritch School of Medicine in 1973. He was inducted into Alpha Omega Alpha in 1972. He trained in internal medicine and nephrology in David Geffen School of Medicine at UCLA where he later served as an assistant professor of medicine. He had a long career in academic medicine at the University of Utah, Medical College of Virginia, and Sanford School of Medicine of the University of South Dakota where he is a professor and chairman emeritus of the Department of Internal Medicine. He is board certified by the American Board of Internal Medicine in internal medicine, nephrology, geriatrics, and critical care medicine. He also has board certifications in nutrition by the American College of Nutrition, pharmacology by the American Society of Clinical Pharmacology, and hypertension by the American Society of Hypertension. He has been awarded with a fellowship status by the American College of Physicians, the American College of Chest Physicians, the American Heart Association, the American Society of Nephrology, the American Geriatrics Society, the American College of Clinical Pharmacology, the Society for Vascular Medicine, and the Society of Critical Care Medicine. He was awarded a distinguished service award by the South Dakota Medical Society in 2002 for a career devoted to medical education and master of the American College of Physicians in 2005.

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