Metabolic acidosis is a disorder frequently encountered in emergency medicine and intensive care medicine. As literature has been enriched with new data concerning the management of metabolic acidosis, the French Intensive Care Society (Société de Réanimation de Langue Française [SRLF]) and the French Emergency Medicine Society (Société Française de Médecine d'Urgence [SFMU]) have developed formalized recommendations from experts using the GRADE methodology. The fields of diagnostic strategy, patient assessment, and referral and therapeutic management were addressed and 29 recommendations were made: 4 recommendations were strong (Grade 1), 10 were weak (Grade 2), and 15 were experts' opinions. A strong agreement from voting participants was obtained for all recommendations. The application of Henderson-Hasselbalch and Stewart methods for the diagnosis of the metabolic acidosis mechanism is discussed and a diagnostic algorithm is proposed. The use of ketosis and venous and capillary lactatemia is also treated. The value of pH, lactatemia, and its kinetics for the referral of patients in pre-hospital and emergency departments is considered. Finally, the modalities of insulin therapy during diabetic ketoacidosis, the indications for sodium bicarbonate infusion and extra-renal purification as well as the modalities of mechanical ventilation during severe metabolic acidosis are addressed in therapeutic management.

中文翻译：

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代谢性酸中毒的诊断和处理：法国专家小组的指南。

代谢性酸中毒是急诊医学和重症监护医学中经常遇到的疾病。随着文献中有关代谢性酸中毒治疗的新数据不断丰富，法国重症监护学会（法国法语国家重症监护病房[SRLF]）和法国急诊医学学会（法国法国急诊医学[SFMU]）有了使用GRADE方法，由专家制定了正式的建议。讨论了诊断策略，患者评估以及转诊和治疗管理等领域，并提出了29项建议：4项建议为强（1级），10项建议（2级），15项为专家意见。所有建议均获得了有投票权的参与者的强烈同意。讨论了Henderson-Hasselbalch和Stewart方法在代谢性酸中毒机制诊断中的应用，提出了一种诊断算法。还治疗了酮症和静脉及毛细血管扩张症的使用。考虑将pH，乳酸血症及其动力学的价值推荐给院前和急诊科的患者。最后，在糖尿病的酮症酸中毒治疗过程中的胰岛素治疗方式，碳酸氢钠输注和肾外净化的适应症以及严重的代谢性酸中毒过程中的机械通气的方式均在治疗管理中得到解决。并考虑其在医院前和急诊科转诊患者的动力学。最后，在糖尿病的酮症酸中毒治疗过程中的胰岛素治疗方式，碳酸氢钠输注和肾外净化的适应症以及严重的代谢性酸中毒过程中的机械通气的方式均在治疗管理中得到解决。并考虑其在医院前和急诊科转诊患者的动力学。最后，在糖尿病的酮症酸中毒治疗过程中的胰岛素治疗方式，碳酸氢钠输注和肾外净化的适应症以及严重的代谢性酸中毒过程中的机械通气的方式均在治疗管理中得到解决。