<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092022000400235</article-id>
<article-id pub-id-type="doi">10.35366/105795</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Interpretación gasométrica avanzada en el paciente crítico]]></article-title>
<article-title xml:lang="en"><![CDATA[Advanced gasometric interpretation in critical patient]]></article-title>
<article-title xml:lang="pt"><![CDATA[Interpretação gasométrica avançada no paciente crítico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Toquiantzi Arzola]]></surname>
<given-names><![CDATA[Marco Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez Bartolo]]></surname>
<given-names><![CDATA[Monserrat]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar Cózatl]]></surname>
<given-names><![CDATA[Israel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Canaán Pérez]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Juárez Bernardino]]></surname>
<given-names><![CDATA[Francisco Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pezzat Said]]></surname>
<given-names><![CDATA[Elías Bernardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General de Zona No. 20 ]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Secretaría de Salud del Estado de Puebla  ]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>36</volume>
<numero>4</numero>
<fpage>235</fpage>
<lpage>239</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092022000400235&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092022000400235&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092022000400235&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La interpretación gasométrica de forma rápida es muy útil en urgencias, ya que establecer de manera oportuna un diagnóstico es de suma importancia. Existen herramientas que nos permiten igualar la sensibilidad de los métodos complejos de Stewart. Evaluar la gasometría de manera tradicional, dependiendo de la escuela preferida: utilizando sólo el bicarbonato o el exceso de base; tiene baja sensibilidad diagnóstica cuando nos enfrentamos a escenarios donde existe más de un trastorno metabólico asociado. Proponemos los siguientes cinco pasos: evaluar el pH, déficit de base, anión gap, exceso de base y el índice cloro/sodio, que son importantes para identificar de manera rápida y sensible una gasometría en pacientes críticos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: The interpretation of a gasometry of rapid form is very useful in an emergency department since to establish in an opportune way a diagnosis performs supreme importance. There exists hardware that allows us to equal the sensibility of the complex m ethods of Stewart. To evaluate the gasometry of a traditional way, depending on the favorite school: using only the bicarbonate or the base excess, it has low diagnostic sensibility when we face stages where more than one metabolic associate disorder exists. We propose the following five steps: to evaluate the pH, deficit of base, anion gap, excess of base, and the index chlorine/sodium, which are important to identify rapidly and sensitively a gasometry in critical patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A interpretação gasométrica rápida é muito útil em emergências, pois é de suma importância estabelecer um diagnóstico em tempo hábil. Existem ferramentas que nos permitem igualar a sensibilidade dos métodos complexos de Stewart. Avaliar a gasometria da forma tradicional, dependendo da escola preferida: usando apenas bicarbonato ou excesso de base, tem baixa sensibilidade diagnóstica diante de cenários onde há mais de um distúrbio metabólico associado. Propomos as 5 etapas a seguir: avaliação do pH, déficit de base, lacuna aniônica, excesso de base e relação cloreto/sódio, importantes para identificar de forma rápida e sensível os gases sanguíneos em pacientes críticos.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Gasometría]]></kwd>
<kwd lng="es"><![CDATA[anión gap]]></kwd>
<kwd lng="es"><![CDATA[índice cloro/sodio]]></kwd>
<kwd lng="es"><![CDATA[brecha aniónica]]></kwd>
<kwd lng="es"><![CDATA[fórmulas]]></kwd>
<kwd lng="en"><![CDATA[Gasometry]]></kwd>
<kwd lng="en"><![CDATA[anion gap]]></kwd>
<kwd lng="en"><![CDATA[index chlorine/sodium]]></kwd>
<kwd lng="en"><![CDATA[anion breach]]></kwd>
<kwd lng="en"><![CDATA[formula]]></kwd>
<kwd lng="pt"><![CDATA[Gasometria]]></kwd>
<kwd lng="pt"><![CDATA[ânion gap]]></kwd>
<kwd lng="pt"><![CDATA[razão cloro/sódio]]></kwd>
<kwd lng="pt"><![CDATA[lacuna aniônica]]></kwd>
<kwd lng="pt"><![CDATA[fórmulas]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malkin]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Historical review: concept of acid-base balance in medicine]]></article-title>
<source><![CDATA[Ann Clin Lab Sci]]></source>
<year>2003</year>
<volume>33</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>337-44</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Henderson]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Black]]></surname>
<given-names><![CDATA[OF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A study of the equilibrium between carbonic acid, sodium bicarbonate, mono-sodium phosphate, and di-sodium phosphate at body temperature]]></article-title>
<source><![CDATA[Am J Physiol]]></source>
<year>1908</year>
<volume>21</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>420-6</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Story]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Bench-to-bedside review: a brief history of clinical acid-base]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2004</year>
<volume>8</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>253-8</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kurtz]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Kraut]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ornekian]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Nguyen]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acid-base analysis: a critique of the Stewart and bicarbonate-centered approaches]]></article-title>
<source><![CDATA[Am J Physiol Renal Physiol]]></source>
<year>2008</year>
<volume>294</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>F1009-31</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Durward]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Skellett]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Mayer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The value of the chloride: sodium ratio in differentiating the etiology of metabolic acidosis]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>2001</year>
<volume>27</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>828-35</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berend]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnostic use of base excess in acid-base disorders]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2018</year>
<volume>378</volume>
<page-range>1419-28</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Magder]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Emami]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Practical approach to physical-chemical acid-base management. Stewart at the bedside]]></article-title>
<source><![CDATA[Ann Am Thorac Soc]]></source>
<year>2015</year>
<volume>12</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>111-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Story]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Morimatsu]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Bellomo]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Strong ions, weak acids and base excess: a simplified Fencl-Stewart approach to clinical acid-base disorders]]></article-title>
<source><![CDATA[Br J Anaesth]]></source>
<year>2004</year>
<volume>92</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>54-60</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dubin]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Menises]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Masevicius]]></surname>
<given-names><![CDATA[FD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Comparison of three different methods of evaluation of metabolic acid-base disorders]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2007</year>
<volume>35</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1264-70</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kuppasani]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Rajan]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Reddi]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Serum anion gap: an important tool in patients with acid-base disorders]]></article-title>
<source><![CDATA[JAAPA]]></source>
<year>2011</year>
<volume>24</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>E4-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kraut]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Nagami]]></surname>
<given-names><![CDATA[GT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The serum anion gap in the evaluation of acid-base disorders: what are its limitations and can its effectiveness be improved?]]></article-title>
<source><![CDATA[Clin J Am Soc Nephrol]]></source>
<year>2013</year>
<volume>8</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>2018-24</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rastegar]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nagami]]></surname>
<given-names><![CDATA[GT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Non-anion gap metabolic acidosis: a clinical approach to evaluation]]></article-title>
<source><![CDATA[Am J Kidney Dis]]></source>
<year>2017</year>
<volume>69</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>296-301</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Emmett]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Approach to the patient with a negative anion gap]]></article-title>
<source><![CDATA[Am J Kidney Dis]]></source>
<year>2016</year>
<volume>67</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>143-50</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Márquez]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cárdenas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Los gaps, una inteligente herramienta para interpretar el desequilibrio ácido base]]></article-title>
<source><![CDATA[Residente]]></source>
<year>2015</year>
<volume>10</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>93-100</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cortés]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diferencia sodio-cloro e índice cloro/sodio como predictores de mortalidad en choque séptico]]></article-title>
<source><![CDATA[Med Int Méx]]></source>
<year>2017</year>
<volume>33</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>335-43</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gattinoni]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Vasques]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Camporota]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Understanding Lactatemia in Human Sepsis. Potential Impact for Early Management]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2019</year>
<volume>200</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>582-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
