<?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>1726-6718</journal-id>
<journal-title><![CDATA[Revista Cubana de Anestesiología y Reanimación]]></journal-title>
<abbrev-journal-title><![CDATA[Rev cuba anestesiol reanim]]></abbrev-journal-title>
<issn>1726-6718</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1726-67182021000300011</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Sistemática para el manejo del equilibrio ácido-base en pacientes graves]]></article-title>
<article-title xml:lang="en"><![CDATA[Systemization for the management of acid-base balance in seriously ill patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Esperón Morejón]]></surname>
<given-names><![CDATA[Pablo Joel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Le&#8217;Clerc Nicolás]]></surname>
<given-names><![CDATA[Jean]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández Ruiz]]></surname>
<given-names><![CDATA[Anabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Docente Clínico Quirúrgico &#8220;Joaquín Albarrán Domínguez&#8221;  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>20</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1726-67182021000300011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1726-67182021000300011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1726-67182021000300011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Las alteraciones del equilibrio ácido-base pueden ser de carácter primario. En la mayoría de los casos dependen de la complicación de una enfermedad preexistente. La frecuencia de estos trastornos es elevada, especialmente, en enfermos hospitalizados en las unidades de atención al paciente grave. Su aparición conlleva implicaciones pronósticas significativas.  Objetivo:  Sistematizar sobre el estado actual del manejo del equilibrio ácido-base.  Método:  Se realizó una revisión bibliográfica en la que se utilizaron las herramientas del método científico. Se examinó toda la bibliografía disponible publicada en los últimos cinco años y así, elaborar una síntesis crítica, acorde al criterio y las competencias de los autores sobre la temática.  Resultados: Se expone la importancia de la evaluación clínica, que unida a los niveles de PCO2, y de exceso o déficit de bases en una gasometría arterial, permiten identificar el trastorno ácido base existente. Igualmente, se destaca que el CO2 tiene una función clave en el control de la ventilación, así como las modificaciones que produce al flujo sanguíneo cerebral, el pH y el tono adrenérgico. Otro aspecto importante fue la reciente práctica clínica de la &#8220;hipercapnia permisiva&#8221; para reducir el metabolismo tisular y de esta manera, mejorar la función del surfactante e impedir la nitración de las proteínas.  Conclusiones:  El manejo de los desequilibrios ácido-base debe ser del dominio de todos los profesionales vinculados a la asistencia médica, pues el retraso de su diagnóstico puede empeorar la evolución y el pronóstico de los pacientes graves.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Acid-base balance alterations can be of a primary nature. In most cases, they depend on the complication of a pre-existing disease. The frequency of these disorders is high, especially in patients hospitalized in critical care units. Its appearance carries significant prognostic implications.  Objective:  To systematize the current state of acid-base balance management.  Method:  A bibliographic review was carried out, for which the tools of the scientific method were used. All the available bibliography, published in the last five years, was examined; thus, a critical synthesis was prepared, according to the criteria and competences of the authors regarding the subject.  Results:  The importance of the clinical evaluation is exposed, which, together with PCO2 levels as well as excess or deficit of bases in an arterial blood gas, allow to identify the existing acid-base disorder. Likewise, it is highlighted that CO2 has a key function in ventilation control, together with the modifications it produces on cerebral blood flow, pH and adrenergic tone. Another important aspect was the recent clinical practice of &#8220;permissive hypercapnia&#8221; to reduce tissue metabolism and thus improve surfactant function and prevent protein nitration.  Conclusions:  The management of acid-base imbalances should be mastered by all professionals associated to medical care, since any delay in its diagnosis can worsen the evolution and prognosis of seriously ill patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[trastornos ácido-base]]></kwd>
<kwd lng="es"><![CDATA[acidosis metabólica]]></kwd>
<kwd lng="es"><![CDATA[alcalosis metabólica]]></kwd>
<kwd lng="es"><![CDATA[acidosis respiratoria]]></kwd>
<kwd lng="es"><![CDATA[alcalosis respiratoria]]></kwd>
<kwd lng="en"><![CDATA[acid-base disorders]]></kwd>
<kwd lng="en"><![CDATA[metabolic acidosis]]></kwd>
<kwd lng="en"><![CDATA[metabolic alkalosis]]></kwd>
<kwd lng="en"><![CDATA[respiratory acidosis]]></kwd>
<kwd lng="en"><![CDATA[respiratory alkalosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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