Electrolytes and Acid-Base Disturbances: Advances in Pathophysiology and Treatment

Topic Information

Dear Colleagues,

Electrolytes and acid-base disturbances are the most frequent and challenging issues in intensive care, nephrology, pulmonary, and general medicine units. In this Topic, we hope to deepen our understanding of these intimidating topics to help and encourage physicians in their practice. Acid-base disturbances are frequent in high-care settings, especially in intensive care and nephrology units where patients face difficult circumstances. A correct identification is key to providing the patient with the best possible treatment. We encourage you to submit your papers to this Topic. Original research and reviews are welcome!

Dr. Caterina Carollo
Dr. Giuseppe Mulè
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Anesthesia Research anesthres	-	-	2024	23 Days	CHF 1000	Submit
Biomedicines biomedicines	4.5	7.8	2013	18.2 Days	CHF 2600	Submit
Diseases diseases	3.7	4.2	2013	21.6 Days	CHF 1800	Submit
Emergency Care and Medicine ecm	-	-	2024	24.1 Days	CHF 1000	Submit
Journal of CardioRenal Medicine jcrm	-	-	2025	15.0 days *	CHF 1000	Submit
Life life	3.9	7.1	2011	15.3 Days	CHF 2600	Submit

* Median value for all MDPI journals in the first half of 2026.

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Published Papers (1 paper)

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All Life Biomedicines JCRM Diseases Emergency Care and Medicine Anesthesia Research

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20 pages, 682 KB  

Open AccessReview

Chloremia Disturbances in Critical Care: A Narrative Review of Pathophysiology, Clinical Impact and Management Strategies

by Nicola Sinatra, Giuseppe Cuttone, Tarek Senussi Testa, Luigi La Via, Francesca Maria Rubulotta, Maurizio Giuseppe Abrignani, Carmelo Zumbino, Giuseppe Mulè, Giulio Geraci and Caterina Carollo

Life 2026, 16(1), 151; https://doi.org/10.3390/life16010151 - 16 Jan 2026

Cited by 1 | Viewed by 3120

Abstract

Chloride, the leading extracellular anion, plays a crucial role in acid-base balance, fluid homeostasis, and neuromuscular function. Despite historical underrecognition, emerging evidence demonstrates significant associations between chloremia disturbances and critical care outcomes. This paper aims to narratively review the pathophysiology, clinical features, and [...] Read more.

Chloride, the leading extracellular anion, plays a crucial role in acid-base balance, fluid homeostasis, and neuromuscular function. Despite historical underrecognition, emerging evidence demonstrates significant associations between chloremia disturbances and critical care outcomes. This paper aims to narratively review the pathophysiology, clinical features, and management strategies of chloremia disturbances in critically ill patients. Chloremia disturbances are common in ICU patients, with both hypochloremia (<96 mEq/L) and hyperchloremia (>106 mEq/L) independently associated with increased mortality, prolonged ICU length of stay, and organ dysfunction. In sepsis, chloride levels exhibit a prognostic value, with threshold effects around 105 mEq/L. Hyperchloremia particularly increases acute kidney injury risk, while hypochloremia correlates with prolonged mechanical ventilation. The choice of resuscitation fluids significantly influences clinical outcomes, with balanced crystalloids potentially reducing adverse events if compared to normal saline solutions. Recent large-scale trials demonstrate lower rates of major adverse kidney events with chloride-restrictive strategies. Optimal management requires careful patient monitoring along with acid-base assessment. Treatment approaches must identify underlying causes to avoid complications. Prevention strategies include protocol-based fluid therapy, medication selection consideration, and early intervention in high-risk patients. Emerging technologies, including continuous monitoring systems and machine learning algorithms, offer promising advances for predicting and managing chloride disturbances. Full article

(This article belongs to the Topic Electrolytes and Acid-Base Disturbances: Advances in Pathophysiology and Treatment)

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