Drolz A, et al. - In this post hoc analysis of prospectively collected data, researchers assessed the acid–base profile of patients with liver cirrhosis and acute-on-chronic liver failure (ACLF), respectively, in comparison with critically ill patients without acute or chronic liver disease. Cirrhosis and especially ACLF was found to be related to metabolic acidosis and acidemia owing to lactate and unmeasured anions. In liver cirrhosis, acidosis and acidemia, respectively, were shown to be related to increased 28-day mortality. In cirrhosis and ACLF, the main contributors to metabolic imbalance were lactate and unmeasured anions.