1. Acid--base disorders evaluation in critically ill patients: we can improve our diagnostic ability
- Author
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Boniatti, Marcio Manozzo, Cardoso, Paulo Ricardo Cerveira, Castilho, Rodrigo Kappel, and Vieira, Silvia Regina Rios
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Acidosis -- Diagnosis ,Acidosis -- Prognosis ,Acidosis -- Research ,Critically ill -- Health aspects ,Health care industry - Abstract
Byline: Marcio Manozzo Boniatti (1,2), Paulo Ricardo Cerveira Cardoso (1), Rodrigo Kappel Castilho (1), Silvia Regina Rios Vieira (1) Keywords: Acidosis; Acid base equilibrium; Strong ion gap; Outcomes; Prognosis Abstract: Purpose To determine whether Stewart's approach can improve our ability to diagnose acid--base disorders compared to the traditional model. Methods This prospective cohort study took place in a university-affiliated hospital during the period of February--May 2007. We recorded clinical data and acid--base variables from one hundred seventy-five patients at intensive care unit admission. Results Of the 68 patients with normal standard base excess (SBE) (SBE between -4.9 and +4.9), most (n = 59 86.8%) had a lower effective strong ion difference (SIDe), and of these, 15 (25.4%) had SIDe < 30 mEq/L. Thus, the evaluation according to Stewart's method would allow an additional diagnosis of metabolic disorder in 33.7% patients. Conclusions The Stewart approach, compared to the traditional evaluation, results in identification of more patients with major acid--base disturbances. Author Affiliation: (1) Critical Care Department, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil (2) Rua Angelo Segalla, 622, CEP 95070-420, Caxias do Sul, RS, Brazil Article History: Registration Date: 01/04/2009 Received Date: 12/11/2008 Accepted Date: 23/03/2009 Online Date: 15/04/2009
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- 2009