Abstract
Abstract
Background/aims
Acid–base status is important for understanding pathophysiology, making a diagnosis, planning effective treatment and monitoring progress of critically ill patients. Manual calculations are cumbersome, easily result in wrong conclusions. We wanted to develop an automated assessment of acid–base status.
Methods
A simplified adaptive MATLAB script processing all available theory to date was created, evaluated and used on blood gas analyses drawn immediately after admission to ICU. The script was compared to golden standard, calculating manually by two experienced ICU physicians.
Results
Results from the script correlated completely with detailed manual calculations of randomly chosen 100 blood gas results and it was able to deliver complex data on cohort level with advanced graphics. The initial blood gas analyses from 8875 admissions constituted the cohort, of which 4111 (46.3%) were normal. Respiratory acidosis was the primary disturbance in 2753 (31.0%) and metabolic acidosis in 464 (5.2%). Respiratory alkalosis was the primary disturbance in 1501 (17.0%) and metabolic alkalosis in 46 (0.5%). Of the disturbances 74.7% were mixed with two and 2.1% with three simultaneous disturbances. Acidoses were less compensated compared to alkaloses.
Conclusions
Acid–base theories are developed on ideal models and not on critical care patients, they require inputs that might not be available, and therefore, estimations are needed. In our cohort, it was difficult to develop a working script based on Stewart, whereas Boston/Copenhagen worked better. Acidoses were more common and more deviated compared to alkaloses.
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine
Reference20 articles.
1. Hughes R, Brain MJ (2013) A simplified bedside approach to acid–base: fluid physiology utilizing classical and physicochemical approaches. Anaesth Intensive Care Med 14:445–452
2. Ratanarat R, Sodapak C, Poompichet A, Toomthong P (2013) Use of different approaches of acid–base derangement to predict mortality in critically ill patients. J Med Assoc Thail 96(Suppl 2):S216–S223
3. Todorović J, Nešovic-Ostojić J, Milovanović A, Brkić P, Ille M, Čemerikić D (2015) The assessment of acid–base analysis: comparison of the “traditional” and the “modern” approaches. Med Glas 12:7–18
4. Matousek S, Handy J, Rees SE (2011) Acid–base chemistry of plasma: consolidation of the traditional and modern approaches from a mathematical and clinical perspective. J Clin Monit Comput 25:57–70
5. Adrogué HJ, Madias NE (2016) Assessing acid–base status: physiologic versus physicochemical approach. Am J Kidney Dis 68:793–802
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献