SciELO - Scientific Electronic Library Online

 
vol.70 issue4Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., ColombiaRisk factors associated with failed weaning from mechanical ventilation in septic patients admitted to an intensive care unit: a case-control study author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Revista de la Facultad de Medicina

Print version ISSN 0120-0011

Abstract

DIAZTAGLE-FERNANDEZ, Juan José; MARCELO-PINILLA, Luis Alejandro  and  CASTILLO-RODRIGUEZ, Cristian Alejandro. Physiological variables of the "metabolic component" of acid-base balance and mortality in intensive care patients. rev.fac.med. [online]. 2022, vol.70, n.4, e201.  Epub Mar 23, 2023. ISSN 0120-0011.  https://doi.org/10.15446/revfacmed.v70n4.93048.

Introduction:

Metabolic acidosis is a frequent pathophysiological condition in critically ill patients. It can be assessed using different physiological variables, but their prognostic value has not yet been well established.

Objective:

To evaluate the association between the variables that allow assessing the metabolic component of acid-base balance (ABB) and 28-day mortality in patients admitted to an intensive care unit (ICU) in Bogotá, D.C., Colombia.

Materials and methods:

Prospective cohort study conducted in 122 patients admitted to an ICU between January and June 2013 and with a stay >24 hours. On admission to the ICU, blood samples were taken, and an arterial blood gas test was performed in order to calculate the following variables: anion gap (AG), corrected anion gap (AGc), standard base excess (BEst), metabolic H+, base excess-unmeasurable anions (BEua), arterial pH, arterial lactate, standard HCO3-st, and strong ion difference (SID). APACHE II and SOFA scores were also calculated. A bivariate analysis was performed in which ORs and their respective 95%CI were calculated, and then a multivariate analysis was conducted using a logistic regression model to identify the variables associated with 28-day mortality; a significance level of p<0.05 was considered.

Results:

Out of the 122 patients, 33 (27.05%) died at 28 days and 51 (48.80%) were women. Participants' mean age was 46.5 years (±15.7). The following variables were significantly associated with 28-day mortality in the bivariate analysis: SID (OR=1.150; p=0.008), BEua (OR=0.897; p=0.023), AG (OR=1.231; p=0.002), AGc (OR=1.232; p=0.003), blood pH (OR=0.001; p=0.023), APACHE II (OR=1.180; p=0.001), HCO3-st (OR=0.841; p=0.015). In the multivariate analysis, only the APACHE II score variable was significantly associated with 28-day mortality (OR=1.188; p=0.008).

Conclusion:

The physiological variables that allow assessing the metabolic component of ABB, both from the Henderson model and the Stewart model, were not significantly associated with 28-day mortality.

Keywords : Acid Base Equilibrium; Metabolic Acidosis; Critical Care Outcome (MeSH).

        · abstract in Spanish     · text in English     · English ( pdf )