Serviços Personalizados
Journal
Artigo
Inglês (pdf)
Artigo em XML
Referências do artigo
Tradução automática
Enviar este artigo por emailIndicadores
Citado por SciELO 
Acessos
Links relacionados
Citado por Google 
Similares em
SciELO 
Similares em Google
Compartilhar
Permalink
Revista de la Facultad de Medicina
versão impressa ISSN 0120-0011
Resumo
DIAZTAGLE-FERNANDEZ, Juan José; MARCELO-PINILLA, Luis Alejandro e 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 23-Mar-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.
Palavras-chave : Acid Base Equilibrium; Metabolic Acidosis; Critical Care Outcome (MeSH).
