論文

査読有り 国際誌
2021年8月

Acidemia subtypes in critically ill patients: An international cohort study.

Journal of critical care
  • Katsunori Mochizuki
  • ,
  • Tomoko Fujii
  • ,
  • Eldho Paul
  • ,
  • Matthew Anstey
  • ,
  • Shigehiko Uchino
  • ,
  • David V Pilcher
  • ,
  • Rinaldo Bellomo

64
開始ページ
10
終了ページ
17
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jcrc.2021.02.006

PURPOSE: To study the prevalence, characteristic, outcome, and acid-base biomarker predictors of outcome for different acidemia subtypes. METHODS: We used national intensive care databases from three countries and classified acidemia subtypes as metabolic (standard base excess [SBE] < -2 mEq/L only), respiratory (PaCO2 > 42 mmHg only), and combined (both SBE < -2 mEq/L and PaCO2 > 42 mmHg) based on blood gas analysis in the first 24 h after ICU admission. To investigate acid-base predictors for hospital mortality, we applied the area under the receiver operating characteristic curve approach. RESULTS: We screened 643,689 ICU patients (2014-2018) and detected acidemia in 57.8%. The most common subtype was metabolic (42.9%), followed by combined (30.3%) and respiratory (25.9%). Combined acidemia had a mortality of 12.7%, compared with 11% for metabolic and 5.5% for respiratory. For combined acidemia, the best predictor of hospital mortality was pH. However, for metabolic or respiratory acidemia, it was SBE or PaCO2, respectively. CONCLUSIONS: In ICU patients with acidemia, mortality differs according to subtype and is highest in the combined subtype. Best acid-base predictors of mortality also differ according to subtype with best performance for pH in combined, SBE in metabolic, and PaCO2 in respiratory acidemia.

リンク情報
DOI
https://doi.org/10.1016/j.jcrc.2021.02.006
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33725556
ID情報
  • DOI : 10.1016/j.jcrc.2021.02.006
  • PubMed ID : 33725556

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