Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients
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 a...
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| Format: | Article |
| Language: | English |
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Universidad Nacional de Colombia
2021-10-01
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| Series: | Revista de la Facultad de Medicina |
| Subjects: | |
| Online Access: | https://revistas.unal.edu.co/index.php/revfacmed/article/view/93048 |
| _version_ | 1797824688731193344 |
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| author | Juan José Diaztagle-Fernández Luis Alejandro Marcelo-Pinilla Cristian Alejandro Castillo-Rodríguez |
| author_facet | Juan José Diaztagle-Fernández Luis Alejandro Marcelo-Pinilla Cristian Alejandro Castillo-Rodríguez |
| author_sort | Juan José Diaztagle-Fernández |
| collection | DOAJ |
| description | 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.
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| first_indexed | 2024-03-13T10:42:54Z |
| format | Article |
| id | doaj.art-168af4c3a0f84575b33d6cae928faae4 |
| institution | Directory Open Access Journal |
| issn | 0120-0011 2357-3848 |
| language | English |
| last_indexed | 2024-03-13T10:42:54Z |
| publishDate | 2021-10-01 |
| publisher | Universidad Nacional de Colombia |
| record_format | Article |
| series | Revista de la Facultad de Medicina |
| spelling | doaj.art-168af4c3a0f84575b33d6cae928faae42023-05-17T22:02:46ZengUniversidad Nacional de ColombiaRevista de la Facultad de Medicina0120-00112357-38482021-10-0170410.15446/revfacmed.v70n4.93048Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patientsJuan José Diaztagle-Fernández0Luis Alejandro Marcelo-Pinilla1Cristian Alejandro Castillo-Rodríguez2Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - Colombia. | Fundación Universitaria de Ciencias de la Salud - Faculty of Medicine - Bogotá D.C. - Colombia. | Hospital El Tunal de Bogotá - Intensive Care Unit - Bogotá D.C. - Colombia.Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - Colombia. | Fundación Universitaria del Área Andina - Bogotá Campus - Faculty of Health and Sports Sciences - Bogotá D.C. - Colombia.Universidad Nacional de Colombia - Bogotá Campus - Faculty of Medicine - Department of Physiological Sciences - Bogotá D.C. - Colombia.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. https://revistas.unal.edu.co/index.php/revfacmed/article/view/93048Acid Base EquilibriumMetabolic AcidosisCritical Care Outcome |
| spellingShingle | Juan José Diaztagle-Fernández Luis Alejandro Marcelo-Pinilla Cristian Alejandro Castillo-Rodríguez Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients Revista de la Facultad de Medicina Acid Base Equilibrium Metabolic Acidosis Critical Care Outcome |
| title | Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients |
| title_full | Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients |
| title_fullStr | Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients |
| title_full_unstemmed | Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients |
| title_short | Physiological variables of the “metabolic component” of acid-base balance and mortality in intensive care patients |
| title_sort | physiological variables of the metabolic component of acid base balance and mortality in intensive care patients |
| topic | Acid Base Equilibrium Metabolic Acidosis Critical Care Outcome |
| url | https://revistas.unal.edu.co/index.php/revfacmed/article/view/93048 |
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