Agreement of simplified Fencl-Stewart with Figge-Stewart method in diagnosing metabolic acidosis in critically ill children
Background The traditional Henderson-Hasselbalch approach has proven to be imprecise in critically ill patients. Stewart’s approach can detect metabolic acidosis missed by traditional approach, including acidosis caused by increased unmeasured agreement (UA). The complexity of Stewart’s method leads...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Indonesian Pediatric Society Publishing House
2007-08-01
|
| Series: | Paediatrica Indonesiana |
| Subjects: | |
| Online Access: | https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/365 |
| Summary: | Background The traditional Henderson-Hasselbalch approach has
proven to be imprecise in critically ill patients. Stewart’s approach
can detect metabolic acidosis missed by traditional approach,
including acidosis caused by increased unmeasured agreement
(UA). The complexity of Stewart’s method leads to development
of simpler modifications, simplified Fencl-Stewart and Figge-
Stewart method. Agreement between both modifications is
unknown.
Objective This study aimed to measure the agreement of simplified
Fencl-Stewart with Figge-Stewart method in diagnosing metabolic
acidosis in critically ill children.
Methods The was performed in Hasan Sadikin General Hospital,
Bandung from July to August 2006, involving <14 year-old critically
ill children. Blood samples for gas analysis, sodium, potassium,
chloride and albumin measurement were taken simultaneously. Test
result was analyzed with simplified Fencl-Stewart and Figge-Stewart
method and recorded with Excell spreadsheet. PASS was used for
interim analysis and DAG_Stat for raw agreement indices and
Kappa calculations.
Results Forty-five (31 males, 14 females) children were enrolled.
Acid base disturbances based on Stewart’s method were identified
in 10 subjects with normal base excess and nine with normal
bicarbonate. Significant increase of UA was detected in 11 of 45
subjects with simplified Fencl-Stewart method, compared to that
of 12 subjects with Figge-Stewart method. Raw agreement indices
showed 95.65% and 98.51% agreement for positive and negative
result, Kappa was 0.94 (P=0.0000).
Conclusions Excellent agreement is shown between simplified
Fencl-Stewart and Figge-Stewart method in diagnosing metabolic
acidosis in critically ill children. Increased UA can be assessed
with both methods. |
|---|---|
| ISSN: | 0030-9311 2338-476X |