scholarly journals An acid-base disorders analysis with the use of the Stewart approach in patients with sepsis treated in an intensive care unit

2016 ◽  
Vol 48 (3) ◽  
pp. 180-184 ◽  
Author(s):  
Jakub Szrama ◽  
Piotr Smuszkiewicz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acid Base ◽  
Stewart Approach

scholarly journals Higher Acid-Base Imbalance Associated with Respiratory Failure Could Decrease the Survival of Patients with Scrub Typhus during Intensive Care Unit Stay: A Gene Set Enrichment Analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 1580 ◽  
Author(s):  
Kyoung Min Moon ◽  
Kyueng-Whan Min ◽  
Mi-Hye Kim ◽  
Dong-Hoon Kim ◽  
Byoung Kwan Son ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Scrub Typhus ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Acid Base ◽  
Gene Set Enrichment ◽  
Gene Set ◽  
Gene Sets

Ninety percent of patients with scrub typhus (SC) with vasculitis-like syndrome recover after mild symptoms; however, 10% can suffer serious complications, such as acute respiratory failure (ARF) and admission to the intensive care unit (ICU). Predictors for the progression of SC have not yet been established, and conventional scoring systems for ICU patients are insufficient to predict severity. We aimed to identify simple and robust indicators to predict aggressive behaviors of SC. We evaluated 91 patients with SC and 81 non-SC patients who were admitted to the ICU, and 32 cases from the public functional genomics data repository for gene expression analysis. We analyzed the relationships between several predictors and clinicopathological characteristics in patients with SC. We performed gene set enrichment analysis (GSEA) to identify SC-specific gene sets. The acid-base imbalance (ABI), measured 24 h before serious complications, was higher in patients with SC than in non-SC patients. A high ABI was associated with an increased incidence of ARF, leading to mechanical ventilation and worse survival. GSEA revealed that SC correlated to gene sets reflecting inflammation/apoptotic response and airway inflammation. ABI can be used to indicate ARF in patients with SC and assist with early detection.

scholarly journals Acid based disorders in intensive care unit: a hospital-based study

2019 ◽  
Vol 6 (1) ◽  
pp. 62 ◽  
Author(s):  
Babu Rajendran ◽  
Seetha Rami Reddy Mallampati ◽  
Sheju Jonathan Jha J.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Infectious Diseases ◽  
Respiratory Alkalosis ◽  
Simple Type ◽  
Acid Base ◽  
Icu Patients ◽  
Mixed Acid ◽  
Base Disorder

Background: Acid base disorders are common in the ICU patients and pose a great burden in the management of the underlying condition.Methods: Identifying the type of acid-base disorders in ICU patients using arterial blood gas analysis This was a retrospective case-controlled comparative study. 46 patients in intensive care unit of a reputed institution and comparing the type of acid-base disorder amongst infectious (10) and non-infectious (36) diseases.Results: Of the study population, 70% had mixed acid base disorders and 30% had simple type of acid base disorders. It was found that sepsis is associated with mixed type of acid-base disorders with most common being metabolic acidosis with respiratory alkalosis. Non-infectious diseases were mostly associated with metabolic alkalosis with respiratory acidosis. Analysis of individual acid base disorders revealed metabolic acidosis as the most common disturbance.Conclusions: These results projected the probability of acid bases disorders in various conditions and help in the efficient management. Mixed acid base disorders are the most common disturbances in the intensive care setup which is metabolic acidosis with respiratory alkalosis in infectious diseases and metabolic acidosis is the most common simple type of acid base disorder.

scholarly journals Admission Anion Gap Metabolic Acidosis and Its Impact on Patients in Medical Intensive Care Unit

2021 ◽  
Author(s):  
Akshay Dafal ◽  
Sunil Kumar ◽  
Sachin Agrawal ◽  
Sourya Acharya ◽  
Apoorva Nirmal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Length Of Stay ◽  
Medical Intensive Care Unit ◽  
Anion Gap ◽  
Acid Base ◽  
Acid Base Status ◽  
Medical Intensive Care ◽  
Time Of Admission

Abstract Introduction Anion gap (AG) metabolic acidosis is common in critically ill patients. The relationship between initial AG at the time of admission to the medical intensive care unit (MICU) and mortality or length of stay is unclear. This study was undertaken to evaluate this relationship. Materials and Method We prospectively examined the acid–base status of 500 consecutive patients at the time of MICU admission and outcome was measured in terms of mortality, length of ICU stay, need of ventilator, and laboratory parameters. The patients were divided into four stages based on the severity of AG. Outcome based on the severity of AG was measured, and comparisons that adjusted for baseline characteristics were performed. Results This study showed that increased AG was associated with the higher mortality. Patients with the highest AG also had the longest length of stay in the MICU, and patients with normal acid–base status had the shortest ICU length of stays (p < 0.05). Conclusion A high AG at the time of admission to the MICU was associated with higher mortality and length of stays. Initial risk stratification based on AG and metabolic acidosis may help guide appropriate patient disposition (especially in patients without other definitive criteria for MICU admission) and assist with prognosis.

Diagnosis of Acid-Base Derangements and Mortality Prediction in the Trauma Intensive Care Unit: The Physiochemical Approach

2005 ◽  
Vol 58 (2) ◽  
pp. 238-243 ◽  
Author(s):  
Matthew Martin ◽  
James Murray ◽  
Thomas Berne ◽  
Demetrios Demetriades ◽  
Howard Belzberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Prediction ◽  
Acid Base

scholarly journals Metabolic acidosis in medical intensive care unit with indicators and their prognostic value- A prospective observational study

2017 ◽  
Vol 8 (3) ◽  
pp. 60-67
Author(s):  
Prem Amalraj ◽  
Arun Kumar Narayanan ◽  
Satish Balan ◽  
Mathew Thomas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Traditional Method ◽  
Traditional Approach ◽  
Serum Lactate ◽  
Anion Gap ◽  
Apache Ii Score ◽  
Acid Base ◽  
Lactate Levels

Background: Metabolic acidosis is a common abnormality in the intensive care unit. There has recently been a surge of interest in nontraditional approaches to the analysis of acid base disorders.Aims and Objectives: This study was undertaken to compare the application of the physicochemical method of Stewart and the traditional Henderson-Hasselbach equation withcorrection for albumin in quantification of acid base disorders.Materials and Methods: All patients with metabolic acidosis admitted to the ICU as defined by a base deficit of >2.5 were included in the study. The APACHE II score was calculated at admission and the predicted mortality was defined. The acid base disorders were quantified by the traditional approach with anion gap correction for serum albumin as well as by the Stewart method with calculation of the strong anion gap acidosis.Results: One-hundred forty patients were included in the study of which 58% were males. In 125 subjects (89%) acidosis was discovered by the Stewart method. The traditional method detected increased anion gap in 109 subjects (78%) but this increased to 124 (88.5%) when corrected for albumin. Both the strong ion gap (SIG) and the albumin corrected anion gap correlated strongly. Serum lactate levels and SIG predicted mortality as did albumin corrected anion gap.Conclusion: Albumin correction of the anion gap correlates well with acidosis as discovered by the SIG and therefore should be used in the ICUs rather than the traditional anion gap. With this modification, we can thus depend on the application of the intuitive traditional method rather than the more difficult to apply Stewart method for analysis of the acid base abnormalities in the ICU.Asian Journal of Medical Sciences Vol.8(3) 2017 60-67

scholarly journals Profile of acid-base disturbances in an intensive care unit of Fortaleza, Ceará, Brazil.

2014 ◽  
Vol 2 (3) ◽  
pp. 108
Author(s):  
Renan Barbosa Rodrigues ◽  
Maria Cristina Farias de Araújo ◽  
Payron Augusto Nascimento ◽  
Patricia Barbosa Rodrigues ◽  
Ricardo Victor Soares Pereira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acid Base

scholarly journals Accuracy of Acid-Base Diagnoses Using the Central Venous Blood Gas in the Medical Intensive Care Unit

Nephron ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 293-298 ◽  
Author(s):  
Sarah J. Schrauben ◽  
Dan Negoianu ◽  
Cristiana Costa ◽  
Raphael M. Cohen ◽  
Stanley Goldfarb ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Venous Blood ◽  
Blood Gas ◽  
Central Venous ◽  
Acid Base ◽  
Central Venous Blood ◽  
Medical Intensive Care ◽  
Venous Blood Gas

scholarly journals Post craniotomy and electrocardiographic monitoring

2021 ◽  
Vol 10 (1) ◽  
pp. 40
Author(s):  
Hendy Lesmana ◽  
Ahmat Pujianto ◽  
Bayu Purnomo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Rhythm ◽  
Electrolyte Balance ◽  
Acid Base Balance ◽  
Acid Base ◽  
Sinus Arrhythmia ◽  
Balance Disorders ◽  
Electrocardiographic Monitoring ◽  
Base Balance

Background: Post craniotomy management mainly emphasizes monitoring complications that occur. Close supervision and monitoring are needed in post craniotomy patients, especially in the first 48 hours so that the patient is placed in the intensive care unit (ICU). Various studies have identified various complications that arise from mild complications to severe complications, namely the death of patients after craniotomy, so that hemodynamic monitoring tool are needed. Electrocardiography is one of the hemodynamic monitoring tools in the intensive care room which is very useful in monitoring heart rhythm abnormalities in post-craniotomy patients.Methods: This descriptive study was conducted on 30 respondents post craniotomy and were treated in the Intensive Care Unit (ICU) for 1-3 days of treatment. An electrocardiographic monitoring analysis was performed on 30 respondents, then confirmed by examination of blood electrolytes and blood gas analysis.Results: In this study 90% of respondents experienced electrocardiographic rhythm abnormalities, 50% sinus arrhythmia, 33.3% sinus tachycardia, 6.7% sinus bardycardia. The results of electrolyte examination 18 respondents experienced electrolyte balance disorders where 4 respondents experienced hyponatremia, 7 respondents experienced hypernatremia+hyperchloremia, 1 respondent experienced hyponatremia+hypochloremia, 5 respondents experienced hyperchloremia and 1 respondent experienced hypokalemia. There are 7 respondents experiencing acid-base balance disorders.Conclusions: in this study showed that most of the patients after craniotomy had heart rhythm abnormalities. The most common arrhythmia is sinus arrhythmia. The pathological conditions that accompany these rhythm disturbances are mostly caused by electrolyte balance disorders, acid-base balance disorders or a combination of the two disorders.

CRITICAL CARE ISSUES FOR THE NEPHROLOGIST: Acid-base Disturbances in the Intensive Care Unit: Metabolic Acidosis

2006 ◽  
Vol 19 (6) ◽  
pp. 492-495 ◽  
Author(s):  
Anton C. Schoolwerth ◽  
Thomas M. Kaneko ◽  
Martin Sedlacek ◽  
Clay A. Block ◽  
Brian D. Remillard
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Acid Base ◽  
Critical Care Issues
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