Cargando…
Early metabolic acidosis in critically ill patients: a binational multicentre study
Objective: We aimed to measure the incidence, prevalence, characteristics and outcomes of intensive care unit (ICU) patients with early (first 24 hours) metabolic acidosis (MA) according to two different levels of severity with a focus on recent data. Design: We retrospectively applied two diagnosti...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692578/ https://www.ncbi.nlm.nih.gov/pubmed/38046393 http://dx.doi.org/10.51893/2021.1.OA6 |
_version_ | 1785152973387595776 |
---|---|
author | Mochizuki, Katsunori Fujii, Tomoko Paul, Eldho Anstey, Matthew Pilcher, David V. Bellomo, Rinaldo |
author_facet | Mochizuki, Katsunori Fujii, Tomoko Paul, Eldho Anstey, Matthew Pilcher, David V. Bellomo, Rinaldo |
author_sort | Mochizuki, Katsunori |
collection | PubMed |
description | Objective: We aimed to measure the incidence, prevalence, characteristics and outcomes of intensive care unit (ICU) patients with early (first 24 hours) metabolic acidosis (MA) according to two different levels of severity with a focus on recent data. Design: We retrospectively applied two diagnostic criteria to our analysis based on literature for early MA: i) severe MA criteria (pH ≤ 7.20 and Paco(2) ≤ 45 mmHg and HCO(3)(-) ≤ 20 mmol/L with total Sequential Organ Failure Assessment [SOFA] score ≥ 4 or lactate ≥ 2 mmol/L), and ii) moderate MA criteria (pH < 7.30 and base excess < -4 mmol/L and Paco(2) ≤ 45 mmHg). Setting: ICUs in the Australian and New Zealand Intensive Care Society Adult Patient Database program. Participants: Adult patients registered to the database from 2008 to 2018. Main outcome measures: Incidence, prevalence, and hospital mortality of patients with MA by the two criteria. Results: We screened 1 076 087 patients. Given the Australian and New Zealand population during the study period, we estimated the incidence of severe MA at 39.5 per million per year versus 349.2–411.5 per million per year for moderate MA. In the most recent 2 years, we observed early severe MA in 1.5% (1350/87 110) of patients compared with 8.4% (20 679/244 740) for moderate MA. Overall, hospital mortality for patients with early severe MA was 48.3% (652/1350) compared with 21.5% (4444/20 679) for moderate MA. Conclusions: Early severe MA is uncommon in Australian and New Zealand ICUs and carries a very high mortality. Moderate MA is over seven-fold more common and still carries a high mortality. |
format | Online Article Text |
id | pubmed-10692578 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-106925782023-12-03 Early metabolic acidosis in critically ill patients: a binational multicentre study Mochizuki, Katsunori Fujii, Tomoko Paul, Eldho Anstey, Matthew Pilcher, David V. Bellomo, Rinaldo Crit Care Resusc Original Articles Objective: We aimed to measure the incidence, prevalence, characteristics and outcomes of intensive care unit (ICU) patients with early (first 24 hours) metabolic acidosis (MA) according to two different levels of severity with a focus on recent data. Design: We retrospectively applied two diagnostic criteria to our analysis based on literature for early MA: i) severe MA criteria (pH ≤ 7.20 and Paco(2) ≤ 45 mmHg and HCO(3)(-) ≤ 20 mmol/L with total Sequential Organ Failure Assessment [SOFA] score ≥ 4 or lactate ≥ 2 mmol/L), and ii) moderate MA criteria (pH < 7.30 and base excess < -4 mmol/L and Paco(2) ≤ 45 mmHg). Setting: ICUs in the Australian and New Zealand Intensive Care Society Adult Patient Database program. Participants: Adult patients registered to the database from 2008 to 2018. Main outcome measures: Incidence, prevalence, and hospital mortality of patients with MA by the two criteria. Results: We screened 1 076 087 patients. Given the Australian and New Zealand population during the study period, we estimated the incidence of severe MA at 39.5 per million per year versus 349.2–411.5 per million per year for moderate MA. In the most recent 2 years, we observed early severe MA in 1.5% (1350/87 110) of patients compared with 8.4% (20 679/244 740) for moderate MA. Overall, hospital mortality for patients with early severe MA was 48.3% (652/1350) compared with 21.5% (4444/20 679) for moderate MA. Conclusions: Early severe MA is uncommon in Australian and New Zealand ICUs and carries a very high mortality. Moderate MA is over seven-fold more common and still carries a high mortality. Elsevier 2023-10-18 /pmc/articles/PMC10692578/ /pubmed/38046393 http://dx.doi.org/10.51893/2021.1.OA6 Text en © 2021 College of Intensive Care Medicine of Australia and New Zealand. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Articles Mochizuki, Katsunori Fujii, Tomoko Paul, Eldho Anstey, Matthew Pilcher, David V. Bellomo, Rinaldo Early metabolic acidosis in critically ill patients: a binational multicentre study |
title | Early metabolic acidosis in critically ill patients: a binational multicentre study |
title_full | Early metabolic acidosis in critically ill patients: a binational multicentre study |
title_fullStr | Early metabolic acidosis in critically ill patients: a binational multicentre study |
title_full_unstemmed | Early metabolic acidosis in critically ill patients: a binational multicentre study |
title_short | Early metabolic acidosis in critically ill patients: a binational multicentre study |
title_sort | early metabolic acidosis in critically ill patients: a binational multicentre study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692578/ https://www.ncbi.nlm.nih.gov/pubmed/38046393 http://dx.doi.org/10.51893/2021.1.OA6 |
work_keys_str_mv | AT mochizukikatsunori earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy AT fujiitomoko earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy AT pauleldho earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy AT ansteymatthew earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy AT pilcherdavidv earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy AT bellomorinaldo earlymetabolicacidosisincriticallyillpatientsabinationalmulticentrestudy |