Literature DB >> 19367388

Acid-base disorders evaluation in critically ill patients: we can improve our diagnostic ability.

Márcio Manozzo Boniatti1, Paulo Ricardo Cerveira Cardoso, Rodrigo Kappel Castilho, Silvia Regina Rios Vieira.   

Abstract

PURPOSE: To determine whether Stewart's approach can improve our ability to diagnose acid-base disorders compared to the traditional model.
METHODS: This prospective cohort study took place in a university-affiliated hospital during the period of February-May 2007. We recorded clinical data and acid-base variables from one hundred seventy-five patients at intensive care unit admission.
RESULTS: Of the 68 patients with normal standard base excess (SBE) (SBE between -4.9 and +4.9), most (n = 59; 86.8%) had a lower effective strong ion difference (SIDe), and of these, 15 (25.4%) had SIDe < 30 mEq/L. Thus, the evaluation according to Stewart's method would allow an additional diagnosis of metabolic disorder in 33.7% patients.
CONCLUSIONS: The Stewart approach, compared to the traditional evaluation, results in identification of more patients with major acid-base disturbances.

Entities:  

Mesh:

Year:  2009        PMID: 19367388     DOI: 10.1007/s00134-009-1496-2

Source DB:  PubMed          Journal:  Intensive Care Med        ISSN: 0342-4642            Impact factor:   17.440


  23 in total

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Journal:  Crit Care Med       Date:  2003-08       Impact factor: 7.598

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Authors:  P A Stewart
Journal:  Can J Physiol Pharmacol       Date:  1983-12       Impact factor: 2.273

6.  Defining acidosis in postoperative cardiac patients using Stewart's method of strong ion difference.

Authors:  Deirdre M Murray; Vicky Olhsson; James I Fraser
Journal:  Pediatr Crit Care Med       Date:  2004-05       Impact factor: 3.624

7.  Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury.

Authors:  Lewis J Kaplan; John A Kellum
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8.  Unidentified acids of strong prognostic significance in severe malaria.

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9.  Conventional or physicochemical approach in intensive care unit patients with metabolic acidosis.

Authors:  Mirjam Moviat; Frank van Haren; Hans van der Hoeven
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Authors:  John A Kellum
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  18 in total

1.  The standard strong ion difference, standard total titratable base, and their relationship to the Boston compensation rules and the Van Slyke equation for extracellular fluid.

Authors:  E Wrenn Wooten
Journal:  J Clin Monit Comput       Date:  2010-03-31       Impact factor: 2.502

2.  Improving acid-base evaluation: the proper use of the old tools.

Authors:  Arnaldo Dubin; Fabio D Masevicius
Journal:  Intensive Care Med       Date:  2009-10-24       Impact factor: 17.440

Review 3.  Has Stewart approach improved our ability to diagnose acid-base disorders in critically ill patients?

Authors:  Fabio D Masevicius; Arnaldo Dubin
Journal:  World J Crit Care Med       Date:  2015-02-04

4.  The repeatability of Stewart's parameters and anion gap in a cohort of critically ill adult patients.

Authors:  Jihad Mallat; Stéphanie Barrailler; Malcolm Lemyze; Younes Benzidi; Florent Pepy; Gaëlle Gasan; Laurent Tronchon; Didier Thevenin
Journal:  Intensive Care Med       Date:  2012-08-25       Impact factor: 17.440

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Authors:  Mathis Hochrainer; Georg-Christian Funk
Journal:  Med Klin Intensivmed Notfmed       Date:  2019-10-22       Impact factor: 0.840

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Authors:  George Liamis; Haralampos J Milionis; Moses Elisaf
Journal:  Drug Saf       Date:  2010-05-01       Impact factor: 5.606

7.  A simplified quantitative acid-base approach for patients with acute respiratory diseases.

Authors:  Michalis Agrafiotis; Maria Papathanassiou; Christos Karachristos; Eleni Kerezidou; Stavros Tryfon; Evangelia Serasli; Diamantis Chloros
Journal:  J Clin Monit Comput       Date:  2019-04-05       Impact factor: 2.502

8.  WITHDRAWN: The association between initial anion gap and outcomes in medical intensive care unit patients.

Authors:  Hiren J Mehta; Gautam Bhanusheli; Paul J Nietert; Nicholas J Pastis
Journal:  J Crit Care       Date:  2012-06-12       Impact factor: 3.425

Review 9.  Year in review in Intensive Care Medicine 2009: I. Pneumonia and infections, sepsis, outcome, acute renal failure and acid base, nutrition and glycaemic control.

Authors:  Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang
Journal:  Intensive Care Med       Date:  2010-01-08       Impact factor: 17.440

10.  Ventilatory changes during the use of heat and moisture exchangers in patients submitted to mechanical ventilation with support pressure and adjustments in ventilation parameters to compensate for these possible changes: a self-controlled intervention study in humans.

Authors:  Jeanette Janaina Jaber Lucato; Thiago Marraccini Nogueira da Cunha; Aline Mela Dos Reis; Patricia Salerno de Almeida Picanço; Renata Cléia Claudino Barbosa; Joyce Liberali; Renato Fraga Righetti
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