Yoav Paz1, Alexander Zegerman1, Patrick Sorkine1, Idit Matot2. 1. Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; General Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 2. Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Anesthesiology, Critical Care and Pain Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. Electronic address: iditm@tlvmc.gov.il.
Abstract
PURPOSE: Severe acidosis is a potentially life-threatening acid-base imbalance. The outcome of patients with severe acidosis has only been anecdotally described. We therefore assessed the discharge rate of such patients from the intensive care unit (ICU) and survival time after the event. METHODS: A retrospective evaluation of medical records of patients admitted to the ICU of Tel Aviv Medical Center between 2005 and 2010, in whom arterial blood pH less than 6.8 was documented during their ICU stay, was performed. RESULTS: Twenty-eight patients were suitable for study entry. Septic shock was the most common underlying medical condition (33%). Nine (32.1%) patients were either discharged alive or survived for at least 30 days in the ICU after their arterial blood pH measurement was less than 6.8. More than a quarter of the patients with life-threatening acidosis (n = 8; 28.6%) were discharged home and returned to their prehospitalization daily activity. Mean follow-up period for these patients was 132 ± 111 weeks. Multivariate analysis identified hyperkalemia, Acute Physiology and Chronic Health Evaluation II score, and Glasgow Coma Scale as determinants for ICU death after severe acidosis. CONCLUSIONS: A significant number of patients can outlast severe acidosis and return to their prehospitalization status. Larger studies are needed to define the patient population most likely to benefit from aggressive resuscitation efforts during severe acidosis.
PURPOSE: Severe acidosis is a potentially life-threatening acid-base imbalance. The outcome of patients with severe acidosis has only been anecdotally described. We therefore assessed the discharge rate of such patients from the intensive care unit (ICU) and survival time after the event. METHODS: A retrospective evaluation of medical records of patients admitted to the ICU of Tel Aviv Medical Center between 2005 and 2010, in whom arterial blood pH less than 6.8 was documented during their ICU stay, was performed. RESULTS: Twenty-eight patients were suitable for study entry. Septic shock was the most common underlying medical condition (33%). Nine (32.1%) patients were either discharged alive or survived for at least 30 days in the ICU after their arterial blood pH measurement was less than 6.8. More than a quarter of the patients with life-threatening acidosis (n = 8; 28.6%) were discharged home and returned to their prehospitalization daily activity. Mean follow-up period for these patients was 132 ± 111 weeks. Multivariate analysis identified hyperkalemia, Acute Physiology and Chronic Health Evaluation II score, and Glasgow Coma Scale as determinants for ICU death after severe acidosis. CONCLUSIONS: A significant number of patients can outlast severe acidosis and return to their prehospitalization status. Larger studies are needed to define the patient population most likely to benefit from aggressive resuscitation efforts during severe acidosis.
Authors: Pedro Videira Reis; Gabriela Sousa; Ana Martins Lopes; Ana Vera Costa; Alice Santos; Fernando José Abelha Journal: Braz J Anesthesiol Date: 2018-04-05